"I have chosen the music for my farewell. The words for my obituary are ready. At the end I have left one line blank. I hope the words ‘With thanks to the Belgian Parliament’ can be written there."
This is what Mario Verstraete of Ghent told the Belgian Senate in 2001 as it was debating the euthanasia legislation that has been in force since 2002. In a long list of experts, doctors and professors, Verstraete, on whose story the film Tot Altijd (with the English title Time of My Life) is based, was the only patient to be heard.
One year later, at age 39, Verstraete died, the first person in Belgium to whom euthanasia was administered under the newly adopted law. His final months were well documented, as he was one of the most outspoken supporters of legalised euthanasia.
Euthanasia is the deliberate ending of a person’s life, at that person’s request. This should not be confused with ending medical treatment ultimately resulting in death or with sedating the patient until death.
Euthanasia is legal in Belgium under strict circumstances only. The patient, who has to be over 18 and capable of making decisions, must submit an articulate and repeated request in writing. His or her medical condition should be incurable, with continued and unbearable suffering which cannot be adequately relieved.
Contrary to what most people think, the patient does not have to be terminal. This was one thing about which Verstraete was particularly concerned. Multiple Sclerosis (MS), the condition from which Verstraete suffered, does not itself lead to death. In a 2001 TV documentary, Verstraete described his situation: “I cannot stand up for very long and – one of the most annoying things – I have incontinence problems, typical for MS patients. All of that is a mess. But my personal limit would be if I could no longer have a social life because of these problems getting worse. Then there would be nothing left for me.”
Verstraete also did not want to wind up languishing in a coma or living with dementia. “I know some people can, but personally I could not accept becoming demented. … I would be a different person, and that I do not want. Or if I were to slip into a coma. People tell these stories of how they know of someone who woke up from a coma after 10 years. That’s fine, but I do not want those 10 years. I don’t want to be put on display in a glass coffin like Snow White. I don’t want to live like that.”
The fact that non-terminal patients can be eligible for euthanasia is little known, says Marc Cosyns, the doctor who treated Mario Verstraete. An advocate of dignified dying, he made his own documentary about the euthanasia of two elderly patients. One of them, Roger, seemed quite healthy at 87, but without medication he would face what he called an undignified death. “Why should I wait until I lie in bed, peeing? Is that living? Who should I be accountable to?” Roger says.
In a moving scene, we see Roger’s last moments, in his bedroom. Dr Cosyns hands him the drink that induces death. “The pharmacist said it tastes of mint. He says hello, by the way,” the doctor says, chatting calmly as his patient takes his final drink. When Roger is finished, he makes a sign with both hands, indicating that everything is fine, and he lies down.
Patients die within minutes of being administered a drink or a drip by a doctor. The reports that have to be filed according to law often mention that this happens “peacefully” and in the presence of the patient’s friends or family. “Serene” is another word that is often used.
Despite strong opposition by the Catholic Church, euthanasia is hardly controversial in Flanders. That people with severe afflictions, such as author Hugo Claus and actor Carl Ridders, take the decision on their time of deaths has become widely accepted. In fact, there is even some outrage when euthanasia is refused, such as in the case of 93-year-old Amélie Van Esbeen, who felt “tired of life”.
The death of Claus, Flanders’ most prominent writer, did cause somewhat of a stir after clergy criticised the way it became a media circus. “By ending life like this, one does not answer the problem of suffering and death. One walks around them in a large circle and avoids them,” said then archbishop Godfried Danneels in his Easter homily. “Avoidance is not a feat, nor front page news.”
In an open letter to the negotiators for the federal government, the driving forces behind the euthanasia legislation express their gratefulness for the wide acceptance it enjoys. They also point out some areas where the law could be refined. They would like to scrap the five-year limit on the declaration of will, in which people declare under what circumstances they would like euthanasia should they no longer be able to express this. They would also like to extend the current law to people who are no longer capable of acting, such as the demented, and to minors.
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