Proposition 53K3245

Projet de loi modifiant la loi du 28 mai 2002 relative à l'euthanasie en vue d'étendre l'euthanasie aux mineurs.

General information ¶

Submitted by

The Senate

Submission date

June 26, 2013

Official page

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Status

Adopted

Requirement

Simple

Subjects

euthanasia young person child infancy freedom of self-determination

Voting ¶

Voted to adopt

Groen Vooruit PS | SP Open Vld LDD

Voted to reject

CD&V LE VB

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Discussion ¶

Feb. 12, 2014 | Plenary session (Chamber of representatives)

Full source

Mr. Speaker, colleagues, the present draft law was transmitted by the Senate to the Justice Committee, whose chairperson is now present. The discussions in the Committee on Justice took place on 14, 21 and 28 January 2014.

During the meeting of 14 January, the request of Mrs Becq of CD&V and Mr Brotcorne of CDH to organise hearings and the request of those same members to request the Speaker of the Chamber to obtain the opinion of the Committee on Public Health was rejected by eleven against five votes. The request by Mrs Becq, Mr Brotcorne and Mr Schoofs to request an opinion from the State Council was also rejected.

The committee concluded that the text transmitted by the Senate required some linguistic and legislative corrections and that these corrections were therefore carried out.

On 30 January 2014, the Senate approved these improvements.

In the introductory presentations for the discussion of the draft law, Ms. Annemie Turtelboom, Minister of Justice, first reminded that several bills were submitted during the Senate parliamentary period with a view to an adaptation of the euthanasia law of 28 May 2002. In the Senate, extensive hearings were organized on this important issue. Following those hearings, it was decided to take as the starting point for the discussions the bill amending the law of 28 May 2002 on euthanasia in order to allow euthanasia for minors.

That text aims to extend the scope of the 2002 Act to include minors.

The text provides a number of conditions. The minor must be subjected, due to an incurable disease, to unbearable physical suffering that cannot be relieved. When the minor makes his request, he must be judgmental, which must be attested by a third party. Both the request of the minor and the agreement of the legal representatives must be documented in writing. Once the request has been handled, guidance is provided to the patient and the parents.

The Minister then outlined the history of the legislation on euthanasia. Both Belgium and the Netherlands have played a leading role in establishing a legal framework for termination of life.

The Minister was of the opinion that this legislation, contrary to what some expected, did not lead to displacement.

In the general discussion of the draft law, Ms. Juliette Boulet of Ecolo-Groen spoke first. She supports this bill, as does her group in general, for various reasons. In particular, the draft law enables her to establish a legal framework necessary to clarify and mitigate situations that are painful but have become even more annoying by failing to respond to a legitimate request of a child who is in great suffering. Ms. Boulet emphasizes that it is important to keep in mind that the law does not obligate anyone. She adds that no one endorses suffering and that no one wishes death. No doctor, no parent, no family member, not even a single patient wants that. As regards the judgment of a child, Ms. Boulet has recalled from her exchanges of thoughts with doctors that they immediately see whether a child is judgmental or not, and whether it can assess the full scope and all consequences of his requests. At the end of her speech, Ms. Boulet once again stated that the Ecolo-Groen group supports this bill, even though it is an ethical issue and some members may vote differently.

Mr Christian Brotcorne of the CDH group points out that such a bill can be approached in two ways. Either one leaves himself guided by emotions and feelings, or one seeks an answer to the question of whether the proposed bill is appropriate, grounded and solidly formulated. According to him, the legislator must be able to rationally answer a matter that occurs, especially when that question is so fundamental and involves so many personal factors. Mr Brotcorne regrets that the Committee on Justice refused once again to obtain expert advice because the work delivered in the Senate was sufficient. However, the speaker agrees that the Senate has thoroughly studied the issue and that this reflection must of course be taken into account. Nevertheless, he considers it his responsibility as a people’s representative to form his own opinion in this dossier. He regrets that some MPs have others, in this case senators, thinking and making decisions in their place.

The extension of the euthanasia law to minors implies, according to Mr. Brotcorne, that every young person facing a serious and incurable disease should be questioned and make a choice. By extending the euthanasia law to minors, Mr. Brotcorne said, the idea that euthanasia is among other means to give young people the possibility to close to their neighbors and no longer be a burden to society threatens to come into existence. Thus, the priority of the CDH faction is to alleviate the suffering of the patients, as well as to deepen the training of health professionals on end-of-life guidance.

To conclude his speech, Mr. Brotcorne recalls the three major strengths of the draft law, namely the criterion of judgment, the concept of “legal representation” and the various problematic concepts used in the draft law.

Given the lack of guarantees in the text and the uncertainties that they entail, Mr Brotcorne cannot support the bill in this form.

Mrs Becq of CD&V recalls that the present bill allows euthanasia for minors, insofar as they are judgmental, physical suffering and terminally ill. Parents should confirm the question of the sick child.

Like Mr. Brotcorne, Mrs. Becq regrets that the Senate has moved to extend the euthanasia law to minors without prior evaluation of the current euthanasia law of 2002. It also regrets that the current draft law extending euthanasia to disabled minors has not been prepared carefully. This is demonstrated by various examples.

Mrs Becq also has some concerns about the philosophy of this euthanasia legislation. The extension of the euthanasia law to minors is labeled as necessary and urgent, as if there is a high demand for euthanasia among minors and as if children with a serious and incurable disease today are left to their fate and must suffer tremendous pain. The hearings in the Senate showed the opposite, according to Mrs. Becq. According to her, doctors today have enough options to deal with serious illness. For these reasons, Mrs Becq believes that instead of extending the euthanasia law to minors, more resources are needed for palliative care.

Mrs Becq finally announces three amendments, two of which address gaps in the current control mechanisms in the euthanasia law and the third introduces an age criterion for minors.

Mrs Lalieux of the PS group believes that this issue, however delicate, should not be a taboo and should not remain untreated. Unfortunately, reality sometimes presses us with the nose on the facts and urges us to act as serenely as possible legislatively. She asks that everyone be well aware that this is not a political game. This bill aims to work out with the necessary humanity, seriousness and thoughtfulness a solution to a problem that unfortunately sometimes occurs. Ms. Lalieux emphasizes that the bill under discussion creates a well-defined framework and is the result of intense work by the senators.

At the end of her speech, Mrs. Lalieux reminds us that euthanasia is not about killing someone, but about delivering someone from his suffering. No doctor likes to commit euthanasia. On the contrary, during the hearings, it was very rightly stated that the doctors and healthcare staff are there to care for patients and, if possible, to heal. However, if suffering becomes unbearable and there is no hope of healing of the child, then doctors, through an action of the legislator, should be given the opportunity to apply euthanasia as a medical act within a fully legal framework. The draft law under discussion provides that space to apply euthanasia to minors from now on. In this sense, it increases everyone’s freedom of choice, but of course with the observance of precise conditions. Everyone is free to decide for himself what is worthy of dying; it is not up to us, says Mrs. Lalieux, to judge about that choice.

Mr. Maingain of the FDF recalls that he was in favour of the euthanasia law of 28 May 2002. After all, he felt that the legislator had to take that step, because in the criminal legal instrumentarium the doctor and the healthcare staff had to be exempted from prosecution. What we are talking about here is different, in the sense that one cannot speak of a life-visual and well-considered choice for an early death, but rather of a case in which a child may not want to suffer unbearable suffering. In this regard, Mr Maingain asks why the text discussed remains limited to physical suffering, while the 2002 law also covers psychological suffering.

Mr. Maingain has several questions and criticisms about the bill. First, on the concept of judgment, second, on the consent of the parents and, third, the bill may, in his opinion, lead to ambiguity and controversy.

According to Mr Maingain, the purpose of the draft law is therefore not achieved and therefore he says that he cannot stand behind this version of the draft law, although he is a fervent defender of the free choice regarding the end of life, also for minors.

Mr Schoofs van Vlaams Belang notes that the present bill does not take into account, inter alia, the case where the parents do not agree on the wishes of the minor. He thus believes that the bill will give rise to disagreement within families. According to him, this is essentially about introducing a justice basis for the fact that someone is killed by another person. Although this is understandable to the doctors concerned, the speaker says that for ethical reasons he cannot agree with the bill.

Ladies and gentlemen, I will submit my own presentation later.

Mrs Temmerman of the sp.a points out that everyone agrees on the sensitivity of the subject. This is about ending life. It is also about the life of a minor.

The speaker repeats that the parents or legal representatives must give their consent. In this way, according to her, sufficient guarantees are incorporated to prevent possible abuses. It also points out that in practice a number of cases are already being applied without a legal framework. Everyone who has to deal with this is convinced that it is a good solution that should be applied today without a legal framework. It therefore advocates providing this legal framework for children, doctors and nursing staff.

Ms. Van Cauter of Open Vld notes that a draft was discussed that she must unfortunately approve, not because she does not want to take on her responsibilities, shut her eyes or look the other side, but because it is in reality intriguing and unfair to have to conclude that children and young people who should have a whole life ahead of them, as a result of illness or an accident, continue to suffer physically.

Ms. Van Cauter notes that pain control is not always enough. Euthanasia should be considered as the ultimate step, even if the patient is a minor. She says that within the existing legislation there are some possibilities to initiate an act aimed at ending the life of a minor. Reports from the hearings in the Senate show that something sometimes has reverse effects. According to her, some healthcare providers are encouraged to reinstate pain-fighting medical acts, because those acts could be considered subsequently as life-end acts. Therefore, the lack of a general framework also has an adverse effect on palliative care. According to Ms. Van Cauter, it is unacceptable to maintain the existing situation. It is not a solution to leave such acts in the illegality and to deny their existence. There is a need for a clear legislative framework, both for the minor patient whose life is approaching the end of life as well as for the child’s parents and for the concerned healthcare providers.

Mrs Marghem of the MR group emphasizes that her speech is not binding for her group: its members have freedom of speech and vote in the file. Ms. Marghem thus emphasizes speaking in her own name. She regrets the intervention of several press groups, which, in her opinion, are also at the origin of the bill under discussion. As a Christian, she has embarked on a personal journey of reflection, which has led her to decide that suffering does not serve a purpose. After hearing the views of the other members, Ms. Marghem wants to turn away from a binary vision, in which two camps are confronted, the good and the bad. It is not a contradiction between the supporters of the bill, who would have an eye for the suffering of the children, and those who oppose the text. Similarly, those who want to ensure a dignified death are not opposed to those who would be insensitive to the dignity of the child. Mrs Marghem does not dispute the need for a debate: healthcare providers are actually asking for the necessary legal credentials to protect their care operations. However, the legal certainty thus understood is not in itself sufficient accountability for the new arrangement provided for by the draft law, as transmitted by the Senate. Finally, the speaker, Ms. Marghem, regrets that such an important bill is being discussed without the advice of the State Council.

Ms. Fonck of the CDH group emphasizes that euthanasia is more than just a legal matter. This is about medical ethics. She is surprised that, in this context, the House of Representatives has not considered a debate in the Committee on Public Health. Ms Fonck emphasizes that the approaching end of life is always different. Each person has a different story to tell in each situation. Therefore, it points out the importance of palliative care teams in this regard. The question is whether legislative action is needed. While there is a clear demand for euthanasia, such requests are more an exception than a rule.

Mr Philippe Goffin of the MR indicates that each member of his group will vote freely on the text. Whether you like it or not, he says, euthanasia in minors is in practice a reality, which, by the way, was already announced in 2002 when the adoption of the law related to the euthanasia for adults. Thanks to this legislation, Mr. Goffin says, it will finally be possible to initiate a genuine dialogue between the doctor, his patient and his parents who are faced with the impossible: to keep their child alive from parental love or to let it go as it wishes. From now on, they will no longer be alone, but in all transparency surrounded, advised and guided by the medical team. Mr. Goffin emphasizes that euthanasia will never be compulsory to children, parents or doctors anyway.

I have summarized all the interventions. I would like to add that several amendments have been submitted by the CDH and CD&V. The amendments were rejected in the Justice Committee on 28 January.

Finally, President Kristien Van Vaerenbergh notes that the title of the French text contains a word that was not included in the Dutch text. This is corrected. The entire draft law, with the legislative technical improvement, is adopted with 12 votes for and 4 votes against.

Mr. Speaker, if you allow me, I will immediately move on to the position of my group.

Colleagues, I think that everyone agrees that the subject of my argument is very difficult in its softest terms. It is a subject that no one of us wants to face. But sometimes it is harsh reality, a reality for which we believe a legal framework needs to be created. No one wants a child to suffer. So please let us hope that the law should be applied as little as possible in practice.

If, however, parents are faced with the disruptive choice to surrender their child, it must, in my view, be in the best interests of the child, parents and caregivers within the limits of a legally defined framework. It is our duty as legislators to also pass laws on very difficult circumstances, on very difficult issues in life.

In addition to the Act on Palliative Care of 14 June 2002, which stipulates, among other things, that every patient has the right to adapted care at the end of life, Belgium has since 2002 allowed euthanasia under strict conditions for adults and children deprived of parental care. The law defines euthanasia as the deliberate termination of life by someone other than the person concerned, at his or her request. Euthanasia is inherent to every society. It is one of the many facets of care for the end of life. It is about recognizing ultimate self-determination or the right to die in dignity.

The present draft law aims to extend the 2002 euthanasia law to the orally and mature minor who is able to reasonably assess his or her own interests and who is in a medical unlikely state of persistent and unbearable physical suffering that cannot be cured and that is the result of a serious and incurable condition caused by accident or disease.

In the Senate Committee on Justice and Social Affairs, numerous advocates and opponents of euthanasia were given the floor in the numerous hearings. It was watchful that all ideological currents were heard. Not only lawyers were heard, fortunately, but also doctors, nurses, patient associations, the Order of Physicians and the associations for palliative care. Thro ⁇ this work, a broad democratic majority has grown over one of the facets of euthanasia, namely the right of a minor to request euthanasia. The bill does not grant the right to euthanasia. The issue is the right to euthanasia.

In order to provide a special protection for our minors, our colleague-senator, who is also a doctor and gynecologist, has watched that a number of additional conditions were registered. It submitted several amendments, which were also adopted, thus incorporating the safeguards that the N-VA wanted in the present bill into the text approved by the Committee on Justice and Social Affairs.

I would therefore also like to emphasize that, thanks in part to the approved amendments submitted by Senator Elke Sleurs, there will be a clear legal framework. Only minors who are in a terminal phase and who are physically suffering have the right to request euthanasia. The possibility of euthanasia for minors should be expressly limited to physical suffering, not to psychological suffering.

For the rest, the minor, like the adult, must be in a state of persistent and unbearable physical suffering that cannot be curated and that is the result of a serious and incurable condition caused by accident or disease. In addition, it must be a physical suffering resulting in the apparent death of the minor within the foreseeable time.

The request of the minor must be voluntary, considered and repeated. It must not have been created due to any external pressure. The euthanasia request must be made by a willing patient. For us, it is important that, rather than taking age as the basis, willpower and discernment in practice are assessed in relation to the patient’s medical condition. All specialists who were heard during the hearings agree on this, emphasizing that the age of the patient is actually of minor importance. The mental age at that time in a child is much more important than the calendar age.

In addition, in the decision-making process and in the assessment of the judgment capacity of the minor – also a very important guarantee – the entire medical and paramedical team of treating physicians is involved, not only the doctor, but also a psychologist and a psychiatrist. The treating doctor shall ensure that the parents have given their consent to the request of the minor patient. That is a very important guarantee, which was also emphasized by Senator Elke Sleurs. The consent of the parents must be written. In this process, parents have the decisive voice.

Finally, it provides for the possibility of psychological assistance for all relatives of the person who dies after euthanasia.

