Appel aux parlementaires belges sur l’éthique médicale

la Société Médical Belge de Saint-Luc

Nous apprenons que notre parlement fédéral désire légiférer à nouveau dans le domaine bioéthique. En particulier, des parlementaires de plusieurs partis proposent deux choses, qui nous semblent graves de conséquences.

Premièrement, ils désirent allonger la durée permise pour avorter; et porter le délai légal à 18 semaines, au lieu de 12 semaines.

Ces parlementaires votent entre eux, un texte et une loi, qu’ils n’entendent pas porter à discussion dans le public. C’est effectivement ainsi que fonctionne la démocratie représentative ; et c’est donc leur privilège, de ne pas devoir tenir compte d’autre avis que le leur.

Cependant, dans une matière aussi sensible, où l’on décide donc bien quel être vivant pourra être retranché de la société, et de sa protection ; où l’on décide qui peut bénéficier de l’appellation d’être humain, et qui n’en peut pas bénéficier, il nous semble que la voix qui s’oppose publiquement à cette décision , doit aussi être entendue. Il ne pourra pas être dit plus tard, que personne ne s’y est opposé.

Nous appelons donc à un grand débat public sur cette importante question.
Nous nous interrogeons cependant, sur la volonté réelle de prise en compte de propositions de ce type. En effet, l’exemple de la France, nous rend assez pessimistes sur la sincérité réelle des parlementaires ; où les avis reçus lors du débat ont été mis de côté, sans en tenir compte , car le résultat n’était pas le résultat escompté par eux.

Deuxièmement, ils désirent forcer la conscience des médecins.

Les médecins qui ne désirent pas participer à un acte qu’ils ont la conviction d’être mauvais, seront forcés par la loi à y participer. Il n’y aura donc plus de liberté de conscience.

La loi serait elle supérieure à l’éthique médicale?

Ce n’est pas l’avis de notre association.

Bien sur, l’exécution d’un ordre gravement injuste de la Loi atténue la responsabilité du médecin, mais sans la faire disparaitre complètement. La responsabilité du médecin dans la collaboration à cet acte procède donc de la Loi, à laquelle l’obéissance est due.

Mais c’est bien ce même raisonnement qui a fait condamner les exécutants des décisions nationales socialistes, au siècle passé, du point de vue de la responsabilité morale.

La contrainte étatique, ne fait donc jamais disparaitre la responsabilité morale individuelle.

Sur cette base, nous demandons avec insistance que soit reconnue et protégée par la Loi, la liberté de conscience des médecins, et la reconnaissance de l’autonomie de notre éthique médicale.

Cette éthique médicale est actuellement assez largement répandue au niveau mondial, tel que re-précisé par l‘Association Médicale Mondiale, qui conclut en matière de début de vie, que « c’est une question de conviction et de conscience personnelles qui doivent être respectés” (Manuel d’éthique médicale, 3e édition, p. 57).

En foi de quoi, nous lançons cet appel à nos parlementaires.

Dr. Henri Marechal
Président de la Société Médical Belge de Saint-Luc
Bruxelles, le 18 Novembre 2019

Appeal to Belgian parliamentarians on medical ethics

Belgian Medical Society of Saint-Luc

We learn that our federal parliament wants to legislate again in the field of bioethics. In particular, parliamentarians from several parties are proposing two things, which we think have serious consequences.

First, they want to extend the duration allowed to abort; and extend the statutory period to 18 weeks, instead of 12 weeks.

These parliamentarians vote among themselves, a text and a law, that they do not intend to bring to the public discussion. This is indeed how representative democracy works; and it is their privilege not to have to consider any other opinion than theirs.

However, in such a sensitive subject, where it is decided which living being can be cut off from society and its protection; where we decide who deserves the name of a human being and who does, it seems to us that the voice that publicly opposes this decision must also be heard. It can not be said later that no one has opposed it.

We therefore call for a major public debate on this important issue.

However, we wonder about the real willingness to take into account proposals of this type. In fact, the example of France makes us rather pessimistic about the real sincerity of parliamentarians; where the advice received during the debate was put aside, without taking it into account, because the result was not the result expected by them.

Secondly, they want to force the conscience of the doctors.

Doctors who do not wish to participate in an act that they believe to be bad, will be forced by law to participate. There will be no more freedom of conscience.

Would the law be superior to medical ethics? This is not the opinion of our association.

Of course, the execution of a seriously unjust order of the act lessens the responsibility of the physician, but does not make it completely disappear. The responsibility of the physician in the collaboration to this act therefore proceeds from the Law, to which obedience is due.

But it is this same reasoning that has sentenced the executors of national socialist decisions in the last century from the point of view of moral responsibility.

The state constraint, therefore, never makes the individual moral responsibility disappear.

