This world first carried out in Belgium did not receive media coverage. Deliberately so. Beyond the medical teams and the families concerned, nobody knows that between 2005 and 2007, four adults who had demanded that the law on euthanasia be applied also donated their organs.

There were four of them in number. Three amongst them died in Antwerp, one in Liège. They were between 43 and 50 years old. All four of them suffered from an irreversible neurological disease. Medicine could not respond to their suffering, nor grant them a better quality of life, which had in their eyes become non existent. All four of them had requested for an euthanasia procedure to be set up, such as was authorised by the legal act of 28th May, 2002. These requests were accepted for all concerned. But these people also expressed the desire that their organs be donated, in compliance with the act of 13th June, 1986. Never before had such a request been officially made and medically carried out. An article published in Elsevier (1) and signed by, amongst others, Professor Yserbaert (Antwerp University hospital) and by Professor Jean-Paul Squifflet (Liège University Hospital Centre), describes how the kidneys, liver, lungs and pancreas of the suffering who had chosen to die were removed and then transplanted into living patients in Belgium and Holland. And the questions raised by such a practice.

‘The situation we went through was exceptional,’ admits Professor Jean-Paul Squifflet, associate head of the abdominal, endocrinal and transplant surgery department led by Professor Michel Meurisse. And for good reason! Very few countries have, as Belgium does, available both legislation which decriminalises euthanasia and another act which authorises the donation and removal of organs. These two laws have nothing to do with each other and yet ‘this double legislative framework was necessary to enable these requests to emerge and be met,’ notes the surgeon.

The choice to die

Between the coming into force of the act authorising euthanasia (22nd September 2002) and the 31st of December 2008, 2,698 people have resorted to this form of death, the large majority of them being in Flanders. Last year, of the 705 ill people who died through this ‘gentle death’, only 126 were Francophones. To meet the law’s application criteria, a person has to be suffering from a rare and incurable disease, causing unbearable, constant and unquenchable physical and mental suffering. The request has to be a written one. If it is accepted after the advice of two (or sometimes three) consultants, the euthanasia is carried out, after a delay lasting a moth.

After the death, the 16 members of the Federal Monitoring and Evaluation Commission examine a declaration of notification compulsorily filled in by the doctor who carried out the act. Up until now the Commission has never judged that a practitioner has gone beyond the limits prescribed by this law. It has thus never begun legal proceedings against any of them.

(1) Organ Procurement After Euthanasia: Belgian Experience, D.Ysebaert, G.Van Beeumen, K.De Greef, JP.Squifflet, O.Detry, A.De Roover, MH.Delbouille, W.Van DOnink, G.Roeyen, T.Chapelle, JL.Bosmans, D.Van Raemdonck, ME.Faymonville, S.Laureys, M.Lamy, and P.Cras., Transplantation Proceedings, 41, 585-586 (2009).