Euthanasia in Belgium: trends in reported cases between 2003 and 2013
Open accessAbstract
BACKGROUND: In 2002, the Belgian Act on Euthanasia came into effect, regulating the intentional ending of life by a physician at the patient's explicit request. We undertook this study to describe trends in officially reported euthanasia cases in Belgium with regard to patients' sociodemographic and clinical profiles, as well as decision-making and performance characteristics. METHODS: technique. We also compared and analyzed trends for cases reported in Dutch and in French. RESULTS: The number of reported euthanasia cases increased every year, from 235 (0.2% of all deaths) in 2003 to 1807 (1.7% of all deaths) in 2013. The rate of euthanasia increased significantly among those aged 80 years or older, those who died in a nursing home, those with a disease other than cancer and those not expected to die in the near future (p < 0.001 for all increases). Reported cases in 2013 most often concerned those with cancer (68.7%) and those under 80 years (65.0%). Palliative care teams were increasingly often consulted about euthanasia requests, beyond the legal requirements to do so (p < 0.001). Among cases reported in Dutch, the proportion in which the person was expected to die in the foreseeable future decreased from 93.9% in 2003 to 84.1% in 2013, and palliative care teams were increasingly consulted about the euthanasia request (from 34.0% in 2003 to 42.6% in 2013). These trends were not significant for cases reported in French. INTERPRETATION: Since legalization of euthanasia in Belgium, the number of reported cases has increased each year. Most of those receiving euthanasia were younger than 80 years and were dying of cancer. Given the increases observed among non-terminally ill and older patients, this analysis shows the importance of detailed monitoring of developments in euthanasia practice.
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In Belgium and the Netherlands, the prevalence of PAD due to psychiatric suffering has increased over the past years.
“In Belgium and the Netherlands, the prevalence of PAD due to psychiatric suffering has increased over the past years.3,4”
From Irremediable Psychiatric Suffering in the Context of Physician-assisted Death: A Scoping Review of Arguments: La souffrance psychiatrique irrémédiable dans le contexte du suicide assisté : Une revue étendue des arguments (2020) · cites this paper as [4]
The Results report that the share of Belgian euthanasia cases involving a neuropsychiatric disorder rose from 0.8% to 3.9% between 2003 and 2013. This supports an increase in a related category, but the paper does not establish a trend specifically for PAD due to psychiatric suffering in the Netherlands; its Interpretation mentions only an increase in Dutch reported cases overall. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn Belgium, a study examining the first 10 years after legislation (2003-2013) (all euthanasia cases n=8,752) reported that the average psychiatric disorders annual change was +0.3%.
“A study examining the first 10 years after legislation (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) (all euthanasia cases: n=8,752) (Dierickx et al., 2016) reported that the average psychiatric disorders annual change was +0.3%.”
From Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature (2021) · cites this paper as Dierickx et al., 2016
The Results report 8,752 euthanasia cases from 2003 through 2013. Table 2 gives an average annual change of +0.3% for neuropsychiatric disorders, but the claim calls this the change for psychiatric disorders specifically; the paper's category is broader. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPhysical and psychological suffering increased during years (average annual change +1.8%), while physical suffering only and psychological suffering only decreased (average annual change -1.5% and -0.3% respectively).
“Physical and psychological suffering increased during years (average annual change: +1.8%), while physical suffering only and psychological suffering only decreased (average annual change: -1.5% and -0.3% respectively).”
From Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature (2021) · cites this paper as Dierickx et al., 2016
Table 2 (shown under Conclusion; page unavailable) reports average annual changes of +1.8% for cases reporting both physical and psychological suffering and −1.5% for physical suffering only. The available passage cuts off before the psychological-suffering-only row, so it does not verify the claimed −0.3% figure. These are changes in the proportions of reported euthanasia cases, not measures of suffering in the wider population. (LLM, conf=0.82)
Experimental — accuracy not yet measured
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Cites
End-of-life decisions in medical practice in Flanders, Belgium: a nationwide survey
Deliëns, L., Mortier, F., Bilsen, J. J. R., Cosyns, M., Stichele, R. V., Vanoverloop, J., & Ingels, K. J. A. O. (2000) · The Lancet · doi:10.1016/s0140-6736(00)03233-5 · Cited by 307 · see citing works
Radbruch, L., Leget, C. J. W., Bahr, P., Müller-Busch, C., Ellershaw, J., Conno, F. D., Berghe, P. V., & on behalf of the board members of the EAPC (2015) · Palliative Medicine · doi:10.1177/0269216315616524 · Cited by 271 · see citing works
Gerlach, M. (2016) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-016-0192-7 · Cited by 230 · see citing works
Recent Trends in Euthanasia and Other End-of-Life Practices in Belgium
Chambaere, K., Stichele, R. V., Mortier, F., Cohen, J., & Deliëns, L. (2015) · New England Journal of Medicine · doi:10.1056/nejmc1414527 · Cited by 187 · see citing works
Self-citationSteck, N., Egger, M., Maessen, M., Reisch, T., & Zwahlen, M. (2013) · Medical Care · doi:10.1097/mlr.0b013e3182a0f427 · Cited by 179 · see citing works
Smets, T., Bilsen, J. J. R., Cohen, J., Rurup, M. L., Mortier, F., & Deliëns, L. (2010) · BMJ · doi:10.1136/bmj.c5174 · Cited by 137 · see citing works
Self-citationMedical End-of-Life Practices under the Euthanasia Law in Belgium
Bilsen, J. J. R., Cohen, J., Chambaere, K., Pousset, G., Onwuteaka-Philipsen, B. D., Mortier, F., & Deliëns, L. (2009) · New England Journal of Medicine · doi:10.1056/nejmc0904292 · Cited by 133 · see citing works
Self-citationPhysician-assisted deaths under the euthanasia law in Belgium: a population-based survey
Chambaere, K., Bilsen, J. J. R., Cohen, J., Onwuteaka-Philipsen, B. D., Mortier, F., & Deliëns, L. (2010) · Canadian Medical Association Journal · doi:10.1503/cmaj.091876 · Cited by 129 · see citing works
Self-citationComparison of the Expression and Granting of Requests for Euthanasia in Belgium in 2007 vs 2013
Dierickx, S., Deliëns, L., Cohen, J., & Chambaere, K. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.3982 · Cited by 117 · see citing works
Self-citationThe Euthanasia law in Belgium and the Netherlands
Deliens, L., & van der Wal, G. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14520-5 · Cited by 109 · see citing works
Self-citationAttitudes and Experiences of Belgian Physicians Regarding Euthanasia Practice and the Euthanasia Law
Smets, T., Cohen, J., Bilsen, J. J. R., Wesemael, Y. V., Rurup, M. L., & Deliëns, L. (2010) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2010.05.015 · Cited by 105 · see citing works
Self-citationCohen, J., Van Wesemael, Y., Smets, T., Bilsen, J., & Deliens, L. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.04.021 · Cited by 93 · see citing works
Self-citationAssisted dying: law and practice around the world
Dyer, O., White, C., & García Rada, A. (2015) · BMJ · doi:10.1136/bmj.h4481 · Cited by 68 · see citing works
The labelling and reporting of euthanasia by Belgian physicians: a study of hypothetical cases
Smets, T., Cohen, J., Bilsen, J. J. R., Wesemael, Y. V., Rurup, M. L., & Deliëns, L. (2010) · European Journal of Public Health · doi:10.1093/eurpub/ckq180 · Cited by 65 · see citing works
Self-citationEuthanasia and other end-of-life decisions: a mortality follow-back study in Belgium
den Block, L. V., Deschepper, R., Bilsen, J. J. R., Bossuyt, N., Casteren, V. V., & Deliëns, L. (2009) · BMC Public Health · doi:10.1186/1471-2458-9-79 · Cited by 55 · see citing works
Smets, T., Bilsen, J., Cohen, J., Rurup, M. L., De Keyser, E., & Deliens, L. (2009) · Health Policy · doi:10.1016/j.healthpol.2008.10.003 · Cited by 53 · see citing works
Self-citationThe Belgian Act on Euthanasia of May, 28th 2002
(2002) · Ethical Perspectives · doi:10.2143/ep.9.2.503856 · Cited by 47 · see citing works
der Weide, M. C. J., Onwuteaka-Philipsen, B. D., & van der Wal, G. (2006) · Health Policy · doi:10.1016/j.healthpol.2006.03.005 · Cited by 32 · see citing works
