End of life > Palliative care
The purpose of this report is to describe the Belgian model of end of life care that, since 2002, has aimed at developing "palliative care for all", while nonetheless authorizing the practice of euthanasia under certain conditions.
The thirteen years since the passage of this decree have culminated in a clash between two opinions:
* one affirms that the decriminalization of euthanasia has truly enabled the development of continuous, palliative care;
* the other, conversely, stresses that making euthanasia commonplace is cannibalizing, and, little by little, distorting the concept of palliative care, which, in principle, focuses on support until death, but without triggering it.
After we have explored the evolution of the philosophy of palliative care in Belgium, it will be useful to examine the consequences of this integrated approach, as much for the well-being of patients as for the proper practice of medicine and management of life's end in health care institutions.
Issues linked to ageing and the end of life are complex and sometimes painful. The questions surrounding this topic are sensitive and cannot have a simple response. They challenge our sense of solidarity and our ingenuity in seeking ways and means to express true compassion and act appropriately.
Several people have become household names as part of the debate on the end of life. Whether we like it or not, they have become part of our collective memory: Karen Ann Quinlan and Terri Schiavo from the United States, Ramón Sampedro and Immaculada Echevarría from Spain, Vincent Humbert and Chantal Sébire from France, Piergiorgio Welby and Eluana Englaro from Italy, Hugo Claus from Belgium, and many others.
The media has focussed on extreme cases which have been brought to public attention because of their particularly dramatic nature. Thus, the discussion has largely been based around certain "unusual" situations with high emotional stakes. Because of this, the complex ...