All additional conditions and guarantees with respect to the minor and his legal representatives, which the N-VA had requested, have been included in the law.

As I mentioned at the beginning of my presentation, this is a topic that no one of us wants to face. Sometimes it is a harsh reality, for which we want to provide a legal framework today.

Colleagues, I am so proud, even though “pride” is a misplaced word. I am pleased that our N-VA members in the Senate have been able to amend the original bill. Therefore, the majority of my group will support the present bill.

At the same time, however, I realize that many members of our movement have very different views about euthanasia. Therefore, I have equal respect for the people of my group who will vote differently tomorrow. For excellence in ethical issues, people’s representatives should be able to follow their own conscience. We give our members that freedom.

Mr. Speaker, Mrs. Minister, dear colleagues, a year ago, day by day, the discussions on the reform of the law on euthanasia and in particular the extension of the decriminalization of euthanasia for minors began in the Senate: 7 hearing sessions spread over three months, 34 doctors, specialists, lawyers, experts of institutions and institutions from all corners were heard, 209 pages of hearing report, 99 pages of discussion report, nothing but for the Senate. The House Justice Committee has discussed this issue in three of its sessions. I would like to thank the rapporteur for the excellent report she provided to us.

This eminently painful, eminently difficult, eminently personal theme leaves no one indifferent. There are, on the one hand, “pro” and, on the other, “anti”. The Senate, then in turn the Chamber, heard, debated and legislated with all the serenity possible in the face of a subject that one would like not to have to address. Suffering, incurable illness and the death of a child are probably what life can reserve the worst. The death of a child is outrageous. She is unfair. This suffering affects all of us directly, deeply, individually.

The facts referred to in the law on which we are to rule tomorrow are disturbing and some realities are so hard, so cruel that one would prefer not to think about them, hoping never to be confronted with them. Like everyone else, I would prefer that no child ever be condemned by the disease, but this reality exists. As the saying goes, “As long as there is life, there is hope.” This is unfortunately false. There are instances where all hope has disappeared, where death is certain and where it will only occur after indescribable suffering.

But it is not because a subject is difficult, that it touches us and saddles us that we should make it a taboo subject and that we should not deal with it. On the contrary! It is necessary to respond to a problem that exists with all humanity, the seriousness and the reflection that it deserves. Our responsibility, our duty as an elected is to provide assistance to all those who are faced with this terrible fatality. Our responsibility is to allow everyone to live but also to die in dignity.

This bill is in line with the philosophy of the laws adopted in 2002 regarding the decriminalization of euthanasia, palliative care and patient rights.

As in 2002, the goal is the humanization of the end of life and the dedication of the autonomy and self-determination of patients.

So today we will try to continue to debate with all the serenity that has guided our work so far, without wanting to make anyone’s trial and without limiting everyone’s possibility to speak on the subject.

Nevertheless, it is sad to see that some are now trying to create controversy, to get into political and media games by instrumentalizing the children themselves. A declaration ...

But I am not talking about you! Let me continue. I am not talking about members. If you have a question, ask me it or I will continue my argument, if you want to.

Tell us then who instrumentalizes children at this stage, outside of Parliament?

If you allow me to continue, I will speak. Thus, a written declaration by some members of the Council of Europe, which only commits its signatories, becomes an assertion that the Council of Europe warns Belgium.

Thus, some are outraged that the cults were not heard while, I think, each of us was able to get to know their opinion in the media. Furthermore, if everyone has the right to speak, the separation of church and state is an essential principle in Belgium.

Thus, some relate the instrumentalization of a four-year-old Québécoise who calls on the King not to sign the law when it will be voted, and that because with such a legislation, she would no longer be there. But its history does not, of course, meet the conditions of the law which is subject to us today.

The text provides for strict conditions. The minor must be in a medical situation without a way out, resulting in death in the short term.

Madame Lalieux, you talked about groups that instrumentalize...

Mrs. Fonck, I didn’t talk about groups.

You talked about people who are instrumentalizing. I would like you to explain to me if in these groups you include all the pediatricians, doctors, specialists who yesterday, last week, the previous weeks, clearly gave their opinion, sent an open letter. I don’t dare to imagine that you can claim that these pediatricians, these doctors, have instrumentalized children in this debate. If you say this, and you have understood it, I find it overwhelming!

Madame Fonck, I haven’t talked about these pediatricians. Every doctor has his freedom of conscience and his freedom in the medical acts he will make, at least if the law allows him to do so. When I talked about instrumentalization, it was in relation to a letter that seemed to say that it was a recommendation of the Council of Europe. This is a statement of 56 members of the Council of Europe. But some have said "The Council of Europe warns ...". This is not a recommendation of the Council of Europe. I spoke of some journalists who had uncovered the statement of this 4-year-old Canadian girl who is in no condition to have euthanasia and who asks our King not to sign the law. I am talking about this and obviously I am not talking about the medical staff who, today, can, in full freedom, practice or not the act of euthanasia, which is already the case for the major.

Madame Lilly, you are bypassing to not answer the question. You’re talking about the caregivers who are on the bed of the patients. All the pediatricians and doctors who sent this open letter and all the pediatricians and doctors, today at an international congress, are sending the same message. They don’t talk about their situation in the bed of their patients, they talk about how this law was conceived, its content, and how the debates took place. You do not answer this question and I understand that you consider that this open letter of all the caregivers is instrumentalization.

You mentioned a lot of things before, but you forgot one. In the Chamber, there were two very small commissions on this subject and zero hearing!

Either you hear me, or you don’t want to hear me. I do not want to argue. I just said that there were three sessions in the Chamber.

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If you find this fundamental, it’s that you don’t make much sense of the height of such a debate!

Pediatricians have spoken out. That is their opinion. Other pediatricians expressed themselves and gave a different opinion. If you are browsing through the Senate hearings, there have been other opinions from other caregivers. Therefore, I was trying to say that we should not judge the "pro" and the "anti", that this situation is serious, that we should not, at a given moment, oppose a family, a child who will make the choice of euthanasia and those who will not make that choice. There is no judgment to make. Each choice is individual and extremely difficult.

Therefore, if you want to provoke a controversy at such a difficult time, it’s your choice, it’s not mine, and I’ll continue to say what I have to say to the tribune. ( with applause )

Mr. Speaker, I am consterned to hear a member publicly acknowledge that today, one can decide to allow child euthanasia after reading press debates and having discussed this matter in committee for only a few hours and having not heard anyone, despicing even professionals in the sector.

It is the flagrant image of the gap that creates between the political world and the field actors, but in relation to this, you are no longer a further proof of it!

The text provides for strict conditions: the minor must be in a medical situation that leads to a short-term death. It must report constant and unbearable physical suffering which cannot be calmed and which results from a serious and incurable accidental or pathological condition.

The project provides that the minor must be endowed with discernment and that he must be conscious at the time he makes this request. In addition to the almost systematic intervention of a multidisciplinary team, the project envisaged the intervention of a third party, an expert (psychologist or pediatric psychiatrist) to assess the child’s discernment ability. There is no universal standard. It will be necessary to analyze from case to case and, depending on the maturity of each and the circumstances, whether the child is endowed with discernment or not, whether he understands the irreversible side of death.

The demand from the child with discernment is also not sufficient. His parents or legal representatives, as required by law, must also give their consent. This also allows not to override the child or leave the doctor alone master.

The courage we must show today is nothing beside what will be needed for children, parents, doctors who – one day ⁇ – will have to face incurable disease and death.

As I said in a committee, euthanasia is not about killing a person but about liberating him from his suffering. No doctor wants to practice euthanasia, nor is he made for it. Doctors and care staff are there to treat and, if possible, heal. The text that will be submitted to vote tomorrow allows minors to express their will to resort to euthanasia. It strengthens the freedom of choice of each but in compliance with the precise conditions of the law.

Everyone is free to interpret what dying in dignity means to him. We do not have to judge his choices. It is not about imposing euthanasia, inciting anyone, forcing anyone, no children, no family, but allowing the child to choose not to eternalize in suffering.

All groups in the Senate recognized the importance and proper conduct of the hearings and the work carried out. Everyone will recognize that it has been thoroughly considered of these to obtain the text that is on the table today, a limited, weighted, thoughtful, tagged text. This text, each of us appreciates it according to his convictions. Within my group we had a long debate and every Socialist MP voted in favour of the adoption of this text.

Mr. Speaker, colleagues, we are here today for a debate on a ⁇ delicate topic – we all acknowledge that – namely dying valuably.

It is a sensitive and delicate debate, especially when it comes to minors, to children. The questions we ask ourselves today are effective at a different level than the questions we ask ourselves when discussing other designs and proposals. Therefore, I also think that we should be able to conduct this debate with the necessary scourge, the necessary nuances and sensitivity. Therefore, I do not want to invoke the contradictions that some would like to use in this debate, sometimes even to avoid fundamental questions. I would like to say in advance that in this debate we want to condemn no one and show respect for everyone’s opinion. However, I also don’t want those who disagree with this proposal to be presented as heartless people who don’t care about pain, who don’t care about the suffering of incurably sick children and the consequences for their environment. Even the one who continues to fight for his life, until the bitter and possibly painful end, must not be blamed for dying unworthy, being a burden to society, or chasing it at costs.

Colleagues, I take the word here as a human being, as a mother, as a Christian Democrat, as a lawyer and as a politician. Depending on my position, the perspective will also be different and I will formulate other concerns and questions.

I think we all agree that no parent chooses to give his or her child terminally ill. No parent wants to see their child suffer pain. It is right, it is a profound human concern. Everyone wants, when there is no alternative, to die worthy and let their child die worthy, without pain. Colleagues, our country, Belgium, is at the top of palliative care, care to assist people in their last moments and ensure that they do not experience pain. The medical science has evolved so that pain can be kept under control, that comfort care can be provided that can ensure a quality and dignified end of life.

Euthanasia, the autonomous question or individual choice to actively end life, cannot therefore be presented as the only way of dying worthy. We oppose an image where euthanasia is sometimes presented as a happy ending. This cannot be the norm.

What pressure does this put on people who are in the final phase of their lives? What expectation pattern is created in this way? What pressure is put on people who do not choose euthanasia? Am I irresponsible when I do not ask for euthanasia for myself or for our child who is terminally ill?

As a Christian Democrat, I find that there is a life-visional gap here that is likely not or very difficult to bridge. We respect the visionary approach of supporters of this design, but we disagree with it.

The confrontation with death brings us into contact with the uncontrollable, with what does not fit in the plans we make and the ambitions we have for our own life or for that of others. However, we cannot turn away from it. We ask ourselves how we can deal with this, how we can give it a place in our lives. This requires time, reflection and dialogue with the other.

We do not assume the ultimate right of self-determination. Humans are not abstract individuals who constantly make rational decisions. People live in connection with others and we don’t take difficult decisions, such as about life and death, alone.

Especially in a disease process, that process takes place in coordination with the patient, the doctor, family and friends. That’s what I found in the Senate reports, not in what I heard from the doctors. We could not hear them.

Give us the time, say the doctors, to allow the process of separation of children and parents to take place in continuous communication, a process that proceeds with the utmost care and with the utmost pain control.

Such a care ethical approach is not the easiest way. It is a dialogue in which each must respect the role of the other.

What lies before us here is the legal possibility for minors to make a choice to die, but can they make that choice in full independence, as proposed, in ultimate self-determination? Are they capable of that? Can we reasonably assume that a six, seven, or eight-year-old can handle this question in the same way as a fifteen, sixteen, or seventeen-year-old adolescent?

Do you think that when it comes to euthanasia and the irreversibility of one’s own death, a child without problems, without any influence from the environment, is able to make such a decision? Do you really believe that a seven-year-old, even an eleven-year-old, will ask for autonomous euthanasia?

You know: absolute autonomy, in which we do not believe for the purchase of cigarettes or drinks. In this regard, however, a law was passed to prohibit the sale of it to young people under the age of sixteen.

Often attempts are made to defend the execution of euthanasia in will-being minors, by asserting that minors who are seriously ill become mature much faster than their peers. Possibly, this is indeed the case with regard to carrying the disease. However, this is not necessarily the case when it comes to decisions about life or death.

As a lawyer, I am very concerned. The present draft is full of negligence, inaccuracies and gaps, also in relation to the current, existing basic self-determination law.

As lawyers, we all want to be able to provide a legal and trustworthy framework. That is the question that is asked here. We must be able to provide a legal framework for doctors who address the demand for euthanasia. However, the present design overlooks its purpose by the great speed and carelessness, which made us experience that the design had to be closed by the Chamber.

For example, it is completely unclear what “judgmental” means. We had a discussion on this issue in the committee. One referred to the Patient Rights Act, while the other of the same party noted that it was not the notion in the Patient Rights Act that should be taken into account.

Do you know what should be understood by “willfulness”? Do you know what criteria doctors will apply? I cannot answer you.

How problematic is it that a target audience targeted in the present draft is not carefully defined?

Who are the legal representatives? After all, it is the legal representatives of the minor who must give consent. Does it also apply to the parent who does not exercise parental responsibility in the event of a divorce? This issue was also discussed.

Will parents be able to go to the court and/or to the juvenile court to request that the decision to euthanize be effectively taken or confirmed? Do you know the answer? We asked, but we did not get the answer. The Minister also owes us the answer.

How can it be stated in the present bill that a judgmental but non-deceased minor, which is the new concept that we have created here, cannot request euthanasia in the event of psychological suffering, while a deceased minor of the same age can request euthanasia in the same circumstances? This is an internal discrimination, which is included in the present draft law.

The euthanasia request may be made by the judgmental minor who is in a medical unlikely situation of persistent and unbearable physical suffering that cannot be remedied within a foreseeable time. What is meant by this? In this law it is written “within foreseeable time”; that is the term “terminal”. However, in the Basic Self-Determination Act, which deals about the same thing but for adults, it is about a “evidently foreseeable term”. Do you want to say the same thing twice or are there two different things? Is the terminal in an adult different from the terminal in a child?

How long will the foreseeable deadline last? Three days, as I hear some say, or three months, as I hear others say? Is it one month or six months? Who will judge about it and on what basis? How will this be clarified and legal certainty created? Can a doctor predict death with certainty? Do you know? I dare not answer it.

The questions I cite here have led to confusing discussions in the committee, which have not received clear answers. Our conclusion was and remains that the present draft is not actually ready to be approved, but that it needs to be adjusted and clarified. This clarification is necessary because the euthanasia legislation is an exception to the criminal legislation. It is necessary to know where the doctor can go. Such questions are asked by doctors, because otherwise they may be punishable.

Colleagues, therefore, I cannot really understand that the bill was not submitted to the State Council for advice. We ask the Council of State regularly, and rightly, for advice on bills, for example, on the bill imposing a ban on extremist organizations, with the argument that it is about principled issues, about fundamental rights and freedoms. However, if it is about euthanasia, about the end of life, then one finds that advice not necessary, then the request for advice is considered a delaying manoeuvre. We do not understand that.

We will now again submit some amendments, because we hope that we can make some improvements even to a law we do not agree with.

There was indeed a debate in the House and one can discuss whether there were three or two committee discussions on this proposal. More could and should it apparently not be. The autonomy that we demand for the end of life must obviously not exist for the Chamber. We must continue on what was said in the Senate, on the written reports of the Senate, but we must not ask the Council of State for advice.

We should not even ask for advice or an explanation on the functioning of the euthanasia law in the Netherlands, which provides for euthanasia for minors over 12 years of age, but we have heard that no question has been registered. We were not allowed to hear these people in the committee.