On this basis, we urge the recognition and protection of the law, the freedom of conscience of physicians, and the recognition of the autonomy of our medical ethics.

This medical ethics is currently fairly widespread worldwide, as re-stated by the World Medical Association, which concludes in the beginning of life, that “it is a matter of personal conviction and conscience that must be respected. “(Medical Ethics Manual, 3rd Edition, p. 57).

In faith whereof, we make this appeal to our parliamentarians.

Dr. Henri Marechal
President of the Belgian Medical Society of Saint-Luc
Brussels, 18 November 2019
Catholic Medical Association Belge Saint-Luc
p/a Abdij der Norbertijnen
Kerkplein 1
1850 Grimbergen
info@cathmed.be

Survival of Patients With Liver Transplants Donated After Euthanasia, Circulatory Death, or Brain Death at a Single Center in Belgium

Nicholas Gilbo, Ina Jochmans, Daniel Jacobs-Tulleneers-Thevissen, Albert Wolthuis, Mauricio Sainz-Barriga, Jacques Pirenne, Diethard Monbaliu

Abstract

Journal of the American Medical AssociationTransplantation of organs donated after euthanasia may help alleviate the critical organ shortage.1 However, aside from preliminary data on lung transplantation,2 data on graft and patient survival following transplantation of organs donated after euthanasia are unavailable. Because donation after euthanasia entails a period of detrimental warm ischemia that hampers graft survival, similar to donation after circulatory death,3 results after transplantation of this type of graft need to be carefully evaluated.


Gilbo N, Jochmans I, Jacobs-Tulleneers-Thevissen D, Wolthuis A, Sainz-Barriga M, Pirenne  J, Monbaliu D.  Survival of Patients With Liver Transplants Donated After Euthanasia, Circulatory Death, or Brain Death at a Single Center in Belgium. JAMA. 2019;322(1):78-80. doi:10.1001/jama.2019.6553

Belgium’s euthanasia commission under fire after shock letter by whistleblower

BioEdge

Xavier Symon

Evidence of gross negligence is mounting against Belgium’s peak euthanasia regulatory body, the Federal Commission for Euthanasia Control and Evaluation.

Dr. Ludo Van Opdenbosch, a neurologist who was a Commission member for several years, resigned in September 2017. Associated Press recently obtained the letter of resignation that Dr Van Opdenbosch sent to senior politicians, which details his dissatisfaction with the oversight processes of the Commission. “I do not want to be part of a committee that deliberately violates the law,” he wrote.

According to the letter, the Commission failed to refer to authorities a doctor who Van Opdenbosch says euthanised a demented patient without consent. The letter outlines the basic details of the case – the patient, whose identity was not disclosed, was euthanised at the family’s request, and there was no record of any prior request for euthanasia from the patient.

Furthermore, Van Opdenbosch states that when he expressed concerns about other potentially problematic cases, he was immediately “silenced” by other members of the Commission. He suggests that because many of the doctors on the commission are leading euthanasia practitioners, they can protect each other from scrutiny, and act with “impunity”.

“It’s not euthanasia because the patient didn’t ask, so it’s the voluntary taking of a life,” said Dr An Haekens, psychiatric director at the Alexianen Psychiatric Hospital in Tienen, Belgium. “I don’t know another word other than murder to describe this.”

However, the two co-chairs of the commission, Dr Wim Distelmans and Gilles Genicot, have strongly denied that there has been any negligence. “It can obviously occur that some debate emerges among members but our role is to make sure that the law is observed and certainly not to trespass it,” they said. They also denied that Van Opdenbosch had been muzzled.

Associated Press had already revealed details of a rift between the co-chair of the Commission, Dr. Willem Distelmans, and Lieve Thienpont, an advocate of euthanasia for the mentally ill. Distelmans suggested some of Thienpont’s patients might have been killed without meeting all the legal requirements.

More than 360 doctors, academics and others have since signed a petition calling for tighter controls on euthanasia for psychiatric patients.


Belgium's euthanasia commission under fire after shock letter by whistleblowerThis article is published by Xavier Symons and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to BioEdge. Commercial media must contact BioEdge for permission and fees. Some articles on this site are published under different terms.

Euthanasia dispute in Belgium: When do doctors cross a line?

CBC News

Associated Press

A disputed case of euthanasia in Belgium, involving the death of a dementia patient who never formally asked to die, has again raised concerns about weak oversight in a country with some of the world’s most liberal euthanasia laws.

The case is described in a letter provided to The Associated Press, written by a doctor who resigned from Belgium’s euthanasia commission in protest over the group’s actions on this and other cases.

Some experts say the case as documented in the letter amounts to murder; the patient lacked the mental capacity to ask for euthanasia and the request for the bedridden patient to be killed came from family members. The co-chairs of the commission say the doctor mistakenly reported the death as euthanasia. . . [Full Text]