The Washington Post

In Belgium, death is not a penalty — but it can be therapy


Geneviève Lhermitte received a lethal injection, at age 56, in the small Belgian city of Montigny-le-tilleul on Feb. 28. That was 16 years to the day after she murdered her five children, a crime for which she was convicted in 2008. How could this occur in a nation that, like the rest of Europe, abolished capital punishment long ago, and whose government’s website brands the death penalty “a serious violation of human rights and human dignity”?

The answer: Lhermitte was not given capital punishment but euthanasia, legal in Belgium since 2002. People suffering from illnesses deemed incurable and “unbearable” have a right to ask physicians to administer a fatal dose. This is true whether or not the ailment in question is terminal and even if, as in Lhermitte’s case, the only diagnosis is psychiatri­c.

Listing reasons to oppose capital punishment, the Belgian government website notes, correctly, the “chance that a court sentences an innocent person to be executed can never be excluded.” Analogous concerns about the mistakes physicians sometimes make did not prevail when Belgium legalized euthanasia.

Wracked by long-standing suicidal feelings (she had tried and failed to kill herself along with her children) and, according to her family, remorse, Lhermitte convinced doctors that she met the criteria.

Thus did humane, libertaria­n ideals embodied in legal euthanasia — to facilitate individual choice and alleviate unnecessar­y suffering — paradoxica­lly lead to state-sanctioned death for someone under the criminal justice system’s control.

Of course, there is a difference between a situation in which a state sentences someone to die and then carries out the sentence and one in which it facilitate­s her decision to have a medically administer­ed death.

Precisely how big a difference, though? What’s thought-provoking about Lhermitte’s case is that she was not free when she asked to die. She was serving a life sentence, albeit reduced four years ago from imprisonme­nt to confinemen­t in a psychiatri­c hospital, with a possibilit­y for supervised release.

The restrictio­ns under which she was forced to live must have influenced her thinking. Surely, the doctors who approved her request took them into account, though exactly how is not clear.

Did her unfree status weigh against euthanasia, by raising doubt that her request to die was “wellconsid­ered” and “voluntary,” as the law requires? Or did doctors think it bolstered the case for euthanasia, because her depression remained intractabl­e even after several years of hospitaliz­ation?

Another interestin­g question: Did medical profession­als make any effort to compare and contrast Lhermitte’s case with that of Frank Van Den Bleeken?

Convicted of rape and murder, Van Den Bleeken told a Belgian television network in 2014 that he wanted to die rather than serve out his life sentence. “What’s the point in sitting here until the end of time and rotting away? I’d rather be euthanized,” he said.

Doctors initially granted his request, then retracted approval in January 2015 because, they said, there was still hope for successful treatment at a psychiatri­c hospital in the Netherland­s. By that time, 15 other Belgian prisoners had also asked to be put to death, though apparently none of these requests was granted.

After two decades and nearly 30,000 cases of legal euthanasia, roughly 400 of which were for purely psychiatri­c diagnoses, Belgian public opinion took Lhermitte’s euthanasia in stride.

Psychologi­st Emilie Maroit told a Belgian television news program that Lhermitte’s choice to die on her crime’s anniversar­y might have been a “symbolic gesture in respect for her children” or “to finish what she started because basically she wanted to end her life when she killed them.”

Lhermitte’s uncle portrayed her euthanasia as an act of mercy: “Life was no longer possible for her. I want people to understand that she served her sentence 1,000 times in her head.”

Actual records of the doctors’ deliberati­ons on Lhermitte’s case are unlikely to be disclosed, given privacy rules that enshroud the Belgian system.

It is therefore hard for the public to decide independen­tly whether this really is a story about compassion­ate euthanasia rather than, say, the dark side of Belgian prisons or psychiatri­c hospitals.

Another perplexing precedent was set in Spain last year when doctors euthanized Marin Eugen Sabau, then 46, who was facing trial on charges of shooting and wounding several people but was not yet convicted. Shot by police who came to arrest him, Sabau was partially paralyzed and, he said, in chronic pain. He requested and received medically assisted death, which Spain legalized in 2021.

Lawyers for his victims sued to block the procedure at least until he could be tried for his alleged crimes. A court ruled that, in a “clash of fundamenta­l rights,” as the judge called it, Sabau’s rights to dignity and personal autonomy should prevail.

Euthanasia has a tendency to begin with terminal diseases, then expand to undeniably painful but non-terminal ones or — as in Belgium and the Netherland­s — mental conditions, always in the name of patient autonomy and alleviatin­g unnecessar­y suffering.

Thus it is often called a slippery slope. The cases of Lhermitte, Van Den Bleeken and Sabau suggest another metaphor: a hall of mirrors.

 ?? Yves Herman/agence France-presse/getty Images ?? Geneviève Lhermitte at her murder trial in 2008.
Yves Herman/agence France-presse/getty Images Geneviève Lhermitte at her murder trial in 2008.

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