As a politician, I almost have to state that it is a symbolic file that indeed needs to be approved as soon as possible. Doctors now have sufficient capabilities; 140 or 160 doctors endorse that in a letter ⁇ ly received to the Speaker of the House. They can control the pain and provide comfort. They may also, in consultation with the patient or his representative, decide to discontinue or not initiate certain medical treatments. And in exceptional cases, where the patient has come into a medical unlikely situation and the medicine is unable to soothe the suffering, active termination of life can be applied as the ultimate remedy, through the justification of the state of emergency, as included in our legislation today.

Moreover, in fact, the demand for euthanasia among minors appears to be very exceptional, ⁇ because the minor simply does not ask for it, not even when the possibility of euthanasia is discussed with him. The figures in the Netherlands demonstrate this.

We want to allow space in this debate to talk not only about euthanasia but also about palliative care. We want to give a place to the dialogue between the doctor, the patient, the parents, the family and the people who love the patient, to embark together on the road to a worthy end of life. Per ⁇ it’s three more precious days that one can spend together, with optimal care without pain and unnecessary suffering.

We continue to ask: will he who does not choose to die continue to behave by his environment, by his family, by society? And will that vulnerable man who does not choose euthanasia not be thrown back on himself, on his responsibility to want to continue to live?

Why is it said that those who choose euthanasia on television are so brave? Why is an extension of the euthanasia law to minors equated with progress? Why are people who choose euthanasia considered progressive? Am I cowardly or am I cowardly because I choose to live?

As a politician and as a human being, I would have liked to go beyond those black-and-white reasonings. We would like to bring the debate in the Chamber to the ground and not to extend it unnecessarily, but the majority did not consider it desirable. Important voices from the medical world should not be heard here. Metaforum, a multidisciplinary group with different life views, which has conducted two years of research on euthanasia, as well as specific research on euthanasia and termination of life in children, was also not allowed to be heard.

Here in the Chamber no longer needed to be debated, because there was certain enough votes. There was a sufficient number of N-VA votes. Even though I heard colleagues from the N-VA express their doubts at the beginning, they all approved this well in the committee. Therefore, it was certain that enough votes would be obtained.

Dear colleagues of the N-VA, that seems to me to a great surprise. Apparently, the PS is not the Bohemian when it comes to fundamental issues such as life and death and you will find in the PS a good ally to be against a request for advice from the State Council. I cannot understand that from you.

Mrs. Becq, until two minutes ago I was planning to applaud if you came from the speaker.

Until now, the debate has been serene and has surpassed the flat party-political games. I deeply regret that you now turn the debate to party-political games, while this theme per definition interferes with the individual beliefs of each people’s representative in the House.

You will see tomorrow in the voting behavior of my group that we are not a phalanx in that regard. Each Chamber Member will have their own insights. There were four people in the committee who had a certain idea about it. Tomorrow you will see how our group votes on this.

I regret the turn you give to the debate. Again, until two minutes ago I would have applauded for you, because I found your presentation worthy and important.

I regret that you are now leaving your argument down to the party-political level.

Mr. Jambon, you can’t imagine how it affected us when we had to determine that a legal advice from the State Council was simply refused because of the short term within which this draft was approved. If that’s not politics, then I don’t know.

I go around. I am concerned and I regret that we as legislators will pass a bill that does not pass the legal validity test. Mr Jambon, I truly regret that we have failed, even though the gap is so deep, to initiate a real dialogue across the party boundaries in the Chamber, to conduct a real debate in order to reach a balanced solution. And yes, I am very sorry that tomorrow a bill will be passed that allows euthanasia for children, even if they do not ask for it themselves.

In her speech, Ms. Becq referred to the letter delivered by pediatricians.

To make things clear, I would like to clarify this. My services were contacted Friday afternoon at 15:37 by Mr. Bosteels of the company VPR Consult informing us that he represented a group of 40 pediatric doctors who issued an open letter regarding the possible extension of the euthanasia law. In that letter, he announced that a press conference was held on Tuesday 11 February. In the afternoon, he wanted two representatives of this group to personally present this open letter to the chairman of the House, as a symbolic act.

I answered that I would like to meet them on Tuesday 11 February after the press conference. This is how I met yesterday with professors Stefaan Van Gool and Benoît Beuselinck who gave me a letter, signed by 160 people. I received them, listened to them, and then forwarded the letter to the different group leaders.

In summary, I would like to clarify that the letter was delivered yesterday, in the afternoon, to all the heads of group in the Assembly, after I spoke with the representatives for almost an hour and a half.

I thought this should be said for the information of each member of our Assembly.

In 2002, the Parliament passed the law on the euthanasia of major and emancipated minors.

At that time, at this tribune, I had already expressed the idea that there could not be a real consensus on this matter that concerns life and death. In a society of freedom and tolerance, it is healthy that each person may judge differently and personally about the exercise of his free will, his right to choose and decide.

Everyone’s position on euthanasia is intimately linked to the very conception that each has of his own life and of his degree of autonomy in relation to any possible transcendence, whether social or moral.

Each person’s position may also depend on the meaning and meaning that is given to suffering. It is also difficult to reach consensus.

It is to take into account the legitimacy of the different opinions and feelings that one is entitled to express on ethical issues that the Reform Movement has always defended the freedom of vote on these subjects. These questions emerge so much from personal intimacy that it seems incongruous to reserve for them a homogeneous ideological voting discipline.

Some mentioned here the appreciation and requests of a number of pediatricians. The Chamber received a petition signed by a number of pediatricians. The senators, in November, had also received a letter signed by other pediatricians whose request was the opposite of the letter received very recently. That is, if the consensus on this subject is extremely random.

Each member of my group will therefore speak in soul and conscience, in a spirit of tolerance and mutual understanding.

For my part, I define the law passed in 2002 as a new essential and fundamental freedom. In fact, this law creates no obligation for the patient or for the doctor. It merits decriminalizing an act resulting from the encounter of two freedoms. I never regretted voting for this possibility of "deathing in freedom". I would like to use this expression rather than that which consists of saying "die in dignity". As every man is worthy, the death of every man is worthy. Dignity lies in the fact that each person is a person and not in the state in which he is. Of course, dignity can accommodate dependency.

The extension of the law on euthanasia to non-emancipated minors obviously raises a multitude of questions, legitimate questions that it would be inappropriate to remove from one side of the hand. Is this extension of the scope of this law useful and necessary? Is there a request from minors or parents? Is the safety of the doctor who practices terminal sedation guaranteed to date?

Does the minor, the teenager, the child, have the capacity to express their freedom and their choice to die and in what way, when their suffering is unfathomable and death is near?

In 2002, the same year as the vote on the euthanasia law, I participated in the debate on patients’ rights, what was called the Aelvoet Act. I voted this law on 6 October 2002. This law applies to minor patients who are represented by their parents or guardians but in its article 12, this law states that the healthcare professional must assess, in case-by-case, to what extent the minor patient is able to judge himself of his interests. At the time, this article may have escaped the consequences it brought. In today’s debate, the Patient Rights Act is an interesting background.

After mature reflection, I am now convinced that the right to address the questions of life and death cannot be reserved for adults. Age does not determine whether or not to talk about the end of his life and his death. I would like to quote the poet Juvenal, a Latin poet, who said: "Maxima debitor puero reverentia". We owe the child the utmost respect. Respecting the minor patient is, first of all, listening to him and accepting that he expresses himself on the most existential issues.

Some opponents of the extension of the law to minors believe that requests are rare and that this rarity could justify the refusal of the extension of the law. However, we are not here in a problem of number and quantity. For each minor patient, the possible approach is unique and total.

The 2002 law provided a series of conditions that frame the possibility of resorting to euthanasia and the enforcement of the law has not resulted in any deviation. Contrary to what I have read or heard in the last few days, in the last ten years, all the decisions of the Federal Commission for the Control and Evaluation of Euthanasia, responsible for the validation of the procedures, have been taken unanimously and in consensus.

In the draft law, additional conditions restrict the scope to minors and we intuitively feel that this is obviously necessary. Let us be clear: euthanasia remains prohibited if these conditions are not met.

The proposed law concerns only minors who are in a medical situation without a way out, who report constant and unbearable physical suffering, who suffer from an incurable condition and whose death is expected in the near future.

Doctors know how the adversity faced by seriously ill children amplifies their maturity. The mental age and the calendar age dissociate. Evaluation of discernment capacity is the central element of taking into account the application for euthanasia. The law provides for the opinion of a psychologist or a psychiatrist. A second doctor should be consulted, as well as the caring team. In practice, the doctor who is in charge of the decision, because one is needed, will rely on the feeling and perception of a multidisciplinary panel. Of course, the consent of parents is essential. In this context, a decision can never be taken lightly.

On the other hand, in the current situation, dear colleagues, the legal insecurity of practitioners exists indeed when they practice controlled sedations and, moreover, terminal sedations which, to put it clearly, lead to the shortening of life and bring the moment of death closer. They then proceed according to the state of necessity. However, there are many euthanasies that do not carry their names.

The proposed law, I think, brings more transparency and objectivity. She entrusts the responsibility for the act to the doctor who will never decide alone and always based on extremely precise tags. As I said, euthanasia remains forbidden when treatment is still possible. It is forbidden in neonatology and in very young children. This seems obvious, and yet we have recently been presented in Sudpresse the case of a Canadian child suffering from a heart disease, who would have escaped euthanasia. This same morning, in La Libre Belgique, an oncologist evokes the case of a fifteen-year-old teenager with a relapse of leukemia who, too, would have escaped euthanasia.

But what are we talking about? In both cases, the solution is strictly therapeutic. It is therapeutic and ⁇ not euthanasia. The draft law does not allow euthanasia when curative treatment is envisaged. Euthanasia is prohibited when death is not planned in the near future.

It is never a matter of deciding on the death of a patient. Therefore, it is never a matter of deciding on the death of a minor patient. The short-term death is already here. The drama is already written. Constant and unbreakable suffering is already a reality. All the opinions of the care team agree at that time. And both parents understand and accept the request of the minor patient to no longer suffer and anticipate death.

Today, it is within the framework of palliative care and possibly terminal sedation that we can ⁇ the calming of suffering. Terminal sedation, like the act of euthanasia, anticipates death. But in the act of euthanasia, the minor patient would have been able to express himself freely and address the question of his imminent death instead of suffering a collective non-dice.

Where there remains the slightest doubt about the discernment capacity of the child, the act of euthanasia shall never be made. and never. When the least reluctance appears in the multidisciplinary care team regarding the justification of this act, it will never be made. The freedom of conscience of the doctor will never be violated. He shall in all circumstances have the possibility and the right to refuse to practice the act of euthanasia.

These are not only the terms, but also the spirit of the bill in draft. It will probably actually concern very few people, and that is so much better! Among them, mostly older teenagers. But she will give the word and will fully respect the minor patient as a full-fledged person having the right and the opportunity to express his feelings on the most essential question of his life and death.

We owe the greatest respect to the child. It is strongly of this conviction that I will support the project that is proposed to us.

I do not like to interrupt you, colleague, but if I hear you talking about “la moindre réticence”, which would be a sufficient reason not to continue with the procedure, I still sit with a question. One of the things that I notice, and I think many people don’t know about it, is that when the doctor who is considering doing the procedure needs to seek advice from another doctor, the law you will approve later does not specify that that second doctor must agree to the analysis of the first doctor. Therefore, it is sufficient to ask another doctor for an opinion. The doctor is appointed by the first doctor. In other words, there are no guarantees that one does not simply ask for advice from someone who is willing to agree with the first doctor anyway. Furthermore, there is nowhere in the law that if that second doctor did not agree with the first doctor, the procedure is not respected.

I just heard a number of colleagues say they are “proud” of the guarantees embedded in this law. I cannot be proud of something that gives the impression that at the slightest “reticence” is reclaimed, while in reality – when one wants to absolutely give up on his purpose – it is sufficient to ask another doctor for advice, but one in advance puts that second advice, which in fact is not advice, aside. I am still wondering if you really find that guarantees that should ensure that one acts prudently in all circumstances. Is this the guarantee of objectivity? I ask myself.

I will then come to another element that you cite. It is interesting to comment on the remarks of a French-speaking colleague. In French it stands “à brève échéance”. In Dutch it stands “within foreseeable time”. Our spokeswoman, Sonja Becq, just asked a number of questions. The minister did not have the opportunity to answer, but she indeed asked the question of what “foreseeable time” actually means. We heard yesterday on TV someone claiming that this means the following: “You will see your child dying within three days, so what does it matter?” Others, including members of the Euthanasia Committee, say that the interpretation used today for “significant time” runs up to six months and possibly even further. Can we agree in this Parliament that this is a very wide difference? For parents facing a ⁇ painful moment, three days, three weeks, or six months can also make a huge world of difference.

None of the applicants can answer the question of what we should mean by “foreseeable time”, or in French “à brève échéance”. I am naturally bilingual and I think “à brève échéance” is a little stricter than “foreseeable time”. I honestly cannot tolerate this ambiguity. The applicants claim that they want to create legal certainty. What they actually do is, for the sake of the trophy to have a law, create non-legal certainty for those who want to do the best in difficult situations.

I repeat again what I have already said. The people in our banks are also dealing with the suffering. We do not want to prolong the suffering. We, however, do not tolerate that one pretends to turn our eyes away from suffering because we do not promptly approve a kaduke, a bad law, which, by the way, is capable of a language error. Of course, it will not be corrected either. It’s about a “this” that actually should be “that” or vice versa. Even language errors are not removed. If you want another proof that one wants to get something approved, then for me it is that stupid language error.

Mr. Speaker, I think it is necessary to ask for the word. I regret that in this so far very serene debate, two attempts have already been made to annihilate the serenity. I have just said that in the N-VA group, with respect for everyone’s opinion, in honour and conscience, each member of Parliament will vote separately.

It was indeed a mistake to say that the N-VA is proud of the guarantees we put in the Senate. I also immediately corrected myself: we are satisfied and confident about the guarantees that have been inserted, in particular the written consent of both parents separately and the medical and psychological assistance provided to the parents and the child. I found it necessary to place it.

Mr. Speaker, I would like to insist: the security framework of the entire text is not the fact of one criterion and then another. If one analyses the law considering that each criterion in itself is an element that must bring certainty in the enforcement of the law, one will not find it. It is certain! It is precisely the accumulation of criteria that ultimately creates the framework in which derivation is practically impossible. I honestly think so!

Indeed, if you remove the words "short term" from their context, obviously, it doesn't mean much. But when you reintroduce them in the present context that specifies that, simultaneously with the prediction of near death, it is necessary that the suffering be unreasonable, that no curative treatment is possible, that a second doctor has given an opinion, plus that of a pediatrician and a psychologist and that in addition, it is necessary that the care team be consulted, you arrive at the natural solution that, unfortunately, is found in hospitals.

And all doctors, regardless of their positioning – some prefer to stay with the use of terminal sedation – follow the same reasoning: “When will we operate the sedation? When will the child or minor be placed in a position where they can no longer react normally with their environment? When will we decide to do this?"It is exactly the same as the moment when we will decide to make an act of euthanasia! Nothing changes in this regard!

We are in a situation where, simply, we are increasing legal certainty compared to other forms of sedation and life-shortening. That exists! It has been ⁇ ! The pediatricians who brought their petition yesterday say they themselves practice this type of sedation. There is no doubt about this.

The short term, it is important to integrate it into a broader framework that leads all those who are interested in the case encountered - there is a need for unanimity in the matter and this is what is happening in practice - to the conviction that the only thing to do well is to avoid the patient from suffering, even if the price is to shorten slightly, probably, life, to bring death closer to avoid the establishment of an irreversible situation.

I think that is the spirit of the law. When we discussed the law on adult euthanasia, we had a question, ⁇ less difficult than today.

We see the absence of any drift while we have heard of it, of prophets at the time. I heard of everything: we were going to empty the rest houses, among others. Nothing of what was announced has happened.

