The Belgian Act on Euthanasia of May, 28th 2002*

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Text of The Belgian Act on Euthanasia of May, 28th 2002*

  • Ethical Perspectives 9 (2002)2-3, p. 182

    Albert II, King of the Belgians,To all those present now and in the future, greet-ings.The Chambers have approved and We sanctionwhat follows:

    Section 1

    This law governs a matter provided in article 78 ofthe Constitution

    Chapter I: General provisions

    Section 2

    For the purposes of this Act, euthanasia is definedas intentionally terminating life by someone otherthan the person concerned, at the latters request.

    Chapter II: Conditions and procedure

    Section 3

    1. The physician who performs euthanasia com-mits no criminal offence when he/she ensuresthat:

    the patient has attained the age of majorityor is an emancipated minor, and is legallycompetent and conscious at the moment ofmaking the request;

    the request is voluntary, well-consideredand repeated, and is not the result of anyexternal pressure;

    the patient is in a medically futile conditionof constant and unbearable physical ormental suffering that can not be alleviated,resulting from a serious and incurable dis-order caused by illness or accident;

    and when he/she has respected the conditions andprocedures as provided in this Act.

    2. Without prejudice to any additional condi-tions imposed by the physician on his/her ownaction, before carrying out euthanasia he/shemust in each case:

    1) inform the patient about his/her health con-dition and life expectancy, discuss with thepatient his/her request for euthanasia andthe possible therapeutic and palliativecourses of action and their consequences.Together with the patient, the physicianmust come to the belief that there is no rea-sonable alternative to the patients situationand that the patients request is completelyvoluntary;

    2) be certain of the patients constant physicalor mental suffering and of the durablenature of his/her request. To this end, thephysician has several conversations withthe patient spread out over a reasonableperiod of time, taking into account theprogress of the patients condition;

    3) consult another physician about the seriousand incurable character of the disorder andinform him/her about the reasons for thisconsultation. The physician consulted

    The Belgian Act on Euthanasia of May, 28th 2002*

    * This unofficial translation was provided by Dale Kidd under the supervision of Prof. Herman Nys, Centre forBiomedical Ethics and Law, Catholic University of Leuven (Belgium).

  • Ethical Perspectives 9 (2002)2-3, p. 183

    reviews the medical record, examines thepatient and must be certain of the patientsconstant and unbearable physical or mentalsuffering that cannot be alleviated. Thephysician consulted reports on his/her find-ings.

    The physician consulted must be independent ofthe patient as well as of the attending physicianand must be competent to give an opinion aboutthe disorder in question. The attending physicianinforms the patient about the results of this con-sultation;

    4) if there is a nursing team that has regularcontact with the patient, discuss the requestof the patient with the nursing team or itsmembers,

    5) if the patient so desires, discuss his/herrequest with relatives appointed by thepatient;

    6) be certain that the patient has had theopportunity to discuss his/her request withthe persons that he/she wanted to meet.

    3. If the physician believes the patient is clearlynot expected to die in the near future, he/shemust also:

    1) consult a second physician, who is a psy-chiatrist or a specialist in the disorder inquestion, and inform him/her of the rea-sons for such a consultation. The physi-cian consulted reviews the medicalrecord, examines the patient and must becertain of the constant and unbearablephysical or mental suffering that cannotbe alleviated, and of the voluntary, well-considered and repeated character of theeuthanasia request. The physician con-sulted reports on his/her findings. Thephysician consulted must be independentof the patient as well as of the physicianinitially consulted. The physician informsthe patient about the results of this con-sultation;

    2) allow at least one month between thepatients written request and the act ofeuthanasia.

    4. The patients request must be in writing. Thedocument is drawn up, dated and signed bythe patient himself/herself. If the patient is notcapable of doing this, the document is drawnup by a person designated by the patient. Thisperson must have attained the age of majorityand must not have any material interest in thedeath of the patient.This person indicates that the patient is inca-pable of formulating his/her request in writingand the reasons why. In such a case therequest is drafted in the presence of the physi-cian whose name is mentioned on the docu-ment. This document must be annexed to themedical record.The patient may revoke his/her request at anytime, in which case the document is removedfrom the medical record and returned to thepatient.

