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Belgium euthanasia cases jump after new law

/ Source: The Associated Press

Cases of euthanasia in Belgium's Flanders region soared to nearly 2 percent of all deaths in 2007 after the country legalized the practice a few years earlier, a medical study has shown.

The survey, conducted by an end-of-life research group at the Brussels-based Free University, said the rise was mainly due to Belgium's 2002 euthanasia law, which gave terminally ill patients more choices.

"We found that the enactment of the Belgian euthanasia law was followed by an increase in all types of medical end-of-life practices, with the exception of the use of lethal drugs without the patient's explicit request," the group said in a letter published in Thursday's New England Journal of Medicine.

The survey is the third such study conducted on the controversial issue in Belgium, said Dr. Johan Bilsen, who helped conduct the study.

His team surveyed a random sample of 6,202 death certificates of people who died between June and November 2007 in Flanders, a Dutch-speaking region that accounts for six million of Belgium's 10 million people. The certifying doctors involved in the sample were also questioned. In all, 118 cases of euthanasia were found.

Bilsen said there was a rising trend in assisted death practices from the first Belgian study conducted in 1998.

"It has doubled since 1998. It is going up from 1.1 to 1.9 percent," Bilsen told the Associated Press.

Most of the patients who chose euthanasia and doctor-assisted suicide were younger, had cancer or were dying at home, the study said.

Bilsen said the trend reflected similar numbers seen in Belgium's northern neighbor, the Netherlands, after that country legalized euthanasia in 2001.

"Yes, at this moment it's quite high in Belgium, but we also saw the same tendency in the Netherlands some years ago," he said.

Bilsen said euthanasia figures in Netherlands were higher than in Belgium, with a rate from about 3 percent to 3.2 percent, but have since dropped to a rate of 1.7 percent of all deaths. He expected the same decreasing trend could happen in Belgium.

Alistair Thompson, a spokesman for British-based anti-euthanasia group Care Not Killing, called the study results worrying.

"We are very concerned about the increase," he said. "We are facing a concerted effort across Europe to have euthanasia legalized but ... in the UK what we tend to see is a drop in support for euthanasia as more and more people understand the morals, the religious and medical and legal arguments against having state-backed euthanasia."

The Belgian study did not include statistics or rates from Belgium's French-speaking region of Wallonia, in the south of the country. Bilsen said statistics from death certificates were not compiled in Wallonia and added that linguistic divisions compounded by ethical divisions over euthanasia also limited the Belgian study.

"The southern part is more like southern European countries and the other part (Flanders) is more like the Netherlands and northern countries" where mercy killings enjoy more support, he said.

The Belgian divide over euthanasia reignited last year when 78-year-old writer Hugo Claus, who suffered from Alzheimer's, ended his life in an Antwerp hospital by euthanasia in March 2008.

Catholic groups claimed media coverage of his death praised the use of euthanasia over palliative care.

Euthanasia was legalized in Belgium in 2002, but under strict conditions. A patient seeking euthanasia must request it more than once, must have a terminal medical condition and must be constantly suffering, either physically or psychologically.