The pluralist assessment committee decides on everything unanimously: it analyses the procedure and all other criteria; except for the notion of "short term" not planned for adults. If the procedure is followed, the file is not entrusted to the Court.

Mr. Bacquelaine, twice you used the phrase "multidisciplinary approach" when deciding to submit the act. However, this is not what is written in the text that is submitted to us. Today, you will entrust the decision first to a pediatric psychiatrist or a psychologist who will have to appreciate the child’s discernment ability, then it may be necessary to obtain the consent of the parents. I will explain it soon.

You remove from the game the multidisciplinary team that accompanies this child in the terminal phase for days, weeks, or even months. It is not your responsibility to make the final decision. Furthermore, as part of the discussion in the committee – I think we will also do so in the plenary – we submitted an amendment to guarantee this multidisciplinary approach. Of course, like the rest, it was rejected.

I disagree with your interpretation of the law.

Mr. Speaker, I will explain this shortly, but we have already said enough that, contrary to what you believe, we are not creating the framework for legal certainty but we are opening the door to problems.

I disagree with what you say, but I respect it. I simply say that it is not only a matter of consulting a psychologist or pediatrist, but also of consulting a second doctor. This is a criterion that relates to the law on the major, but that applies in the same way to minors.

The provisions of the 2002 Law apply in this case as well. Some additional criteria have been added. Therefore, the consultation of a second doctor is mandatory; read the law carefully. There is also a need for consultation with the care team.

You know, like me, I hope, how these multidisciplinary oncological consultations take place in hospitals that take care of patients with cancer. This consultation is the general rule, without exception in Belgium. All consultations concerning children with cancer in hospitals are carried out in a multidisciplinary manner.

This is a rule of good medical practice that is generally established. There is no exception! In practice, this is where the possible requests of the minor will be discussed and that is where the decision-making will come. In the end, a doctor will have to do it. It is a question of responsibility. The doctor who will perform the act of euthanasia must take responsibility. This is a necessity, otherwise there is no responsibility at all! If there is a dispute or if a procedure is considered to be bad by the evaluation committee, there must be a responsible person who assumes. This responsible person who knows that he must assume, he will never make a decision that would go against the care team, against the psychologist, against the pediatric psychiatrist, against the second doctor. Let us be serious! We are actually improving the legal certainty of the end of life! It is not perfect and it will never be. When we are in the middle of life and death issues, one cannot consider that we are in a mechanistic approach that will solve the problem globally once and for all! No, we remain in human affairs! The problem arises in the same way when deciding to administer a terminal sedation. The mental process is the same since in the terminal sedation, we know that we go towards the death of the patient and we know that we anticipate it.

I think the problem of legal certainty of decision-making is true in all areas when approaching the end of a child’s life. We must have a minimum of confidence and optimism about the human nature of those who take care of suffering children. This confidence and optimism is necessary in the face of a decision as difficult as the one we have to make. It is the spirit that inspires me in this matter.

Mr. Bacquelaine, I understand that you are trying to rewrite the law and, at least, to sell it otherwise than it is written. With regard to the intervention of the multidisciplinary team, your law provides that the discernment capacity of the child is evaluated by a pediatric psychiatrist or a psychologist, psychologist who may not be absolutely trained for children and who is not necessarily a doctor.

There is no provision in this law that the discernmental capacity of the child should be assessed by the multidisciplinary team.

Of course yes!

And yet, it is the multidisciplinary team that follows the child, young or younger, long-standing, whether he has cancer or not, since children die due to other incurable diseases than cancers, Mr. Bacquelaine: neurological diseases, severe myopathies, severe heart problems; it is this team that can know whether this child has or does not have the ability to discern.

This is not at all how it happens!

A child, even more than an adult, evolves. It is the doctors and nurses who have established a strong relationship of trust with the child who can evaluate the ability to discern. But to believe that this law sets up such a mechanism is a deceit!

You are reinventing the law. The law provides here that the ability to discern is entrusted to a pediatric psychiatrist or a psychologist who must decide. You pass there next to an element that is, for us, fundamental. You deny the reality. You will reiterate that the caregivers will do so. and no! Either you make a law and you do it correctly, or you do not make a law and trust the caregivers. This is our option. But what you have planned, I repeat, is absolutely not this mechanism.

and yes!

Do not try here, because health professionals and medical academies are constantly asking you in this direction, to convince us that this is the mechanism you have planned. We submitted an amendment so that discernment capacity is first assessed by the multidisciplinary team, who knows the child and has been following him for a long time, and then by a pediatric psychiatrist. You did not want this procedure. We regret it.

I hope you have the opportunity to come back to it in your speeches.

Mr. President, Mr. Bacquelaine, I fully agree with your analysis and your defense of the bill under consideration. However, I would like to add one element that should be taken into account and recalled regularly. Euthanasia involves the formulation of a request from the child concerned. I think this is a crucial element. In fact, this is a completely different procedure from that in which it is the doctor who alone evaluates whether it is necessary to consider, propose and concrete the administration of a substance that will have the effect of ending the suffering of his young patient. In my view, demand is therefore a primary element.

It also raises the question of the assessment of discernment capacity. The law could have been improved. We had also submitted an amendment that included the fact that the multidisciplinary team that, according to the law of 2002, gives its opinion on the admissibility of the application for euthanasia can express themselves as to the capacity for discernment. We re-submitted the above-mentioned amendment because we consider that it would have been desirable to provide for an external opinion in the law. This notice is useful since it is known that it sometimes happens that in the area of adult euthanasia, some hospitals give instructions. In doing so, we get out of the field of the freedom of conscience of doctors. But it would also have been interesting if the multidisciplinary team could make known that, in its opinion, the child concerned is in discernment capacity, just as it can express itself regarding the receptivity of the request. In fact, it is very likely that she will do so, but it would have been appropriate that this be specified in the law.

In fact, what is required is the assessment of discernment ability. The one who will in the end forge his conviction as to whether or not to perform the act of euthanasia, is the doctor to whom the child has addressed, at a given moment, to ask him to summarize his suffering. That doctor who will make his decision in conscience will be the only responsible, and no one else. He knows that the law inhibits him to make his decision on the basis of a verification of the ability to discern the minor. The law helped him to determine this discernment capacity by anticipating the opinion of a psychologist and a pediatric psychiatrist, ⁇ outside the multidisciplinary cell, which would not be worse. In fact, there must also be a look that is not only intra-muros.

This will help them build their convictions. But he remains responsible for the conviction that he has that the child or minor has a real capacity for discernment. It is him and he alone. It is he who makes the decision. They are not the others. The others are consulted but do not make the decision. The doctor responsible for the possible act of euthanasia therefore makes the decision by having measured and taken all his precautions regarding the reality of the discernment capacity of the child.

To support his conviction of the child’s ability to discern, he will help the opinion of a pediatric psychiatrist and a psychologist as well as, of course, of all those in charge of the treatment. How can we imagine it could be different? This is what worries me about how some perceive the reality of hospitals today and how this is happening. No one will take responsibility for practicing an act of euthanasia on a minor child, without taking all the opinions and advice of the persons in charge of the treatment! This is the spirit of the law and this is perfectly clear!

Of course, one can always assume that this is not yet enough and that this or that needs to be clarified. I often repeat what Nobel Prize winner Albert Claude once said: “If you want to prevent a project from succeeding, demand that it be perfect.” Because perfection is not human, you will never ⁇ it.

I believe that the law very well specifies the spirit of conviction of the doctor who practices the act of euthanasia, namely that he must take into account the whole of a procedure defined in the text of the law and that it makes that in the end he will only make his decision if he has the certainty, the intimate conviction that he can follow a request of this nature. He will never do it with joy of heart. He will do it because in conscience he will feel that he must do it.

Mr. Bacquelaine and Mr. Germany would like to intervene.

I would like to ask a question to Mr. by Bacquelaine.

Is this the same question as the one that has already been asked?

No, Mr the President. I have noticed that mr. Bacquelaine adheres to the text of the law and that he fully agrees that it is not a multidisciplinary team that has to decide on the ability of discernment. This is not what the law says. The law says, on the contrary, that it is an opinion that is asked from a pediatric psychiatrist or a psychologist who is located outside this multidisciplinary team. Mr. Bacquelaine, what happens then the day when the multidisciplinary team, itself, is convinced, by its practice and by the fact that it has followed this patient for weeks or months, that this child is capable of discernment and that the pediatric psychiatrist who has been consulted says the opposite? What happens then?

All the criteria are cumulative. If only one criterion is not met, euthanasia is illegal.

Can they turn to another paediatrist?

This is not planned.

It is not forbidden; therefore it is not said that one only consults a pediatric psychiatrist, only once. I ask for a clarification. We will ask the question to the Minister of Justice, because this is an important element of clarification.

I would like to add one point to Mr. of Dallemagne. Your group leader said a few moments ago that your positioning is to trust the team. So trust all the people around you, that is, the team, but also the communication between the surroundings, parents, the patient, the pediatric psychiatrist and/or the psychologist and the multidisciplinary team.

So the law is not necessary, is it?

But trust the agreement and the dialogue that can be between them, right!

This is what we want to do; this is the subject of our amendment.

As well as you, Mr Dahlman.

If you trust the caregivers, in this case, no matter how I turn and turn this question a thousand times in my head, I still can’t understand why you do this law this way. Indeed, the fact that you did not want to hear all those who write this open letter, pediatricians, doctors, testifies to very little consideration on your part and, above all, to your lack of trust in the caregivers. If you really trusted the caregivers, you ⁇ ’t have done things that way.

As for the multidisciplinary team, Mr. Bacquelaine, I persist and I sign, you entrust the ability to discern, on the basis of the law, only to a pediatric psychiatrist, or even a psychologist.

I give the floor to Mr. Bonte, who replaces Mrs. Temmerman, who suffers.

Mr. Speaker, colleagues, as it fits in this difficult debate, I will do my utmost to guard the serenity. I see this as a debate in which there can never be winners and losers. The reporter described the law as a law that we all hope it should not be used. The question is whether we, as legislators, should set a framework, with the consequences associated with it, for the pursuit of dying in dignity of young people in very difficult and painful circumstances.

I followed the debate and I remember that here twelve years ago, with the same serenity and dignity, the euthanasia law was passed. This law had a long history. During the discussion of this law, there were a lot of hearings in this house. There have been extensive discussions for months. The result was a step forward in ensuring the necessary legal certainty, when people make certain choices in their pursuit of dying worthy.

Let’s look at what exactly is in the euthanasia law, because I hear the same discussions repeat in this debate. Many conditions must be met before one can invoke the euthanasia law to end life. There is a mandatory consultation between the patient and the doctors. All alternative therapeutic options should be discussed, including palliative care. Even in our society there are very good and beautiful developments in it for people who choose that path. The doctor must also ensure the continued suffering of the patient and the durability of the demand for euthanasia.

I therefore believe that the very many keys in the euthanasia legislation provide the greatest possible certainty against all kinds of fears of possible abuse.

Particularly the dialogue between the patient and the doctor and the rest of the medical team is crucial, also in the bill that lies ahead of us. The euthanasia law of 2002 effectively granted self-determination to people in those difficult circumstances, after all of those conditions have been met. However, it has sought to supplement the right to self-determination without effectively bringing other people, such as caregivers or family members, into legal trouble. This is according to the 2002 euthanasia law.

The question that comes with it is: who are we à la limite – we may all be parents or witnesses of painful situations – to determine that the patient still has to continue with his struggle, with his suffering? Who are we to decide that he or she may not have the opinion to choose the most difficult path? What brings us to the moral point of determining that someone who is convinced that this is his or her last way out of suffering should not end it?

Dear colleagues, the way people deal with that unbearable suffering and the approaching end of life is and remains a very personal matter. I listened very carefully to Mr Beckett. I have great appreciation for the fact that, in part, it tries to define where the boundary of that right to self-determination lies and where one should give up one’s fate. As far as we are concerned, it is a good thing to define as far as possible that self-determination. This is the fundamental philosophy behind euthanasia.

Twelve years ago, there was already a debate about age limits, about whether that right to self-determination should not be defined for people under eighteen and who are in the same painful, hopeless situation, alone or with their surroundings, together with their caregivers, their doctors. At the same time, we have noted that it is very arbitrary to introduce such an age limit in the law. We also pointed out then that an age does not fit in that legislation. That’s why we have made a series of proposals here in the House and Senate since 2006 with colleagues from other political groups, to try to reconsider this mess.

Why is the age of eighteen that now works in the law not actually a good grind?

First and foremost, of course, there is the arbitrary character of a figure and of an age. Each of you knows that at the age of eighteen one is more mature than the other. A younger under the 18-year-old limit, such as a 16-year-old with a terminal brain tumor, may experience the same pain as a 18.5-year-old. The 18,5-year-old can make the choice he wants to make, while the 16-year-old can not. The age criterion is therefore in any case arbitrarily given, if we leave the law unchanged.

Second, there is also a contradiction arising from the age limit. The contradiction lies in the differences between the euthanasia law, on the one hand, and other legislation in the health field, on the other. In such laws, we write, as in the Patient Rights Act, that even minors are sufficiently mature and balanced to make a number of equally crucial decisions, which can also relate to life chances.

There is therefore, to some extent, a contradiction in this regard. It is about trying to estimate to what extent people are able to make a judgmental choice in this difficult context.

I just want to point out that we have gone further in the context of patient rights.

Since we, in our capacity as legislators, have given judgmental minors so much participation and decision-making in the Patient Rights Act, it seems almost evident to us to be consistent and to give the minors concerned also participation and decision-making in terms of life-ending choices.

Mr. Chairman, Mr. Bonte, the problem is precisely that in the committee we have been discussing the fact that in the present bill a new concept of willpower is inscribed, which however is a different concept with presumably a different content – I formulate it in question form – than the same concept in the law on the rights of patients.

We discussed in the committee whether we are talking about the same concept or about a different concept. There is no clarity on this subject. This is about it.

Mr. Speaker, Mrs. Becq, I have listened very closely to your comment on this point.

Mr. Speaker, Mrs. Becq, we have had the same discussion in the committee. Then there was a clear answer to that question. I assume that the Minister will repeat the answer again later. While in this legislation we have defined the judgment capacity of the minor shortly, we have given in the Law on Patient Rights a description of what should be understood by judgment capacity. We have written a lot of things in the Law on Patient Rights in short and in long. We are talking about the patient who can be considered capable of a reasonable assessment of his interests.

That is what the psychologist or child psychiatrist should examine, a clinical understanding, task-oriented and task-specific.

This was clearly stated in the committee and will be repeated here again. It is the same concept that is clearly defined in the Patient Rights Act.

I could not be present in the committee, but I have seen in the committee report that there have been long discussions, especially on the concept of “judgment.”

I have read that some people find this too vague and insignificant, that we should better define a new concept. However, I fear that it is always ⁇ difficult for a legislator, and even almost impossible, to define that very accurately.

It is also not up to the legislator to try to define this very clearly. There are many forms of misery. Each problem will be different and each individual’s reaction to it will be different.

Let that judgment be established by those who are best able to do so, in particular the caregivers, the doctors and the designated health care professions, as stated in the law. I think it is up to youth psychiatrists and psychologists to find the appropriate input.

I think it would be a wrong choice if we as legislators go too far in this. From the criticism of judgment and discernment, I concluded that these concepts do not end in the rights of patients alone. They are already included in the Judicial Code. From a judicial philosophy, from the Judicial Code, we today accept that minors have the required discernment, but that is apparently more difficult in terms of health law.

Colleagues, our group will support this extension of the law. We will not do so with tires and bells or with the greatest euphoria because of the delicacy of the problem, but also because it will get its concrete grip in the interpretation of the concept of judgment and so on.

