Dr. L?opold Vanbellingen:

Let me come back to the distinction between what I would call suicidal patients and those who have clarity on their wish to die. It is true that if we look at the figures in Belgium and the Netherlands, most patients who ask for euthanasia are not suicidal, as such.

If we look at the case of elderly people who do not have a terminal illness but polypathologies, which now accounts for 18% of all euthanasia in Belgium, these patients do experience psychological suffering and they consider themselves tired of living. Are they suicidal? No, but they do suffer from mental illness.

Another specific case that my colleagues refer to is the problematic issue we now see with young people suffering from mental illness. These people are in many cases suicidal. Let me go to the Belgian commission's latest report on this issue as an example. It suggests that the case of young patients' failed suicide attempts have made the commission aware that there is another more dignified way of ending one's life. This means that euthanasia is now viewed as a more dignified alternative to suicide, especially among young people.

We need to keep in mind that all countries that legalised assisted death have this subjective approach that does not allow us to judge what the patient says about his suffering and, therefore, we cannot question what the patient says about his own suffering, including his own psychological suffering. That also explains why many doctors and psychiatrists in Belgium and the Netherlands now consider that they have to consider euthanasia as one of the options, especially when the treatments do not work as they had hoped. We recognise that there is a mental illness but we are not ready to say that these patients are not eligible for euthanasia because of this mental illness. It is also related to the principle of non-discrimination, which explains the fact that even though the law in Belgium and the Netherlands did not really change with respect to the substantive conditions and criteria, incredibly, the law is interpreted as making patients with mental illness eligible for euthanasia.