« Death pact » and euthanasia of 45-year old twins : analysis

(Le questionnement des pays étrangers est tel, que nous avons traduit pour eux notre analyse déjà parue en français et en néerlandais.)

Identical twins (monozygotic) Eddy and Marc Verbessem were born deaf. Inseparable and single, they had always lived together under the same roof. They were euthanized together at their request on December 14, 2012 in the UZ Brussel (University hospital) in the borough of Jette. They were 45 years old.

Their request for euthanasia was based on a diagnosis of glaucoma, a degenerative condition of the optical nerve which can lead to blindness. According to our information (difficult to verify), they suffered from a genetic anomaly which would progressively but irremediably cause them to go blind. This, together with the idea of loosing their independence, was unbearable for them.

The media presented this as a “first”. There had never been a case of two brothers requesting and being granted joint euthanasia. There had, however, been instances of couples being euthanized together.

Is this a case of infringement of the limits of the Belgian law on euthanasia ?
Not necessarily. It is quite likely that all the conditions required by the law had been officially met. They no doubt made a voluntary and repeated request, free from any outside pressure. They based their case on an incurable medical condition and unbearable psychological suffering, stemming from the anticipation of future suffering linked to blindness and the loss of autonomy. As for the other necessary conditions, one may suppose that they were also met : various information to be provided, a second medical opinion to be sought, etc.

The twins had not reached the final phase of their illness
The general public, especially abroad,  is above all shocked by the fact that the twins had not reached the terminal stage of their illness. It ought, however, to be pointed out that the Belgian law also permits euthanasia when death is not imminent. In this case, two further conditions apply in conjunction with those already mentioned. First of all, another medical opinion has to be sought either from an independent medical practitioner, from a psychiatrist or else a doctor specialized in the pathology in question. In the present instance, a psychiatrist with the medical team which euthanized the twins will probably have been consulted. Subsequently, at least another month of reflection has to pass between the time of the patient's written request and the act of euthanasia itself.

The rot has set in
Nonetheless, this matter has caused a certain degree of unease. Why?  It is as though, imperceptibly, euthanasia has come to represent the most dignified human response to situations of suffering. The Belgian law is designed and has been interpreted in such wide terms that euthanasia and medically-assisted suicide appear acceptable from the moment the interested person has freely formulated his or her request. Euthanasia requires the presence of an incurable disease. Indeed, but the list of incurable conditions is practically unending (diabetes, rheumatism, arthritis, …). The patient has to be able to make a case for unbearable physical or psychological suffering. Indeed, but the notion of psychological suffering is left to the subjective appreciation of the sufferer. Furthermore, as has already been said, euthanasia is permissible even when death is not imminent. All in all, the legal arrangements are practically tailor-made to allow euthanasia in all cases of voluntary and repeated request by all those suffering from various ills, from solitude or from a lack of will to live …. As the threshold of tolerance decreases in the face of illness or suffering, euthanasia does indeed risk becoming mundane, even trivial.

This affair requires our attention because it challenges both medical practice and society to come up with ways of accompanying not only the dying but those who suffer while living their lives.

It must be clear to all of us that we are already witnessing the trivialization of euthanasia in Belgium. The proof of this is that at the time when the law was being debated and was finally passed, a majority of members of Parliament felt that society was not ready to accept the euthanasia of minors and the mentally sick. Today, on the other hand, politicians from various parties consider that the time has come to take this step. In their opinion, the general public is now ready to accept a position it would have disapproved of ten years ago. One cannot, therefore, deny that euthanasia and assisted suicide have indeed been trivialized…

Is this really the way in which society intends to deal with the distress and suffering of an ageing population or those who have become vulnerable due to illness or a handicap ?