I would like to emphasize once again that these are young people in a medical unlikely situation, with persistent and unbearable physical suffering that cannot be curated – contrary to what I read in a number of emails – and in which the death will be fixed within the foreseeable time.

In those circumstances, we must take our responsibilities and create a framework for this. And that is precisely what is here and what drives us to support this bill.

Mr. Speaker, Mrs. Minister, colleagues, I stand here today with a small heart but still with a great deal of confidence.

I stand here with a little heart because it is an unfair and unfair reality that children become incurably ill and must die.

I stand here with a little heart because of the reality that pain and symptom control are not always sufficient to fight physical suffering.

I stand here with a little heart because of the finding that pain is sometimes undertreated by the opponents of euthanasia, who fear being accused of disproportionate sedation.

I stand here with a little heart because of the terminology used by some opponents, who say that we are passing a law that would spit children to death, while we, as I read what precedes today and as I have followed the debates, create a legislative framework that seeks an answer to one of the most difficult questions of life, in particular how to deal with the end of life of a terminally sick, judgment-powered, therefore conscious minor, who is sometimes very young. It is a minor whom we think he should have a whole life ahead of him, in whom we have placed our hope for the future.

I stand here with a little heart because of the criticism that some give, as if we had gone fast, thoughtlessly and carelessly over one night of ice. Ladies and gentlemen, this is not correct. Since 2002, and I have heard colleagues who were already sitting here witness to it, there is a debate and reflection on this difficult topic.

Debates and hearings were also held in the Senate in the past year with all the actors in the field. It is not just about lawyers, but also about doctors and specialists in the matter who are in the everyday reality and know what they are talking about.

I have said that I am here with a little heart but also with confidence. I have confidence and hope for progress in medical science. I hope that there will be sufficient resources available to support further scientific research.

I trust everyone who cares for our sick children every day. It ranges from cleaning women who avoid bacterial infections to nurses, doctors and trained doctors who give their lives with one goal in mind: saving lives. I also have confidence in palliative care teams and the care team I see every year in my congregation that sometimes takes sick children. Sometimes I wonder where they get the courage. I have seen the joy of life and the need to survive in the eyes of the children.

I also have confidence in my parents. I haven’t met a single parent who isn’t worried. They all want their child to live and survive, sometimes on the stubborn. Doctors enter, sometimes against their knowledge, with the danger of being driven to therapeutic tenacity. I have confidence in that, colleagues.

I also have confidence in the text that will be used by those who work with it on a daily basis. The proposal is based on the right to a decent end of life. That is a right of personality, a fundamental right, also for a minor, and therefore it is the judgmental minor himself who must ask the question. The question arises from the judgmental minor patient who is terminally ill. The terminal illness is not only attested by his doctor. The physician should also make a second judgment.

Thus, the proposed regulation follows the existing euthanasia legislation, in the sense that the question comes from the patient himself. This is a repeated written question from the patient himself.

To avoid confusion, I would like to say that I disagree with Mrs. Becq’s decision when she proposes, unless I misunderstood her, that with this law we would allow euthanasia to children who do not ask for it. Colleague Becq, that is not correct and I hope that it is a promise or that I misunderstood you. For all clarity, the euthanasia question should come from the patient himself.

Mrs Van Cauter, I would definitely like to answer you to make it clear. A child may be able to ask that question, in any way, but we wonder to what extent a child can decide autonomously. Per ⁇ a child asks that question because of the circumstances or the factors it has to deal with. You are also a mother and then you know how sensitive a child is to the moods, experiences and feelings of the parents. Therefore, we ask ourselves whether a child really asks to die, or whether it is a question to stop the pain because the parents suffer pain with it. We put this philosophical question very clearly and we would like everyone to think about it.

Mrs. Becq, thank you for applying that nuance. The way you explain it now puts things in a clear perspective.

My explanation is the same as then.

Mrs Becq, I really don’t want people outside the House to have the idea that we may pass a law tomorrow that allows euthanasia to be performed on a child who has not asked for it.

Colleagues, allow me to go deeper into the nuance that was put up recently, by coming back to what was said during the hearings, as that matches what Mrs Beck just said. These hearings were held in the Senate and we were able to read their reports. It is about the judgmental capacity of the child, about the question of whether or not the conscious question of the minor can be answered.

Well, 95 percent of those who spoke there advised us not to assume a hanging age, precisely because it is impossible to set an age limit for who would be competent or incompetent, judgmental or non-judgmental. That would be arbitrary, as Mr. Bonte said. It would not be consistent with reality, and it would also be unfair to deny judgmental young people the right to die in dignity because they have not reached a certain age.

Again, for the report, judgment is a clinical concept. It is not a legal term. I am neither a doctor nor a psychiatrist nor a psychologist, but they are formed to judge judgment and they will do so in a task-specific way, as we do in the Law on Patient Rights.

Is anyone able to judge consciously whether what he asks is a conscious question? The Patient Rights Act clearly defines judgmental powers. I quote for the report: “The minor patient who can be considered capable of a reasonable assessment of his or her interests.” This is a clinical concept that is assessed by specialists.

There is also the legal reality. Mrs Becq already mentioned it. If the judgment of the minor is established and all other medical grounds are met, to know that the patient is terminally ill, suffers unbearably and asks the question as a judgmental minor, then there is also the legal reality of the capacity to act. This law stipulates that the minor must be assisted and can only enforce the request if he or she obtains the written consent of his or her legal representatives. They are usually the parents. The parents jointly assume parental responsibility; they are the legal representatives of the child. There can be no doubt about the fulfillment of this concept.

I know that in certain circumstances parental responsibility is entrusted exclusively to one of the two parents, but there can also be no doubt as to the fulfillment of the concept. I also know that children sometimes lose their parents at an early age, and there can be no doubt that it will then be the guardian who will have to agree with the minor’s euthanasia question.

This law, if passed, will not bind anyone. I would like to emphasize that it is an en-en story. We must continue to focus on therapy, pain and symptom control, palliative care, psychological assistance and sedation. The patient should also be allowed the freedom to possibly exercise the right to a decent end of life or to euthanasia.

I think it is important to emphasize the latter. It creates a right for the patient and it also lets a light burn in such situations. However, we cannot ignore the fact that it is a daily reality for doctors that they are faced with a compelling demand to end life if at the very last moment there really is no other solution possible. Today we push those doctors to disproportionate sedation that ultimately results in death. I think that this situation needs to be clarified. It should clearly be about pain control, sedation, but not disproportionate sedation, not slow euthanasia. If we talk about euthanasia, it should be a conscious question from the patient and with the necessary protection for the doctor through the legal guarantees.

Colleagues, I think I have said the most and I will decide as I started: with a little heart, but with a lot of confidence, I will vote yes tomorrow.

Mr. Speaker, I would like to comment on what Ms. Van Cauter said about age and judgmental capacity.

What is this famous willpower?

I would like to point out what is not in the report, because Metaforum has not been heard. We had to find the information on the internet. Metaforum emphasizes two years of multidisciplinary research from different universities and from different perspectives of life, and states that “the individual differences in development are indeed ⁇ large, depending on both the patient and his environment”. In the case of minors, it is assumed that a child and youth psychiatrist can determine the capacity of will by discernment. However, the objective assessment of the decision-making capacity is ⁇ difficult. For adults, there are specific tools to estimate this capacity in a structured manner. However, they vary greatly among themselves.”

I refer to this Metaforum report to say that there is no clarity about the criteria.

And then this. Obviously, it is necessary to determine age in other legislation, but not here. However, this is equally arbitrary.

Mr. Speaker, Mrs. Minister, Ladies and Gentlemen, dear colleagues, today we are gathered in plenary to address the difficult issue of the euthanasia of minors.

Allowing minors to resort to euthanasia is a complex topic, a difficult issue. Allowing a child to die: a phrase that no one would ever want to have to say. No doctor, no parent, no child would like to be in a situation where death is better than life. It is an existential question, a question of existence. Of existence and even of weight of existence, when it is too hard and this situation turns into resistance.

This is a difficult question, because it arouses pain and anxiety in each of us. In fact, it is our finitude and death is rarely accepted in our society. Some religions or philosophies see it as a passage to something else, to another world; others see it as a final point. For many of us, death is perceived as a pain.

So, to deal with the question of allowing or not allowing the death of a child, in our society, is eminently complex and must, it seems to me, be considered with humility, with respect for the convictions and mental constructions of each.

As far as I am concerned and as far as our group in general is concerned, I will support this project.

Some will speak and vote differently. We are well within an ethical positioning. We have had many and serene discussions between us. I would like to thank everyone for their mutual respect.

We will support this project because it allows the establishment of a necessary legal framework to clarify and soothe painful situations, but made even more difficult by the lack of a response to a legitimate request of a child in great suffering.

I will also insist on one important element, which we must keep in mind in the votes we will make tomorrow: the law does not force anyone.

The current legal framework and the one under discussion do not evacuate what exists or what precedes the discussions on the request for euthanasia. The law will not obligate anyone and does not exclude in any way the devices to alleviate suffering, used today, nor all the solutions and palliative care that our country has put in place more than a decade ago already and that we have supported.

I repeat, the law does not force anyone. We are setting up an additional system for those and those who want to use it.

I would like to repeat here some of the words I have already spoken in the committee. It would have been useful, or even wise, not to speak of extending the existing law dedicated to the major. It would have been more interesting to develop a specific law. The provisions relating to minors differ from those relating to adults. In other words, not all elements of the 2002 legislation will find an equivalent echo in the aforementioned provisions. I think of the repeated request, the written letter, the early declaration and, of course, the role of parents.

To better prepare this case, I met several doctors who perform euthanasia acts and who accompany families before and after these acts. This is a humble medical staff, listening to patients and their surroundings, who are there to soothe suffering, try to make life triumph, but also to allow humans in tremendous suffering to be heard, respected in the way they live or survive the disease, and in the way they wish to spend their last days, sometimes their last hours.

I remembered an important phrase from the exchanges I could have had with these doctors. I have already mentioned this in my speech in the commission, but since I consider it fundamental, I would like to repeat it here. They said to me, "In reflection, it is the patient who guides us."

For the medical staff who experience the pain of patients with an incurable disease, the will to make life triumph still exists. Euthanasia is not a therapeutic option. No one can justify suffering. No one wants the death of a person. Not a doctor. Not a parent. Not a member of the family. Not even the patient. If it happens that the latter is exhausted, that he can no longer, that he no longer wants bites that extend a life of suffering, of treatments, of operations, of whole weeks alive for a few thin hopes of breath of life sometimes crossing a discharged body.

When a patient wants to talk about euthanasia, they must be able to give them answers. Doctors I met have told me that when a patient wants to talk about euthanasia, it is that the time has come for him. Who are we to determine if the person still has to fight, that he cannot give up. Sometimes talking about euthanasia without carrying out the act would be enough to soothe the worries of a suffering human being.

If I say “being human,” it is intentional. Indeed, I believed to understand that in the daily life of untreatable diseases care units, the difference between a major and a minor does not really exist.

When speaking of a child’s discernment capacity, I was able to understand that for a medical team, it appears quite quickly that a child is in discernment capacity or not and that he fully understands the extent and consequences of his requests. Moreover, many often say that they consider that a child is, from the beginning of a treatment, in full discernment capacity. The medical body addresses him as an adult. He is told what will happen, what he will undergo as interventions, the extent of his illness and its consequences. When it comes to children, it is often insignificant to speak of major or minor but it is useful to know that children with the ability to verbalize or not will express differently their suffering as well as their willingness to mitigate it. We also need to know that at present the medical body already helps children to leave, whether through a cessation of care or through the establishment of comfort care through terminal sedation. These are not anonymous acts.

Finally, children who endure this test are often prepared for death. This also emerges from testimonies during these encounters: their room neighbor who left, the photos in the corridor of the children who preceded it. Nothing is normal in this course, but we must see that this journey transforms the personality of children and those who surround them and that this person, in the face of pain, in the face of the inexorable, in the face of the relentless verdict, evolves quickly. The people I met told me how impressive it was to see that these children were no longer and that their illness stole their childhood, their innocence, their carelessness.

With regard to the multidisciplinary team and its involvement in the assessment of discernment capacity, in a process of managing a life end resulting from an accidental serious condition or a serious and incurable pathology, a multidisciplinary team is set up to best accompany the patient and his environment. It is responsible for helping the patient and his/her surroundings to live this moment as best as possible. Often this team has been there since the beginning of the process and people have learned to know each other. From the testimony heard on this subject, I remember that everyone remembers the patients who left. Each patient has its own history and each member of the medical team also has its own history with that person. The act of euthanasia is never a banal act and remains engraved in the memory of each member of the medical team.

Therefore, and given the important role played by it, we considered, within my group, that it was important to involve the multidisciplinary team in the ability to discern the minor. During the work of the committee, we had submitted an amendment that goes in this direction. Certainly, this element is already present in the law on the right of patients, but it seems important to us to be able to mean it precisely in the provision concerning the minor.

Indeed, beyond the provision of the skills of a pediatric psychiatrist or psychologist, it seems to us that the multidisciplinary team, which follows the patient from the beginning, also has a good ability to analyze on the person and, precisely, on his ability to measure the extent and the consequences of such a request.

Many have spoken in this sense in recent days, from field people who know how much the team that surrounds the patient from the beginning is an excellent interlocutor to carry out this examination of discernment ability. That is why we are going to submit our amendment again.

Unfortunately, we had to see that we were not supported in the committee. We regret this because this amendment gives a greater role to the multidisciplinary team in examining a child’s discernment ability. Moreover, a large part of the questions that appear today can be calmed if we allow this change through our amendment.

It is important to consider the involvement of parents. As with any choice in the life of a family, whether it is separated or not, whether it is united or divided, sometimes the father and mother disagree, whether it is the choice of a school, an educational choice, the administration of medications or the establishment of heavy treatment. What one could see as a therapeutic hardness could be seen by the other parent as a necessity to keep alive.

Every human being reacts differently to the suffering of a child and even more of his child. Add to this anger, rebellion, denial, rejection, sadness, powerlessness, even fatality. Everyone reacts differently and this must be respected. Each person puts in place the means to hold the blow, not to fall. A process is triggered and the person will evolve with the illness, unfortunately, of his child and the different stages of treatment or non-treatment. Each situation is different. Every situation is a difficult pain to overcome for everyone, whether the child is adult or minor.

No one can predict the reaction of parents, of the surroundings, to the announcement of the inevitable, to the announcement of the horror, from wherever they come, whatever their convictions. But the multidisciplinary team is there to surround them. Parents and surroundings are involved. They are the partners of an inevitable process.

From the very beginning of the discovery of a disease and the diagnosis, parents are involved. The multidisciplinary team is there to accompany the patient and his/her surroundings in the difficult process. This is the case today, and this should also be the case for an euthanasia request made by a child.

A situation of a serious, incurable illness of a child is extremely difficult to live. The death of a child is not natural. This is unacceptable for parents. In general, if the multidisciplinary team is present - as Mr. Bacquelin, this is almost always the case – from the start of the treatment of an incurable disease, for which death is the only way out, parents are prepared to leave the sick child. The aftermath is always difficult, but it will be less, ⁇ , if you know that you’ve tried everything before.

That said, and with regard precisely to the text that is submitted to us today, we have also proposed an amendment regarding the way in which the involvement of parents and their role is considered.

The text submitted to us today states that the treating physician must ensure that the legal representatives of the minor agree on the request of the minor patient. This must be done in writing.

We have been asked and asked about a possible divergence of views between the minor patient and his or her parents. It is difficult for parents and for the medical team, when a child manifests exhaustion, to act as if nothing has been heard; but it is also difficult, and sometimes insurmountable, for parents to access this request.

