We aim to protect all human life, also the doctor's life! !

Since 2002, euthanasia is, under certain conditions, decriminalized in Belgium. I belong to the increasing group of doctors who believe that the law brings more problems than it solves.

There is no need to quote the Bible or any encyclical, my argument can be based entirely on scientific / empirical observation. Indeed, the only "benefit" of this law is that it has transformed our country into a laboratory where we can see beyond the philosophical considerations and the reality of daily practice the profound changes in attitude and aberrations that such law may induce a decade.

Let us remember that this law was originally promoted under the pretext of giving the physician in situations of extreme physical suffering (pain, distress, asphyxia, delusions) - and therefore in rare situations - the means to intervene to relieve the suffering, by either willfully causing the end of the patient's life, or trying to control the symptoms, although at the same time, by his act, he shortens the life unintentionally, without incurring the risk of being pursued by the law for murder.

It is clear that in 2012, the law recognizes a much broader application. In the media recently were published articles evoking the euthanasia of depressed people, of the twin brothers afraid of becoming blind, of an author with the first signs of Alzheimer's disease. Proponents of the law themselves rejoiced also that death by euthanasia of two known Belgians had brought more to the fore the possibility of euthanasia, but regretted that, after a transient increase, the number of requests of information about euthanasia has declined again (De Standaard 21/5/2008, "euthanasia kent Claus-effect"). We therefore clearly do not find ourselves in extreme conditions where the doctor has his back to the wall facing a situation that is imposed on him, but in a context where you want to "break the taboo" on requests for euthanasia "sub-underlying" and "repressed".

Euthanasia is therefore clearly invoked not to address situations of extreme psychological distress, but situations of physical suffering, which are also fairly common. There are people who are not faced with an acute physical uncontrollable pain, but who are struggling to give a sense of their illness and lose the courage to live. Others go a step further and claim the right to euthanasia in the name of individual autonomy. Rather than being faced with problems of physical suffering, we are suddenly faced with problems of a philosophical, metaphysical or even religious order. This is the question of the meaning of life, the meaning of suffering and the autonomy of the human person.

Palliative medicine can perfectly control the physical pain, suffocation, anxiety and most other symptoms of physical suffering. We also have the possibility of palliative sedation that allows the patient to dive into sleep if the symptoms can not be controlled otherwise. In general, the patient will die peacefully in the following days, and the doctor will have a clear conscience, having chosen to control the symptoms and not directly to give death, even if death may intervene a little faster because of his act.

On the other hand, is the medicine suitable and called to answer the question of the meaning of life, the meaning of suffering and the autonomy of the human person, and even more so to offer death as a solution to these problems?

It seems to me that it is for psychologists, philosophers, priests, rabbis, imams, secular counselors, etc.., to answer this question. A doctor has not, in fact, began his long studies in order to heal the sick? Probably a psychologist and a priest or philosopher can help a patient to find more meaning in their suffering and to cope with the constraints of human life.

Many people seek support in religion, which often speak of eternal life and give meaning to suffering. Others are inspired by the existentialism of Camus to help them seek to do good even in circumstances of suffering not selected. Others still act as epicurean and try to live the carpe diem throughout their illness. The purpose of this list is neither to be exhaustive nor to propose any attitude, but to show that these solutions are beyond the realm of medicine. The problem itself is beyond the realm of medicine.

Why then the indication of euthanasia could not rather be decided by psychologists, philosophers, priests, rabbis, imams and secular counselors? And perhaps even implemented by these professions? The act itself is not complicated and does not require special skills. Or why not ask the funeral services if they are interested in collaborating? In terms of organization, the latter solution seems quite handy!

Of course, this argument borders on the absurd! But in my opinion, it is equally absurd to ask the medical profession to be in charge for the solution of metaphysical problems of its citizens/patients, and this by an act having a great impact on his conscience.

After all the media coverage surrounding this law, euthanasia requests have increased significantly. Previously, the question arose from time to time in the presence of a terminally ill patient. Now, to discuss euthanasia is almost part of the first consultation in oncology, and demands are so little in accordance with the law. It is not uncommon for the patient to spend more time on the issue of euthanasia rather than to take into account the different treatment options that a doctor may offer by its expertise. For the caregiver, this becomes very difficult to bear because each request for euthanasia demands to be taken seriously and often leads to long and heavy discussions... If that occurs from time to time for extreme situations, it's manageable, but if these issues occur too often and at any time, burn-out for doctors and nurses is not far away (De Standaard 13/12/2010, "Verplegers willen spuitje niet meer geven").

Relatives should also be protected as shown by recent articles of an engineer who lost his mother by euthanasia for depression reasons without being aware himself (De Morgen 05.01.2013, "Mijn moeder kreeg een dodelijke injectie en ik wist van niks ").

This is why, as a doctor loving his profession, I much prefer the situation before 2002. And therefore I am obviously opposed to any extension of this law.