Belgian Catholic group explains switch on euthanasia
The inviolability of life is no longer an absolute value
Mercatornet, 6 May, 2017
Reproduced under Creative Commons Licence
Raf De Rycke
Last week marked an important step in the
integration of euthanasia into the Belgian
healthcare. A religious order in the
Catholic Church, the Brothers of Charity,
which is responsible for a large proportion
of beds for psychiatric patients in Belgium
it will allow euthanasia to take place
in its facilities.
This has been an extremely controversial
move because the Catholic Church is
unequivocally opposed to euthanasia. In 1995
John Paul II declared that "euthanasia
is a grave violation of the law of God,
since it is the deliberate and morally
unacceptable killing of a human person". And
Pope Francis described it earlier this
year as a symptom of a selfish
The local organisation has clearly split
from Rome on this issue. The
superior-general of the order,
Brother René Stockman, has described the
decision as "a real tragedy".
Euthanasia for psychiatric patients has
already happened dozens of times in
from now on it will be hard to find an
institution in Belgium where
euthanasia is not being offered as an
In the email interview below, the
chairman of the board of the Brothers of
Charity in Belgium, Raf
De Rycke, an economist who has worked
with them for years, explains the point of
view of the dissidents.
BioEdge: Is allowing euthanasia as an option
a world-first as the official position of a
Raf De Rycke: That is hard to say because Catholic
institutions will not always make such views official and public. Sometimes
they have a certain practice but not an official position. Anyway, there is
a chance that our position is world-first because there are only a few
countries that have a euthanasia bill and not all these countries have a
network of Catholic institutions.
What proportion of places for the mentally ill are run by the Brothers
in Belgium (and in Flanders)?
The Brothers of Charity run 12 psychiatric institutions in which daily
about 6,000 patients are treated. That represents about 25% of these
institutions in Belgium (about 30% in Flanders).
The refusal of the Brothers to allow euthanasia in their institutions
has been described by critics as a major obstacle to the growth of
euthanasia. So will this change in policy, if it goes ahead, have a big
impact on psychiatric care in Belgium?
This will not have such a big impact in practice because our first and
preferred option remains to focus on the patient's life perspective. At the
same time we take the euthanasia request seriously and clarify the patient's
underlying motives. However, a request can only be accepted if all the
prudential requirements are met.
We have elaborated a series of prudential requirements that enforce the
application of the law: three fundamental requirements, five procedural
requirements, the determination of the conscientious decision and an
additional requirement specific for the residential context.
Finally, the application of these prudential requirements will be
critically evaluated by an evaluation committee, which is a completely
innovative option in this matter. Our prudential requirements are strict and
will not lead to a major change in practice, maybe to some exceptional
What has happened up to now if someone requested euthanasia in one of
your hospitals? Did it happen often? Did you allow terminal sedation?
Up to now, we also took seriously a euthanasia request, but we
communicated beforehand that euthanasia could not be carried out by the
staff and not within the institution. If there was a continuous request
according to the conditions of the law, the patient was referred to another
psychiatrist or service. Terminal sedation is not a solution to euthanasia
in mental illness because these patients are simply not terminal.
Brother Stockman [the superior-general of the Brothers of Charity],
not to mention Pope Francis, has often expressed his opposition to
euthanasia. Is euthanasia compatible with Catholic, or Christian, values?
This depends on the underlying fundamental ethical view. For some people,
values may be absolute, as for instance the inviolability of life. This
implies that this value may never be violated and euthanasia is excluded a
But at the same time, other values such as autonomy, quality of life and
care relationship may be seriously violated. In our view, values are
fundamental, essential cornerstones for making good decisions, but not
absolute ones. Values can thus be weighed against each other without prior
determination of which value has the priority.
In each situation these values must be assessed. In order to make a
responsible decision, the prudential requirements help distinguish how
inviolability of life, autonomy, quality of life and the care relationship
are at stake.
We work with an open normativity that assesses values in any concrete
situation, and not with a closed normativity that knows in advance what
consideration should be made at all times, in all circumstances, regardless
the intention and the wide range of effects.
The assessment of values we propose, is based on personalism and on
proportionalism. Personalism means that the ethical criterion for evaluating
decisions is the extent to which these decisions serve the promotion of the
human person, adequately considered, in all their constitutive
dimensions, and thus not only in the biological dimension.
Proportionalism means that there should be a reasonable proportion of the
underlying values, taking into account the intention, the act, the effects
and the circumstances, and thus not only the act in itself. Personalism and
proportionalism belong, without doubt, to the rich tradition of Catholic
moral theology, which includes different approaches.
How was the decision made? Was it taken by the Board running the
Brothers’ institutions, or by the religious congregation itself? Was there a
split between the laymen and the brothers?
This decision was taken by the Board running the institutions in Belgium,
consisting of brothers and laymen. The decision was supported by the Board
of the religious congregation in Belgium. The process lasted more than a
year and many different groups, such as ethics committees, boards of
directors and psychiatrists, were consulted repeatedly. Throughout this
process of consultation, these various groups have come to an agreement,
although this does not exclude disagreements among individuals. At the
Belgian level there is no split between laymen and brothers.
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