What we had proposed in the committee, through an amendment, is to provide for the possibility for parents not to oppose the request of their child; that is, to open a third path between refusal and agreement. This would be the compliance of taking into account the precise request of a minor patient; and also taking into account the difficulty, or even inability, for a parent, to sign a document acting his consent to the death of his child.

Madame Boulet, this is contradictory. I hear you say a small sentence from time to time assuring us of your confidence in the caregivers. You also make a law about which some exclaim that children will finally be able to die in dignity. As if today, doctors and caregivers were not able to let children die in dignity!

As for your last parental remarks, you have so little trust in caregivers that you are obliged to pass a law. In this law – I invite you to think about it as a mother – you ask parents to sign, take their bic and sign the agreement to kill their child! It is terrible! Should parents be involved? and yes. This question is obviously existential and today they are associated with the end of life. Does it require the consent of the parents? and yes. But you have been up to writing in this law that they must sign for agreement. Ask yourself what your reaction would be if it was your child. It is cold in the back.

Madame Boulet, when I hear you talk about the multidisciplinary team, your words are amazing. You have negotiated the text. You seem to realize that our arguments are valid and correct.

On the other hand, I hear that you raise in a second point questions that are extremely difficult, especially for parents.

In this discussion, we must respect each other’s views. As I said in the introduction, Mrs. Fonck, this calls for things that are very difficult. You are parent. I am a parent. Even people who don’t have children are extremely sensitive to these issues. I told them that we should be respectful and humble.

I have listened to all the interventions from the beginning to the end and I will listen to yours too carefully if you intervene. I would have liked you to do the same. Apparently you did not listen to me.

The text of today indeed provides for the agreement of the parents. We are also looking for a new approach that will allow parents to...

The [...]

Madame Fonck, it also happens to you very often in the majority of supporting things... Isn’t that Mr. Brotcorne?

(Brouhaha on the banks of the CDH)

I ask you to listen with respect and humility to everyone’s views.

Dear Mrs. Fonck, I went on the field. I suppose you will let us know that you are the only one who has taken each other’s pulse on the field. It is not true! We will therefore submit an amendment on the establishment of a third route.

In order to be able to make their mourning, some parents will find it important to have been able to participate in some way in this decision. Others will say, “I can’t make this decision because it’s too difficult but I want to respect my child as a full-fledged patient and be able to tell him that I respect his opinion, even if it’s too hard for me.” For this reason, we put this amendment back on what has been called the “third way.” Some will say, “I can’t.” Others will say, “I can.” Have you watched the testimony broadcast by some TV newspapers? Others will say, “I cannot, but I do not oppose.” I think this is a respectable act. This is what the Ecolo-Groen Group offers today.

Finally, as regards the multidisciplinary team, we have already had these discussions in the Justice Committee, Ms. Fonck.

I personally trust her for the work she does today, for the work she will do tomorrow. Furthermore, I believe, as some hope, that the adoption of this legislation will clarify the framework, clarify a situation that sometimes leaves us uncomfortable.

Today, some pediatricians have ⁇ that they disagree.

Society is diverse. I think the world of medicine is also diverse; that’s also desirable. As said by mr. Bacquelaine, it is desirable to have a debate, it is interesting that we disagree, it is good that society is divided and that the medical body also thinks differently on eminently existential issues. All opinions must be respected.

To conclude on the agreement or disagreement of the parents, I will add that this third way could sometimes help parents to live their grief maybe a little more serenely. We would have appreciated that with our colleagues in the Justice Committee we could take the time to discuss this aspect and support this aspect of the problem. This is the point of the amendment we are submitting today.

Nothing is fixed in such a process. I repeat: one case is not the other, not all parents will react in the same way, not even the patients. Parents are forced to make important decisions concerning their children or to respond to existential demands on their part. The adoption of our amendment allows for more nuances thanks to the various options we define today.

The Senate worked almost nine months to produce this text. We believe that the result is going in the right direction. Nevertheless, I regret that the House could not have worked in better conditions and that we could not have taken more time, in particular to analyze the relevance of the two elements that we highlight through the two amendments, supported by many professionals.

As I stated in the committee, Mrs. Fonck, the decision is not easy. I think that you can respect each other’s positions.

On this question, but also on others, we asked to organize hearings. When we asked for the opinion of the State Council, I would like you to remind us of Ecolo’s position.

I made a proposal to Mrs. Becq saying that we agreed to propose a review by the State Council but that, given the little time we had left to work serenely in parliament, it might be more relevant to request a quick analysis from the State Council. This proposal was rejected, in particular by Ms. Becq.

It is well known that the State Council will only decide whether the body that wants to deliberate is competent for this legislation. He will not decide on the substance.

However, my proposal was worth considering. I have made suggestions, we have made openings. I have submitted amendments, I have requested that we discuss. I think I have given some signs of opening up. We are presenting amendments on the points highlighted in the committee.

We wanted to ask the advice of the State Council. We also asked to invite a group. Mrs Marghem proposed to invite the Netherlands, but everyone voted against. I wonder how we want to conduct this debate. Is it intended to be extended? Do you want to engage in a discussion? I assume that this discussion was apparently not possible.

Mr. Speaker, I would like to intervene simply to say that there is what you say, and what you do. In your actions, you refused the hearings. You have rejected the opinion of the State Council. I think that is very clear. And you shouldn’t reinvent history over and over again, because you’re probably uncomfortable with the expression of the set of pediatricians in yesterday’s open letter.

I am not uncomfortable, Mrs. Fonck. I made this known in the committee, when we discussed the referral to the State Council of hearings. I am sorry, but at some point, I joined the acts to the word. I am consistent and not at all uncomfortable. There is no worry. Other members of my group will speak. Therefore, I do not see at all where the inconsistency or the discomfort is.

Ms. Fonck, all this is known and how people voted is shown in the reports.

There was no doubt!

I would like to introduce a nuance. When we say we want to take the time to discuss a subject, it seems to me that we have the right to say it and that it has nothing to do with hearings, opinions. Parliamentarians may want to argue long with each other because the decisions to be made are also political decisions.

Also, Mrs. Fonck, do not try to blur the tracks with your interventions which testify to a closure of mind and to too much rigidity!

To colleagues Becq and Fonck, I would like to point out that with their presentation, they do some disgrace to the rich and relatively serene debate that we are conducting today. Although there are no experts today, there were quite a few important and relevant things said here. Also from members of Parliament who will not support this text, I have raised something today. That is my first comment.

Secondly, it has already been mentioned several times, but I would like to emphasize this also for the public opinion: there has been an enormous length of work on the design by our colleagues in the Senate. This can be repeated as often as it is said here that there would be no time for a parliamentary debate. There was a parliamentary debate. Now we are doing it in a qualitative way. There have been a series of hearings in the Senate.

Third, without wanting to be polemical – I address Mrs. Becq, because Mrs. Fonck may be more difficult to judge about it, since she was not present in the committee on the day concerned – I recall that colleague Boulet had formulated a proposal. She has tried to build bridges to get out of the annoying procedural discussion we had at the beginning of the discussion in the Justice Committee. She submitted the proposal for urgent advice from the State Council, but that did not interest you. That gave me the impression – I’m verry sorry – that it might not be the opinion of the State Council, but the delay of the parliamentary discussion. I think then that we do not serve the present delicate file by delaying its handling even further and discussing it in an electoral period. I am pleased that we are now conducting the debate. There has been a lot of preparatory work and colleagues have already formulated a lot of interesting comments.

There was indeed a discussion about an urgent opinion of the State Council. We agreed to ask for an urgent advice, but not a three-day advice, because it would only be about constitutionality. We agreed with the request for an urgent consultation on one month, but that could not be done because it was not certain that the texts could still be discussed in time. I am not saying that this was the position of your group. There was no opinion from the State Council. That is point one.

Second, the debate was indeed held and we can indeed do it now, but can you call it a discussion during two or three committee meetings? There are other proposals and drafts for which there are plenty of hearings and discussions in the Senate and on which hearings have been held here again, without causing any problem. But today, when it comes to euthanasia, that is a problem. That is the only conclusion we make.

Mr. Speaker, I hoped that another logic would prevail and that more serenity would reign during this session.

It is true that we rejected the opinion of the State Council. But for this text that comes to us from the Senate, the President of the Senate, Mrs. de Bethune, could have asked this opinion of the State Council alone, without a vote. We would then have had a text with the opinion of the State Council. But there was no demand. Similarly, subsequently, no request was submitted by your group, by the CDH. Suddenly you feel the need. We have worked. If we held three sessions, it’s because you didn’t want to talk anymore. We have always said that we should not vote specifically at a given time. We were open to discussing for hours and listening to you to try to move forward.

The debate took place. It continues today. Everyone has to give their position.

I would like to see no more those eyes that judge us! We should not oppose people who, in conscience, will vote for or against. You are giving us lessons. I regret it.

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Ladies and gentlemen, I’ll let everyone talk. This is unbearable for everyone. I give the floor to Mr. Brooke who asked for it.

I will try not to be unbearable.

What our colleague Karine Lalieux has just said sufficiently demonstrates what has been said from the outset, namely that the Senate has not necessarily worked in the best way possible.

You tell us that our Senate group has not sought the opinion of the State Council. That’s why, today, we consider that this is a gap in the way the case has been dealt with, even if only for the quality of the legal terms used and to avoid any inconsistencies.

I am surprised, however. I do not feel that the debate that is taking place here is not serene. It is not because someone expresses an opinion that is not that of the majority who supports the proposed text, because I say that I do not agree with this text, that I eventually dismantle its mechanisms and that I sometimes put my finger on the political will to go fast, that I do not allow the serenity of the debate.

I just express a point of view that is not yours and with which you disagree. I don’t always agree with yours, even though we are sometimes in phase, Mrs. Boulet. I wish that sometimes we can go beyond our own intentions and that actions can follow. This has not been possible and I know that things are not so simple. This proves at least one thing: what we are doing now shows that our text is not mature and is not sufficiently secure.

I have not heard any instigation, no scream, no accusation. We ask questions, we ask clarifications from time to time. I don’t understand why some people accuse us of wanting to argue. We are talking quietly. In the questions asked, I do not see any of them being moved or ad personae. We must stop making us believe that every time there is a question, it is a controversy and an incident. and no! This is a serene debate, and it is very well so.

Mr. Speaker, I will conclude by saying that I am serene and that I do not feel uncomfortable. This is really a difficult debate and there will be different expressions.

I would like to repeat that even though it is an ethical vote and colleagues will vote differently – and I respect their point of view – our group is in favor of this legislation.

The legal framework will clarify the situation when the limit of the tolerable is reached for everyone, for the patient but also for the family and the medical team. When the minor patient has made a request to be able to stop living because life is too rough and he is exhausted, it is necessary to be able to hear this request and provide an appropriate response. This is the meaning of the text we support today.

Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker. Bacquelaine stated earlier that we all have the right, in this assembly, to have different opinions. On a matter as sensitive as this—everyone has said it, I’m not going to go into the pathos on that subject—it’s illusory to think that we’re going to reach a consensus and a text that would satisfy everyone. Let us accept the difference; let us accept ourselves as we are.

Excuse me already if I am going to express a point of view which is not the point of view of the majority; but do not believe that by this, I do not want a serene debate and I attack personally one or another person who would be carrying an opinion different from mine. Thank you, let’s stay here!

I have not been instrumentalized, Madame Lalieux, by anyone. At least I did not have that feeling. I also do not have the feeling, Mr. Jambon – but he is not there – that if I express a point of view that is not consistent with his, I do everything at once from the political low. No to No! I try to give you the point of view of my group and mine at the same time.

I will extend my argument in four points. First of all the method. Then, the question of whether or not to legislate. Then, our point of view as a political group: I think that it is not enough to say that we disagree with a point of view, but that we must state our position and what we would rather have considered to develop. Finally, as a lawyer, I will put my finger on some difficulties that appear to me when reading the text. Other of my colleagues, more knowledgeable on the medical aspect, may intervene on other elements of this dossier.

First element: I have a real regret, and I think others here share it, even among those who support the text. Mrs. Boulet’s intervention also makes him think. We may not have, at the level of the House, done all that was necessary to impregnate one another of the necessity of this text, of its quality, and of the fact that it would meet the objectives pursued by the authors of the proposal.

It is true that we only had two small afternoons of debate; Mrs. Lalieux spoke of three. Per ⁇ we had a presentation from Mrs. Minister quite quickly at the end of the committee and we started the discussions at the next meeting.

This reminds me of prisons: it is the minimum service. The minimum service that the Chamber could undertake in such a file.

I have often heard many of our colleagues praise the work of the Senate: extraordinary work, numerous hearings, etc. It was enough to take his footsteps, trust him and vote as one man, or almost, the text coming from this assembly. I confess that I have hardly had the habit of hearing such language in our parliament; rather we have the feeling that the Senate operates as it desires and that the House must review the texts, reapprove them and re-discuss them.

As a committee, I told you that on a personal basis, I would have liked to build up an intimate conviction following hearings, readings of written opinions, complementary to those that had been provided to the Senate, very necessary as we see it today. In fact, practitioners question us, all of us as legislators. Are you not going too fast? Are you sure of what you are doing? Are you surrounded by all the useful and necessary hearings in order to grasp the subject?

We could have answered such questions without, however, undermining the will of some, willing to vote on this text, not by urgency – except election deadline and end of our work in a few weeks – but because it was unimaginable that this text could not result from now and that our work must be restarted in the framework of another parliamentary session after the elections of 25 May. On such subjects, either we took them earlier and we had the time to carry them out, or we gave ourselves today the time to perform the work properly.

The medical world has reacted, but the legal world has also reacted to this text. In this case it would have been indicated to take the opinion of the State Council and to conduct hearings. It is not too late: can I try the call to this Assembly, wise by definition, to take back the time to go to the bottom of things and to send the text back to the assembled committees of Justice and Public Health – even this has not been “allowed” to us – to try to reach a result that keeps the way better?

This was about the method adopted.

The second point that I would like to address is whether there really was a need to legislate on this subject. As for the emergency, I have already stated that, in my opinion, it did not exist.

That said, some claim that requests come from minors for euthanasia to be applied to them. Others say these demands do not exist. I do not have enough data to make a definitive opinion. In any case, if there are requests, they can only count on the fingers of one hand. I’ve heard of five requests, but I don’t know if they are distributed over one or more years. Still it is that this does not seem to be a very large or widespread demand.

I can remind you, dear colleagues, that when a law is drafted it is in the general interest and not in response to particular or exceptional cases that do not justify legislation.

The debate that is taking place today in civil society shows sufficiently that cases are rare, which doctors confirm to us. The example of the Netherlands that adopted a law on the euthanasia of minors proves this. In view of the figures that have been brought to my knowledge, there was no demand in this direction. This is a country where legislation has been enacted while there is no demand. The Federal Commission for the Control and Evaluation of Euthanasia said there was no request for the 18- to 20-year-old. This comforts me in the idea that the need for legislation is not established. It is necessary to distinguish between what falls under the general interest and the common good and what falls under the particularity. In my opinion, everything leads to the belief that the bill on the extension of euthanasia to minors will have an anthropological scope that overlooks the exceptional cases to which it wants to respond.

Can I also indicate – Mrs. Minister of Justice will ⁇ not contradict me – that, to my knowledge, no file has been transmitted to a prosecutor’s office which would have transmitted it to a correctional court, or even to a court of assises, due to the revelation of an euthanasia practice.

Usefulness, necessity or urgency? You can legitimately ask the question. Finally, is the purpose of the bill to provide a legislative framework for euthanasia of minors to avoid legal uncertainty? Or is it more about protecting the doctor who would have practiced it, when the law does not allow it? What is the purpose of a law? Where is he? I have not yet understood or met him. It is known that end-of-life situations are treated, managed and accompanied, but that euthanasia is not an act claimed, claimed with a voice and cry as being an emergency and a necessity, by the medical body in particular.