Palliative Care and Euthanasia
Broeckaert, B., & Janssens, R. (2002) · Ethical Perspectives · doi:10.2143/ep.9.2.503854 · Cited by 29 · see citing works
Oregon’s Death With Dignity Act
Sperling, S. K. (2018) · JAMA Oncology · doi:10.1001/jamaoncol.2017.5302 · Cited by 28 · see citing works
Cohen, J., Wesemael, Y. V., Smets, T., Bilsen, J. J. R., Onwuteaka-Philipsen, B. D., Distelmans, W., & Deliëns, L. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-307 · Cited by 23 · see citing works
Self-citationA Comparative Analysis of the Law regarding Euthanasia in Belgium and the Netherlands
NYS, H. (2002) · Ethical Perspectives · doi:10.2143/ep.9.2.503847 · Cited by 19 · see citing works
Berghe, P. V., Mullie, A., de Smet, M. D., et al. (2017) · Cambridge University Press eBooks · doi:10.1017/9781108182799.005 · Cited by 19 · see citing works
Chambaere, K., Bilsen, J. J. R., Cohen, J., et al. (2010) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2009.10.001 · Cited by 16 · see citing works
Self-citationWesemael, Y. V., Cohen, J., Bilsen, J. J. R., et al. (2012) · Health Policy · doi:10.1016/j.healthpol.2011.12.001 · Cited by 14 · see citing works
Self-citationMedia Coverage of Medical Decision Making at the End of Life: A Belgian Case Study
Brussel, L. V., Landeghem, P. V., & Cohen, J. (2013) · Death Studies · doi:10.1080/07481187.2012.738766 · Cited by 9 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- [22]22. Annual report 2012 [report in Dutch]. The Hague (The Netherlands): Regional Euthanasia Review Committees; 2013. Available: https://www.euthanasiecommissie.nl/de-toetsings commissies/uitspraken/jaarverslagen/2012/nl-en-du -fr/nl-en-du -fr /jaarverslag-2012 (accessed 2016 Sept. 2).
- [25]25. Annual report 2014 [report in Dutch]. The Hague (The Netherlands): Regional Euthanasia Review Committees: 2015. Available: https://www.euthanasiecommissie.nl/de -toetsingscommissies/uitspraken/jaarverslagen/2014/nl/nl/ jaarverslag-2014 (accessed 2016 Sept. 2).
Cited by
Sorted by citations
Dierickx, S., Deliens, L., Cohen, J., & Chambaere, K. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1369-0 · Cited by 129 · see citing works
Self-citationEuthanasia and assisted suicide in psychiatric patients: A systematic review of the literature
Calati, R., Olié, E., Dassa, D., Gramaglia, C., Guillaume, S., Madeddu, F., & Courtet, P. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.12.006 · Cited by 88 · see citing works
Steck, N., Junker, C., & Zwahlen, M. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-020992 · Cited by 82 · see citing works
van Veen, S. M. P., Ruissen, A. M., & Widdershoven, G. A. M. (2020) · The Canadian Journal of Psychiatry · doi:10.1177/0706743720923072 · Cited by 42 · see citing works
Should Mental Disorders Be a Basis for Physician-Assisted Death?
Appelbaum, P. S. (2017) · Psychiatric Services · doi:10.1176/appi.ps.201700013 · Cited by 37 · see citing works
Evenblij, K., Pasman, H. R. W., van der Heide, A., van Delden, J. J. M., & Onwuteaka-Philipsen, B. D. (2019) · BMC Medical Ethics · doi:10.1186/s12910-019-0404-8 · Cited by 35 · see citing works
Incidence and Prevalence of Reported Euthanasia Cases in Belgium, 2002 to 2023
Wels, J., & Hamarat, N. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.6841 · Cited by 15 · see citing works
Konder, R., & Christie, T. (2019) · Healthcare Policy | Politiques de Santé · doi:10.12927/hcpol.2019.26073 · Cited by 9 · see citing works
- Authors
- Dierickx, S., Deliens, L., Cohen, J., & Chambaere, K.
- Affiliations
- Vrije Universiteit Brussel (BE)
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Impact Inc.
- Published
- 2016-09-12
- Volume
- 188
- Issue
- 16
- Pages
- E407-E414
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC5088089
- OpenAlex
- W2520003588
- Cited by
- 73
- References
- 26
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 9 · 2022: 8 · 2021: 15 · 2020: 5 · 2019: 9 · 2018: 5 · 2017: 4
- FWCI
- 5.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (publishedVersion, other-oa)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- euthanasia, Belgium, physician-assisted death, palliative care team, cancer, elderly patients, sociodemographic factors, decision-making, Netherlands, France
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Belgium, Decision Making, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Referral and Consultation, Databases, Factual, Euthanasia, Active, Voluntary, Young Adult
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