What’s noteworthy about euthanasia in Europe, though, has been its tendency to expand, once the taboo against physician-aided death was breached in favor of more malleable concepts such as “patient autonomy.” “What is presented at first as a right is going to become a kind of obligation,” Belgian law professor Étienne Montero has warned.

If you were a psychiatrist and a chronically depressed patient told you he wanted to die, what would you do?

In Belgium, you might prescribe this vulnerable, desperate person a fatal dose of sodium thiopental.
Charles Lane is a Post editorial writer, specializing in economic policy, federal fiscal issues and business, and a contributor to the PostPartisan blog. View Archive

Between October 2007 and December 2011, 100 people went to a clinic in Belgium’s Dutch-speaking region with depression, or schizophrenia, or, in several cases, Asperger’s syndrome, seeking euthanasia. The doctors, satisfied that 48 of the patients were in earnest, and that their conditions were “untreatable” and “unbearable,” offered them lethal injection; 35 went through with it.

These facts come not from a police report but an article by one of the clinic’s psychiatrists, Lieve Thienpont, in the British journal BMJ Open. All was perfectly legal under Belgium’s 2002 euthanasia statute, which applies not only to terminal physical illness, still the vast majority of cases, but also to an apparently growing minority of psychological ones. Official figures show nine cases of euthanasia due to “neuropsychiatric” disorders in the two-year period 2004-2005; in 2012-2013, the number had risen to 120, or 4 percent of the total.

Next door in the Netherlands, which decriminalized euthanasia in 2002, right-to-die activists opened a clinic in March 2012 to “help” people turned down for lethal injections by their regular physicians. In the next 12 months, the clinic approved euthanasia for six psychiatric patients, plus 11 people whose only recorded complaint was being “tired of living,” according to a report in the Aug. 10 issue of JAMA Internal Medicine.

If you find this sinister, I agree. Bioethicists Barron H. Lerner and Arthur L. Caplan, who reviewed the data from the Low Countries in JAMA Internal Medicine, observe that the reports “seem to validate concerns about where these practices might lead.”

That’s putting it mildly. Thienpont acknowledges that “the concept of ‘unbearable suffering’ has not yet been defined adequately” and that “there are no guidelines for the management of euthanasia requests on grounds of mental suffering in Belgium.”

Yet she and her colleagues continue to put the mentally ill to death, insisting that they are respecting their wishes — though, as she writes, “further studies are recommended.”

Thienpont’s co-author Wim Distelmans, a leading advocate of euthanasia, has ended the life of a 44-year-old who was anguished, but not terminally ill, due to a botched sex-change operation. Distelmans also put to death identical 45-year-old deaf twins who said they lost the will to live upon learning they would eventually go blind.

Frank van den Bleeken, imprisoned for 30 years for rape and murder, sought euthanasia from Distelmans, citing his incurable violent impulses and the misery of life behind bars. Belgian officials and Distelmans initially agreed; a lethal injection the murderer might have gotten as punishment in the United States would be supplied as therapy in anti-death penalty Europe.

In January, however, Distelmans backed out just before the scheduled procedure — there was still hope for van den Bleeken to get treatment at a facility in the Netherlands, he said.

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