What is the position of the CDH, as a political group, in relation to this bill? I will tell you first of all that we consider a society to be measured by the values it intends to promote. For us, however, the protection of vulnerable people is a fundamental value. We want and understand that this fundamental value remains in our society.

Children are granted a certain degree of autonomy. But, at the same time, we all agree that the minor is, by definition and by essence, a vulnerable person. I refer you, dear colleagues of the Justice Committee, to our interesting and important work on how to treat disabilities, including those of minors. We wanted to adapt and modernise our legislation to make it more effective, taking better into account the interests of these vulnerable people. We want to continue in this direction.

Faced with this double objective of the minor’s autonomy and of his necessary protection as a vulnerable person, such a project that authorizes the euthanasia of minors and that, somewhere, allows the minor not to make the choice of death but to ask ... This is the nuance that is done today. It is not the right of the minor to be euthanized but it is the right of the minor to request euthanasia, an act that will lead to the death of that minor. Everything but banal. Therefore, surrounding us with as much opinion as possible was not inconsistent and unacceptable.

Extending the law on euthanasia to minors implies, furthermore, by force of things, even implicitly, even indirectly, involuntarily ⁇ , imposing on this minor a questioning, a choice when he will be confronted with a serious and incurable disease.

Every seriously affected minor, at the end of life, could in the future be tempted to say, "Now that the law allows the euthanasia of minors, that I am affected by this serious disease and that I am at the end of life, will I ask for euthanasia, should I ask for euthanasia?" Imposing such questioning constitutes a violent approach, hardly acceptable. It cannot be denied the increased fragility of minors, even if, simultaneously, a minor in such a situation may have a greater maturity than that of minors who are not confronted with this situation.

But also from this state appears an increased fragility. Is one sure that the proposed choice, that the faculty left to the minor to make this choice, will he be able to manage it? Do we not risk, by extending the law on euthanasia to minors, to make the idea pass through that ultimately, euthanasia is a means among others and like another to allow people to no longer be a burden for their relatives, a burden for society? Somewhere it is shocking and unacceptable!

In the face of a young sick at the end of life, is euthanasia the only answer we want to bring? I think I can answer by the negative and that is the case for all members present in this homicide. I think no one will say that is the only answer. But is this the only priority response to which we will need to join all our efforts and on which we are working? Is euthanasia really the appropriate way to respond to the suffering of young people? Is it not more essential or more fundamental, in such a situation, to convey a clear message, which would say in essence that our society will not abandon him, that he will be accompanied by his family, by the medical and caring team and that, to the end, that this team will do everything possible to remove suffering?

In recent days, we have heard enough of such prominent personalities as the director of the University Hospital for Children Queen Fabiola tell us that today, treating suffering is something quite possible, feasible.

It is possible not to remove, but to relieve the pain.

In the Senate report, I noted that doctors who practice euthanasia and palliative care specify that in 90% of cases, patients who apply for euthanasia eventually opt for these palliative care after they have been listened and their situation taken into account.

For us, as elected Humanist Democrats, the priority would rather have been to alleviate the suffering of patients and develop the training of health professionals in end-of-life accompaniment. For us, it is essential to strengthen and multiply initiatives aimed at improving the end of life of minors, in particular through pediatric palliative care and the linking palliative care teams that go to the home of the young, who is not always and necessarily hospitalized, in order to offer a multidisciplinary approach to the child and his family. Furthermore, we consider that relatives (parents, family, friends) should also benefit from enhanced support in such a dramatic situation as this. Their suffering is very real, often difficult to overcome and also deserves special attention.

If I had to summarize this philosophy of accompanying patients at the end of life in one sentence, I would paraphrase an emeritus cancerologist and French academic, Jean Bernard, who said: "To add life to the days when you can no longer add days to life." As a paediatric palliative care nurse told the Senate: “It is premature to start a reflection on a possibility of extending the euthanasia law because not everything has been done to improve the conditions of accompanying and receiving these seriously ill children and their relatives.”

Therefore, dear colleagues, was it not a priority to work on these palliative care before considering any amendment to the law on euthanasia?

Extraordinary work is currently being done by palliative care teams and we still seem to have a long way to go with them.

In particular, I think of the need to strengthen and adequately fund the nursing staff of multidisciplinary home-accompanying teams, improve access to home-patient caregivers for palliative care, and develop family rest mechanisms to allow experienced families who participate in accompanying their loved ones at the end of life to breathe for some time.

This is the position that we want to defend as our elected members.

As regards the text submitted to us, it is provided that the minor who is faced with physical and unfathomable suffering and whose death is expected to occur shortly, must formulate his request. This should be submitted to a pediatric psychiatrist or a psychologist who will evaluate your discernment ability and the parents must give their consent.

In order to legislate, we impose conditions and modalities. There is no legal text that is not accompanied by terms and conditions of application. During the work in the Senate, the text was subject to amendments. Between the original version and the version that the Senate has adopted and that it asks us not to modify, otherwise we will no longer be in time for an approval before the end of the legislature, because of the necessity that there was to gather a majority on this text, it has become inconsistent. Indeed, by drawing from one, by keeping what the first had written, by rewriting to please a third, one ends up with a text that presents serious inconsistencies and which will open the door to a lot of legal uncertainty.

We can make a trial of intent. When amendments are submitted, or when they say they want hearings, or when they ask for the opinion of the Council of State, it is not to make a back guard struggle, of lingering conservatives who absolutely do not want to hear about this text brought by a majority. From the moment when a majority considers it necessary, useful or appropriate to legislate, it is our responsibility to ensure that the text is the best possible and that it is not a source of legal uncertainty or interpretation.

In this regard, I think the text is completely missing its objectives.

For me, and for others who have already emphasized this, a primary source of legal uncertainty is this criterion of discernment capacity. The minor who is likely to issue an opinion must be able to discern: this reference has been preferred to that of age.

It may be that age is not the most obvious criterion, but it has the merit of clearly distinguishing the boundary between minority and majority from the 18th year. Before the age of 18, the young person cannot make certain acts; afterwards, he can do so without raising existential, philosophical, ideological and other questions. Maintaining an age is a real criterion, but the commission did not want it.

She has preferred a case-by-case approach, a personal approach that takes into account the particular situation of each minor, considered individually according to his own formation, his ability to understand, his own faculties, his perception of the medical condition in which he is. Certainly, but at the same time, she instituted this ability to discern as a magical criterion: it would allow to respond to situations on a case-by-case basis; it might be more human, more understandable to apply the proposed text.

I do not agree with this position at all. Indeed, imposing the criterion of discernment capacity raises many questions. At this point, I have at least five and I will share them with you soon, if you allow it.

As part of a request for euthanasia, what does discernment mean?

Mr Browne, we would like you to proceed a little faster. I understand that you are asking questions about elements included in the law: what does “short term” mean, “discerning capacity”, “the opinion of a child psychiatrist”, etc.

Are you against euthanasia?

Yes, I think I first had... If you had listened to me – but it’s true you were a bit apart, ...

I have listened.

I’ve even said that I agree with you that we ⁇ ’t agree. Yes to! I said: Yes.

Honestly, where do you want to go?

I just told you; I think I was very clear in the way I formulated things. From the moment one considers, or a majority considers, that legislation is necessary, it is our responsibility that the text be as good as possible.

I have said! If you had listened to me, Mr. Bacquelaine, you would have heard it; therefore – I will not repeat, otherwise the president will still remind me of the order – we would have liked to ask for the opinion of the State Council, to hold hearings and we have submitted amendments.

We could also say that we have not submitted any amendments to the Senate. In the Senate, our group considered that it should be so. And here, we considered that if there should be text, this text should be the best and least subject to interpretation possible. Because, Mr. Bacquelin, problems may arise, that’s plausible.

On the number of euthanasies, some tell us there are no requests for minors; others say there may be one or the other. In these few possible cases, we will see that the text as you propose us may cause difficulties.

If I raise the question of discernment, it is because in the commission, the Minister of Justice, who also represented the Minister of Health – not the government since it is not a point of government – did not necessarily always answer all the questions.

Where did I want to go in relation to that? A capacity for discernment, that is, a free and informed consent; a consent given after information has been provided to the person concerned. Will the minor in the dramatic situation referred to here – an incurable disease, unbearable suffering, a terminal phase – understand the scope of the explanations given?

Do we also have the certainty that this demand, due to its discernmental capacity, is indeed its own; that it is not a consequence of the feeling of its surroundings? This can also sweat and cause you to make a request that is not necessarily yours.

The second problem I see in the way the text is written is that the person who will evaluate this criterion, from whom sufficient skills and knowledge will be required to evaluate this criterion of discernment, will be a pediatrist or psychologist. However, these experts have not been heard in the Senate.

We have not audited those people to whom we are going to give an extraordinary responsibility, that of telling at a given moment whether, yes or not, a minor is capable of discernment. We did not hear them. It might have been interesting to know how they took up this mission that is intended to be entrusted to them.

At the limit, if it is a pediatric psychiatrist, it still passes because it is a doctor who has special training for children. If it is a psychologist, I regret having to say it, despite all the recognition I can have for the title of psychologist, but psychologists are not often doctors and they are not necessarily ⁇ devoted to the problem of children and sick children.

Do we agree that they will be asked to speak about discernment capacity and not about health status?

Yes, the law requires the psychologist or pediatric psychiatrist to assess the child’s discernment ability. I come to my third observation, namely that the law does not give him any tools to know how he will appreciate it. Under what criteria? From his only experience, from his only personal interpretation? It is delicate. The consultations of these professionals might have helped us.

To tell a young patient at the end of life that his application will first be submitted to a person outside the team that has accompanied him since the beginning of his illness and that that person will appreciate if he is able to understand what he is asking is an intrusion that constitutes additional violence. If things go well, it goes again. But if the pediatric psychiatrist or psychologist gives a negative opinion. This means that there is a barrier to the faculty that was offered to the young. He is told that he can ask for it but that there is a barrier because he has not received a consistent opinion from the pediatric psychiatrist or psychologist and that, consequently, his request for euthanasia cannot be pursued. Isn’t this adding suffering to suffering?

Mr. Brotcorne, you just confused me. You say, if there is a law, it should be as good as possible. That is why you submitted amendments.

and yes.

Are you not in the logic that there should be a law? For us there should be no law.

I said that too! Amendments will be submitted on the accompaniment of multidisciplinary teams. This is what my colleague, Ms. Fonck, will come to explain soon.

But I answer your question: for me, a law was not necessary. I said this recently during my presentation.

That is true, but if all amendments are accepted, is there a law or is there no law? If there is a law [...]

I just said that from the moment you discuss a law, I try to make sure it is as good as possible. You may not agree with me, but that’s how I see my job. We do not always agree with everything we are proposing, but we still try to improve the texts.

The second source of insecurity is the place of legal representatives. by Mr. Bacquelaine said earlier that it is a multidisciplinary team that is involved. But at some point, who makes the decision? Is it the child who makes the request? Is it a multidisciplinary team? This is how things are presented to us. I, when I read the text, think that there are at least two categories of people who have some form of veto in this case: it is the pediatrician or the psychologist who would say that the minor does not have the age of discernment and it is the legal representatives who could say, by common agreement, that they do not want it. This is the easiest case to imagine. Everything stops and there is again, suffering in relation to the state of the minor. But what if, tomorrow, the legal representatives, in the case of father and mother – they may be together, separated, divorced – do not have the same point of view on the matter. What if one says yes and the other says no? Should you say no to a child’s request? Is an appeal open to the parent who considers that his or her point of view has not been taken into account? Will he rush to the courts of the judicial order, in reference to the president of the court of first instance, to obtain that his right be consecrated? There is a risk. I am not saying it will happen, but it is plausible. From the moment we legislate as we do, where we impose terms and conditions, if one of the conditions is not met and someone thinks he has the right to have his point of view recognized, he will go to the courts. There is therefore an obvious risk of a judicialization of a situation which, in my view, does not need to be and which will further accumulate difficulties.

The last source of uncertainty, I think – we’ve already talked about it here – is in relation to the Patient Rights Act. I recall that in the Law on the Rights of the Patient, a minor who is considered to be able to understand his or her particular interest may, on his or her own, consent to a therapy or to a medical act. They do not even need the consent of their parents. Here, we are in conflict with the Law on the Rights of the Patient, since the minor whom one might say is capable of discernment and who asks to benefit from euthanasia may be answered that his father or mother does not agree and cannot claim it. And the Minister, to whom the question was asked, was unable to answer us.

She was also unable to answer us when we asked her what would happen if a pediatric psychiatrist or a psychologist claimed that the child was not capable of discernment. Can one ask a second pediatric psychiatrist or psychologist to evaluate the child, or even a third or a fourth? When does the chain stop?

Mr. Speaker, I conclude my speech by recalling that we consider that extending the law on euthanasia to minors can be interpreted as spreading the idea that euthanasia is a means like another to allow the young to no longer be a burden for his loved ones and society. We cannot accept it!

We believe that the debate on euthanasia that we are currently dealing with should be resumed in a much broader context of accompanying people at the end of life. We are in favor of the establishment of a thorough reflection on palliative care, on the improvements that can be made in terms of providing care and accompanying relatives.

Mr. Speaker, dear colleagues, in the face of a suffering minor, we believe that euthanasia is not the answer we want to offer him because it is not the message we want to address him. In contrast, we rather defend the message to be passed on to this young man that he will be accompanied to the end by the caring team, that everything will be done to avoid his suffering and that the dialogue that has been created between him, his parents, his relatives and this caring team will not be interrupted but that on the contrary, in this especially difficult phase for him, he will be supported by his relatives.

I think it should also be supported by the law!

There are 10 speakers.

I would like to remind you that the Regulation stipulates a maximum speech time of 30 minutes per person. I ask you to respect it.

For a discussion on a draft law, the Rules of Procedure are set for a maximum of 30 minutes per person bedraagt. But that is not an obligation.

Mr. Speaker, Mrs. Minister, colleagues, of course, we also have respect for all opinions that pass on the floor, no matter how different and different they may be from ours. I can immediately say that I have heard from the colleagues in my group that we all still have the most affinity with the argument of colleague Becq. With us, there are relatively fewer Christians in the group, but I think that is not the focus of the whole discussion. I also immediately add that we ⁇ do not want to make it an ideological struggle or an ethical conflict. In my presentation, I will focus on the legal aspect, in consultation with my colleagues from my group.

I would like to add that the more than three thousand emails and letters we have received in the last few weeks have definitely impressed us. Not only was the number impressive, it also applied to the statements taken, in this case against this bill, both on the ideological, philosophical, ethical, political and legal level, by doctors, nurses, child psychologists, child psychiatrists, lawyers and let us mention. Therefore, the temptation is very great to quote them. A selection would then in fact be necessary. However, I did not dare to do so, because everything that came upon us was very valuable. I would like to thank them for taking part in the debate, whether on the internet, whether through the mailbox. They cannot come here today to give their opinion, but therefore we stand here, of course, as representatives of the people, in this case against the legislation, as it will be approved and because it will be approved, let that be clear.

I give a good advice to those who are in doubt and who will be given the opportunity tomorrow in their group to vote differently than the majority of the group. Read the emails and letters, go through them. There are very good things in it. These matters are so striking that I regret the way they have worked in the committee.

No advice has been sought from the Public Health Committee, no hearings have been organized, for example, nor with aid providers who in the Netherlands provide palliative care to children and minors whose life is approaching the end of life. That would have been very useful. Also in the majority and on the French-speaking side there was apparently demand for it, but that question was wiped off the table.

