Euthanasia in cases of advanced dementia: a further extension of Belgian law?

In recent weeks, the issue has received considerable media attention following the euthanasia of Lode Deconinck. Deconinck had previously attracted media attention in Flanders for his appearance on the cooking programme ‘Restaurant Misverstand’, which featured participants in the early stages of dementia. Lode Deconinck’s euthanasia at this stage of the disease provided an opportunity for the pro-euthanasia consortium LEIF (the equivalent of the ADMD) to relaunch a petition for the extension of the euthanasia law, launched in 2019 and which has so far gathered more than 92,000 signatures.  

The Flemish Christian-Democratic party CD&V also organised a study day on 27 April at the Flemish Parliament, dedicated to extending euthanasia to cases of advanced dementia, with the aim of informing the drafting of the bill currently being prepared by their minister. The party wishes to be free from any deadlines or pressure, and to this end, it says, is taking up the issue: “We cannot assume that life with dementia is by definition undignified,” explains the MP in charge of the dossier, Els Van Hoof: “Dignity is expressed not only through self-determination, but also in the way we care for one another. ’ It is here, in a sense, that the ‘Christian compass’—to which CD&V chairman Sammy Mahdi says he is committed—comes into play in revising the law. 

He does not hesitate to describe the current law as “flawed legislation that leaves doctors in a state of uncertainty and leaves families without clear guidance”. He is in fact referring to the possibility of obtaining euthanasia in the early stages of dementia (‘too early’ according to those advocating the extension), whilst not allowing for the possibility of obtaining it once dementia has reached an advanced stage. 

The CD&V aims to reassure people regarding the reform that will be proposed, highlighting two key principles:  

• On the one hand, advance care planning must be at the heart of the process and be based on ongoing dialogue between the patient, carers, relatives and, where applicable, the trusted person. 

• Secondly, an advance declaration of euthanasia will not suffice in itself; the suffering must be terminal and unbearable for the patient at the time of the euthanasia. Furthermore, the patient’s current wishes must be respected, even if they contradict the content of the advance declaration. 

 Despite the safeguards announced by the Flemish Christian Social Party, there can be no doubt about the social consequences of such an extension. How, indeed, can we rule out the possibility that the option to request death in advance in the cases described will have a negative impact on people who find themselves – or will find themselves – in such situations? This extension would pave the way for various forms of pressure – even implicit – on a large number of people, not only to draw up an advance directive for euthanasia, but also at the time of its potential implementation. The central difficulty will remain determining the patient’s wishes, which will place a heavy burden on the shoulders of the doctor concerned. Furthermore, to echo the warning of Joris Van Cauter, a lawyer who spoke at the aforementioned seminar, ‘once you crack the door open, all it takes is a draught to open it fully’. 

It should be noted that statistically, one in five people will be affected by dementia sooner or later, and this proportion is set to rise further in the coming decades. 

At present, more than a third of patients suffering from severe dementia do not receive palliative care during the last three months of their lives. Before offering them the option of euthanasia, is it not a priority, in terms of patients’ rights, to strengthen this care, which could certainly improve their comfort and help restore their sense of dignity? 

In various countries across Europe and the world, parliamentary debates on euthanasia are intensifying. Within countries that have recently spoken out against any legalisation of this practice, it is not uncommon for the Belgian and Canadian cases to be cited as illustrations of the slippery slope upon which a society ventures when it chooses to open the door to induced death. A further extension of the Belgian law could, paradoxically, reinforce other countries’ mistrust of embarking on the path towards euthanasia. 

For a more in-depth look at the ethical and legal issues surrounding euthanasia for people with dementia, see the opinion of the IEB commissioned by the Health and Equal Opportunities Committee of the Belgian Chamber of Representatives.  

Sources: De Standaard, La Libre (28 April 2026)