22 January 2025 - The Federal Commission for the Control and Evaluation of Euthanasia publishes its biennial report for 2022-2023
The Federal Commission for the Control and Evaluation of Euthanasia has today presented its biennial report for 2022 and 2023. This report provides a detailed statistical analysis of the application of the law on euthanasia in Belgium as shown by the review of registration documents, and also makes recommendations aiming to improve the management and modernisation of its processes.
Continued increase in euthanasia registration documents
In 2022-2023, 6389 euthanasia declarations were recorded (2966 in 2022 and 3423 in 2023), representing an average increase of 12% per year.
One notable trend is the gradual increase in declarations made in French, which today account for 29.4% of the total (compared with 70.6% in Dutch).
The Commission would like to point out that only procedures that intentionally end a life at the request of the patient, in accordance with Article 2 of the law, are considered to be euthanasia. The use of non-lethal or potentially lethal drugs, such as morphine, to relieve suffering, although they can bring about a more rapid death, do not fall under this definition.
The data shows that the majority of patients concerned were over 70 (70.3%), with a significant proportion of patients over 80 (42%). The largest group of patients was in the 80-89 age bracket (28.5%). Requests from patients under 40 remained very rare, accounting for just 1.2% of cases.
Only one euthanasia procedure carried out on a minor was recorded in 2022-2023.
Of the 6389 euthanasia cases reported, 80.8% involved cases where death was foreseeable in the short term.
The main conditions behind the requests for euthanasia were:
- Malignant tumours (cancers): 57.5% of cases,
- Polypathologies: 21.5%,
- Diseases of the nervous system: 9.3%,
- Diseases of the circulatory system: 3.4%,
- Cognitive disorders: 1.3%,
- Psychiatric conditions: 1.2%,
- Other causes, such as diseases of the osteoarticular system, diseases of the digestive system or traumatic lesions, accounted for 2.7% of cases.
Oncology patients were the largest group of patients requesting euthanasia, particularly when death was expected in the short term. These cases mainly concerned malignant tumours of the digestive organs, respiratory organs, breast, blood (lymphoma) and genital organs (female and male).
After cancer, the main reason behind requests for euthanasia remained polypathologies, particularly in patients for whom death was not expected in the short term. This group is becoming increasingly significant. Since the law entered into force, we have seen a consistent rise in the proportion of requests for euthanasia made by this group, reaching 23% in 2023. This percentage will continue to rise as polypathologies are associated with the ageing process that patients go through.
Euthanasia cases concerning psychiatric conditions (such as recurrent depression) or cognitive disorders (such as Alzheimer's disease) remain marginal, accounting for 2.5% of cases. As with all euthanasia cases, these met the legal conditions and were carried out with particular care.
In 74.4% of cases, patients were suffering from both physical pain and psychological suffering at the same time, as a direct consequence of one or more serious and incurable conditions.
The places where euthanasia cases were carried out also changed:
- 49.5% took place at home, indicating a substantial percentage decrease compared with previous years,
- 31.9% took place in hospitals, including in palliative care units,
- 17% took place in rest homes and rest and care homes, a proportion that increased slightly. It should be noted that, in almost all cases, the patient was living in the rest home.
The data also shows that fewer than 1% of euthanasia cases involved patients who had made an advance declaration.
Legally compliant practices
The Commission highlighted that the declarations received met the essential requirements of the law:
- Voluntary, considered and repeated request made without external pressure.
- Serious and incurable medical condition, where the patient is in a medical situation without a medical solution.
- Constant, unrelievable and unbearable suffering caused by this condition.
Conclusion: an evolving practice
The detailed data in this report not only shows a consistent increase in registration documents, but also a variety of medical situations, patient profiles and locations where these procedures are carried out.
As in previous periods, no cases were forwarded to the Public Prosecutor in 2022 and 2023, demonstrating the health professionals' compliance with the law.
In its report, the Commission considers that over the past two years (2022-2023), the application of the law has not given rise to major difficulties or abuses that would require legislative initiatives.
Priority recommendations
To face current and future challenges, the Commission is proposing several essential measures:
- Improving the human and administrative resources, which are currently insufficient to support the increase in cases.
- Reviewing the remuneration of the Commission's members to recognise the complexity and volume of the work carried out.
- Completing the digitalisation of processes to improve efficiency in the processing of declarations.
An ambitious vision for the future
The Commission is advocating for the creation of a department dedicated to euthanasia, which would bring together all administrative, scientific and communications skills required for modern-day management. This department would also enhance training, research and information on end-of-life care, with a coordinated outlook focused on patients' rights.
The Commission is calling on public authorities to act quickly to ensure the longevity of its essential missions and meet citizens' expectations surrounding end-of-life issues.