    5. All the requests formulated by the patient, aswell as any actions by the attending physicianand their results, including the report(s) of theconsulted physician(s), are regularly noted inthe patients medical record.

    Chapter III: The advance directive

    Section 4

    1. In cases where one is no longer able toexpress ones will, every legally competentperson of age, or emancipated minor, candraw up an advance directive instructing aphysician to perform euthanasia if the physi-cian ensures that:

    the patient suffers from a serious andincurable disorder, caused by illness oraccident;

  • Ethical Perspectives 9 (2002)2-3, p. 184

    the patient is no longer conscious; this condition is irreversible given the cur-

    rent state of medical science.

    In the advance directive, one or more person(s)taken in confidence can be designated in order ofpreference, who inform(s) the attending physicianabout the patients will. Each person taken in con-fidence replaces his or her predecessor as men-tioned in the advance directive, in the case ofrefusal, hindrance, incompetence or death. Thepatients attending physician, the physician con-sulted and the members of the nursing team maynot act as persons taken in confidence.

    The advance directive may be drafted at anymoment. It must be composed in writing in thepresence of two witnesses, at least one of whomhas no material interest in the death of the patientand it must be dated and signed by the drafter, thewitnesses and by the person(s) taken in confi-dence, if applicable.

    If a person who wishes to draft an advancedirective is permanently physically incapable ofwriting and signing an advance directive, he/shemay designate a person who is of age, and whohas no material interest in the death of the personin question, to draft the request in writing, in thepresence of two witnesses who have attained theage of majority and at least one of whom has nomaterial interest in the patients death. Theadvance directive indicates that the person inquestion is incapable of signing and why. Theadvance directive must be dated and signed by thedrafter, by the witnesses and by the person(s)taken in confidence, if applicable.

    A medical certificate must be annexed to theadvance directive proving that the person in ques-tion is permanently physically incapable of draft-ing and signing the advance directive.

    An advance directive is only valid if it is draft-ed or confirmed no more than five years prior tothe persons loss of the ability to express his/herwishes.

    The advance directive may be amended orrevoked at any time.

    The King determines the manner in which theadvance directive is drafted, registered and con-firmed or revoked, and the manner in which it iscommunicated to the physicians involved via theoffices of the National Register.

    2. The physician who performs euthanasia, inconsequence of an advance directive asreferred to in 1, commits no criminal offencewhen he ensures that:

    the patient suffers from a serious andincurable disorder, caused by illness oraccident;

    the patient is unconscious; and this condition is irreversible given the

    current state of medical science;

    and when he/she has respected the conditions andprocedures as provided in this Act.

    Without prejudice to any additional conditionsimposed by the physician on his/her own action,before carrying out euthanasia he/she must:

    1) consult another physician about the irre-versibility of the patients medical condi-tion and inform him/her about the reasonsfor this consultation. The physician con-sulted consults the medical record andexamines the patient. He/she reports onhis/her findings.When the advance directive names a per-son taken in confidence, the latter will beinformed about the results of this consulta-tion by the attending physician.The physician consulted must be indepen-dent of the patient as well as of the attend-ing physician and must be competent to givean opinion about the disorder in question;

    2) if there is a nursing team that has regularcontact with the patient, discuss the con-tent of the advance directive with that teamor its members;

    3) if a person taken in confidence is designat-ed in the advance directive, discuss therequest with that person;

  • Ethical Perspectives 9 (2002)2-3, p. 185

    4) if a person taken in confidence is designat-ed in the advance directive, discuss thecontent of the advance directive with therelatives of the patient designated by theperson taken in confidence.

    The advance directive, as well as all actions by theattending physician and their results, including thereport of the consulted physician, are regularlynoted in the patients medical record.

    Chapter IV: Notification

    Section 5

    Any physician who has performed euthanasia isrequired to fill in a registration form, drawn up byth