Colleagues, I find it very regrettable that it is almost an abnormality here today that we wanted to step into the Council of State, because we are critical of the bill. This is not an abnormality. The political games have not been played today, which have been held in the committee. The political games came from those who otherwise invoked the Council of State. Of course, one party uses the State Council as the other cannot use it, and vice versa. As for this bill, I repeat what I said in the committee. If this does not go to the Council of State, why does the Council of State still serve?

The debate in the Senate has been conducted extensively. Why is the Senate removed, and not the Chamber? Here the debate could eventually be held only halfway, not on the basis of all the arguments that everyone would have wanted to know.

In short, colleagues, the parliamentary debate culture has been violated this time in the House, ⁇ not in the Senate. That is why I regret it even more.

Colleagues, I had announced that I would choose a number of legal inserts to criticize the bill. I cast three questions. They are in the same line as colleague Becq’s speech. But well, in such a fundamental discussion it is not intended to hold a more original discussion with more tires and bells.

First, as a lawyer, I can say that the concept of “judgment capacity” creates a problem. Nowhere do I see constitutive elements that give a complete and full-fledged definition of the “judgmental capacity of a non-disabled minor.”

In law, we know the concept of “action capacity”. This is very clear. It begins at eighteen years. When the age of seventeen ends and the age of eighteen begins, one is capable of action. The concept of “judgmental capacity” is now introduced for a definite choice that a non-abduced minor must make. A disabled minor cannot buy a home. He cannot take a mortgage. He cannot sell a vehicle. But he is considered fit to decide to take his own life in his own hands.

The question is whether it is not encouraged by anyone. Talk to the minor. That minor does not live alone in the world, as much as a major who may want to end his life, in whatever condition that person is in, because the euthanasia law goes far beyond that for adults than for minors, even if the present draft is approved today. I am delighted about this in a certain way. Nevertheless, considering a minor judgmental without giving a conclusive definition of it, and leaving it in the hands of so-called experts, I find very dangerous.

I come to my second point, namely the definition in the law, which is very important. I quote: “The minor patient who is judgmental is in a medical unlikely state of persistent and unbearable physical suffering that cannot be curated and that within a foreseeable time results in death, and that is the result of a serious and incurable condition caused by accident or disease.”

These are seven elements that play a role in passing to euthanasia of a minor on his request. One would say that those seven elements are very weighty, well-considered and balanced. All these factors must play a role, but I draw one out: “within the foreseeable term”. What is a foreseeable deadline? Children sometimes live for years with an incurable disease. They often suffer unbearable pain. Everyone in their personal sphere may know children who have been terminally ill. No matter how bad it is, one has been able to experience it. Often, one lives even stronger with a child than with an adult.

Sometimes the pain at the end of a child’s life is much less intense than the pain experienced one or two years earlier. Therefore, “in the foreseeable term” is a stretchable and vague concept. The situation can last for years and then problems arise.

I present to you the following hypothesis, which really is not meant to mock anyone. Imagine parents coming to tell you that they had a fifteen-year-old daughter who was incurably ill and suffered physically unbearable pain and whose suffering could no longer be relieved. They were convinced that their daughter would die within half a year, have been on a journey with her and have let her fall asleep, on her own request, while she may – no doctor knows how to tell – have six months to live. This is a ⁇ cruel casus.

I don’t think the law will apply to this, but theoretically it becomes possible with the legislation. It should be well understood that minors may at some point choose to end their lives, when they suffer unbearable pain and are incurably ill, even if they are not at all at the end of their lives. That can. This is even possible with children aged ten. In the present legislation, children are now made a kind of mini-washers, what they are never. That is the contradiction today between those who believe in the feasibility of man and society and those who do not believe in it and are not convinced of it. We ask respect for those who do not believe so much in the evolutionary nature of everything that is science and history, and who do not believe so much that man and society are feasible.

The third and final issue is the euthanasia. Indeed, a whole process has been developed. Some argue that the multidisciplinary team ultimately has no control over the euthanasia of the minor, others believe so. Eventually, a child psychiatrist and a child psychologist will intervene. Of course, that’s no more than logical, but it’s still a “but” advice. Ultimately, the consent is with the child and the parents.

What if both parents differ in views? No response has been formulated to that. There is no solution for that. Can you imagine that at the end of a child’s life, in those last days or hours, one parent must go to court to stop another parent, or to urge the other parent to give his or her consent? This may be the case with the legislation that is now in place. I am convinced that you have wanted to avoid all this, but the law as it is now written can be implemented in that way. Where is a child’s peaceful and decent life?

Finally, colleagues, I have my legal argument behind me, but I still want to check for a moment the genesis of this law, of this legislative initiative as it has left in the Senate. The reason why we discuss the law on the end of life of minors who choose to do so here today is in fact in a very different issue that was initially chosen to extend the euthanasia law. Proponents of euthanasia were and are convinced that the law should be extended. That is their good right. It has begun – let this be clear – with discussions about people who are dementia. It was not just about demented elderly, the largest group. It was about people who, consciously, capable of acting and also judgmentally, at some point in their lives, are faced with the choice of whether they want to live even further at the moment when they no longer have all of their spiritual abilities. The question was whether they could make that choice at any given moment. However, that discussion turned out to be too difficult. It is not a shame to say that the advocates of euthanasia have had to crawl back and have had to give up this intention. In the end, the discussion ended up on a side track, with the group of minors, and with this I do not mean that it was not intended to discuss this side track as well. In the end, therefore, one has landed at this very small group of persons whose life is approaching the end and who could make a choice, the group of minors. At least, the supporters of euthanasia have agreed that minors can make that choice.

So the debate ended up on a very different track. I have the awkward feeling that the supporters of euthanasia today think that they should pull this out of the fire in order not to perish in the eyes of their backbone. Again, it is no shame that the problem of demented elderly has not been solved.

A very different thing, and I am formally in it, is the fact that in some bills – including that of sp.a – it was written that premature borrels could be euthanized up to 24 or 26 weeks after birth at the request of the parents. This is a bridge too far for us ideologically and ethically. I know that the debate today is not about this, but it was explained in the Committee for Justice by the sp.a. group.

I find that a very dangerous evolution, because then one decides on the end of life of human beings who cannot make a decision about it themselves, who have absolutely no judgment capacity, let alone be capable of action. A very large group among the supporters of euthanasia apparently wants to go there. This too was eventually removed from the discussion, fortunately.

I quote a member of the British Conservative European Parliament, Nirj Deva, a man of Indian origin. “The irony of human history shows that when we start deciding which human lives are worth living, the moment inevitably comes when someone else makes that decision for us.”

At some point, others in our place will decide whether our lives are still worth living. As for me, the debate is therefore contaminated. Therefore, I fear that when this matter comes to the table again in the future – there are lobbies in certain areas, and euthanasia is ⁇ one of them – there may be no step into the State Council, there may be no hearing again, and that the decision about the life that is worth living can be given in the hands of others.

I therefore understand the perception on the international level, where Belgium has a questionable figure. I just gave an English-language quote, but I ⁇ do not agree with all the negative considerations about this law in the Anglo-Saxon world. That convinces me, as a Flemish nationalist, the more that it is very difficult to judge other cultures from one’s own culture and that one cannot simply judge other cultures from a certain view. The criminal judgments on this law, especially from the United States, I ⁇ do not make to mine.

However, you must realize that Belgium, which loves to play the conscience of the world, will have to sing a little lower from today. This is also the voice of the Council of Europe. I do not make those statements into mine either. We have our own vision and we are opposed to the Flemish Interest in our own way, so we do not make all those statements our own, not even the statements of the Council of Europe. However, you must be aware that the cameras here will not appear tomorrow to wave the country. If only Belgium suffered, it would hurt me less, although this is not the law we should cheer for if Belgium hits a mud figure. However, the Flemish and French-speaking communities will not do well when this law is passed. Belgium will once again become the country that is the prey of ridicule, because I have seen it in the media in recent weeks. Flanders, Wallonia and Brussels will also bear the consequences.

It is the same as it was when the law on adoption by holebies was introduced. For a very small and very limited group there is a heavy ideological struggle. At the international level, the boomerang will eventually return. Let’s look at which countries have all refused to allow adoptions to Belgian parents because holebi adoption is allowed here.

Colleagues, it may sound cruel, but Belgium has since the previous euthanasia law already landed in the post-Kevorcian era, as I call it. Everybody will have heard of that doctor, Dr. Kevorkian, who traveled around the United States, not to commit euthanasia, but to help people in suicide. This discussion has not yet been fully carried out, but I would like to make a distinction. There is another difference between euthanasia, on the one hand, and aid in suicide, on the other. Euthanasia occurs in the light of the end of life, where a push is given. For one it is ethical, for the other it is not. Assistance in suicide occurs when people sometimes suffer not even physically but mentally intolerably, and when they have not fallen into the prey of an incurable disease. Well, that debate is not held with this bill, but it is at least indirectly a consequence of it, because the colleagues who are absolutely in favour of euthanasia always want to go further. Helping in suicide is thus in fact legitimized in Belgium.

I would also like to refer again to the Federal Control and Evaluation Commission, which in fact makes it misleading. Although there are numerous cases of euthanasia, an ever-increasing number, there has never been any criticism from that committee. At the same time, we should be well aware that both on the French-speaking and Dutch-speaking side the supporters of euthanasia in that committee are in the majority, if I am not mistaken. Until now, it is a “comité de salut public and faveur de l’euthanasie.”The functioning of that commission will nevertheless have to be thoroughly examined again, because it is impossible that in all those cases of euthanasia committed since the introduction of the law, there has been no irregularity. That cannot be fooled of me. That committee wants to make us believe that we live in the perfect world when it comes to euthanasia, but those who believe in it will definitely hit the ball wrong.

I will end with what I started. The last part of my presentation may have been ethically and ideologically coloured, but that was also just to outline how the contradictions between pro and contra euthanasia relate.

Finding a middle way is very difficult. You must always choose. Finally, the end of life is also so radical. It ends or one continues to survive. In any case, it ends at some point. When it is chosen, it is a black-and-white choice and the consequences are also black-and-white.

I conclude by saying that this law ultimately creates more problems than it pretends to solve. This is a sad matter, especially in such a very sensitive case. The Flemish Interest will therefore vote entirely and unanimously against this law.

Mr. Speaker, Mrs. Minister, dear colleagues, suffering is unbearable for anyone, and the suffering of a child is even more.

Today, no patient, and therefore no child, should suffer. As I said in the committee, each end-of-life situation is unique and requires a particular approach.

I am not against the principle of euthanasia even for minors. Requests can be submitted, even if they are exceptional. Palliative care allows to control suffering and to maintain the quality of the relationship of the seriously ill child with his relatives, but sometimes we fail to control these two aspects. It is in this context that ethical discussions become difficult.

Even if the most sophisticated medical conditions are at the appointment, even if the environment is formidable and accompanies the sick in a remarkable way, sometimes one finds himself in the impasse. In this case, the question of euthanasia may arise. The request for euthanasia must be heard and considered.

Of course, this is my position here as a nurse, as a doctor who has often been confronted with very seriously ill and end-of-life patients.

This is not a debate for or against euthanasia. We are not in the patient’s bed. Here, we must consider a bill whose purpose should be to establish a general rule and not to regulate exceptional situations.

I have heard some of you, in the committee, in this hall, but also some senators, say that, thanks to this law, children will finally be able to die in dignity. Dear colleagues, unlike you, I think that today, caregivers already accompany seriously ill children as best as possible and in dignity.

The open letter that ⁇ 200 pediatricians have sent to you – I don’t know if your group leaders have sent it to you – contains a sentence that I can’t stop reading: “In the current state of medicine, the means to soothe suffering are widely available in our country, much more than in most other countries.”

Further in the text, pediatricians say: “This political precipitation creates the impression that the situation is dramatic in our country and that action must be taken urgently. We oppose this false impression with a formal denial and affirm that the situation in our country is far from dramatic. Probably, it is not borrowed” – it is to you that they address, ladies and gentlemen – “a sufficient attention to the praiseful and effective initiatives of many caregivers. Their work will never be appreciated at its just value.”

I have heard some of you say that finally children would have the right to request euthanasia. But, dear colleagues, children already have the right to say that they can no longer, that they suffer and that they want to die. Your law does not give a right to children whatever some say, whatever some believe.

I also heard you say that you worked seriously and rigorously. The state council is broken! Not interesting, despite all the unanswered questions that remain. To all the questions we asked in the committee, the answers were laconic. But, Mrs. Minister of Justice, I understand that you cannot transform yourself into a minister of health in two shots of tablespoon.

All the questions of the caregivers, including those addressed to the Minister of Health, remained unanswered. The Minister of Health, by her absence, sends to the Senate, in a committee, in a plenary session, the signal that this debate does not even require that she is interested in it. We must be the only country in the world where the Ministry of Health considers this issue as totally anecdotal.

Since this is the tone, maybe we will have to change the tone too!

Never, absolutely never, nobody, nor those who have deposited this law, nor those who will vote this law have questioned the capabilities and talent of our caring staff. No one has ever done it, and no one can afford to do it. We have a remarkable care staff. We here allow to get out of acts that are undoubtedly placed in our hospitals in the illegality and we allow the caregiver, the family and the child to be in the legality. This is what we will frame today.

I also recall, as has been said and repeated in the tribune, that the child is given the right to ask that he may diminish his suffering by an irreparable act, that of giving death.

It seems that when this law is passed, a caring staff will be pleased to practice euthanasia. There is obviously no obligation, no incitement, no willingness to make sure that there is euthanasia everywhere in our hospitals. There is simply a possibility, a freedom, a choice.

I do not know how you can make these intention trials to the Minister of Health. It is just shameful. The Minister of Health participated in our discussions. She is interested in it. She is a mother, like you, Mrs. Fonck! To say here that the Minister of Health finds this anecdotal debate is totally insulting, and I oppose it.

"Without a doubt is not paid sufficient attention to the praiseful and effective initiatives of many caregivers": these are not my words, Mrs. Lalieux. These are the words of the caregivers themselves.

Thanks to this law, a child will have the right to ask for a reduction in suffering tomorrow, which would mean that today, children do not have the right to ask for a reduction in suffering. I am false about this. Of course yes!

Contrary to what you said, the Minister of Health has not participated in any of the discussions on this matter! By its absence, I think she considers it an anecdotal or accessory question. Yes, I think we must be the only country in the world where the Minister of Health is not interested in debates on the issue of minors euthanasia, is not interested in the questions that caregivers are asking themselves today, is not interested in how caregivers will have to take this law into account, is not interested in the gap that exists between their obligation to comply with the law on patient rights and the law you propose to us. Madame Lalieux, I cannot accept your attempt to protect the Minister of Health.

Dear colleagues, since you have not taken the effort to listen to the caregivers in the Chamber – and the Minister of Health – I strongly suggest you read the open letter that the pediatricians have sent you. Oh yes, you considered that the interventions from the outside were instrumentalization!

Ms. Fonck, I ask you not to systematically attack one another.

I will say what I have to say. Ms. Fonck continues to show bad faith. We believe that this case deserves more than controversy, than personal attacks. Mrs. Fonck, you persist in saying, “I know, and you don’t!”

Mr. Speaker, I think I will leave this session because I can’t hear such things anymore!

We should try to keep a little bit of serenity.

In my view, Ms. Fonck highlights one element that has disturbed us all. I imagine that some colleagues, including some who support this bill, also regret the lack of a debate in the health committee, with the minister. It’s not controversial to say it, but, objectively and calmly, I think it’s amazing!

I believe that we are the only House in the world that has not gathered the Health Commission or the Health-Justice committees to organise this debate. This is not an attack, but it must be said.

Mr. Dallemagne, I may be the only one in this Assembly to have listened to the debates since the beginning of the session. All your arguments have already been advanced many times by your group; we have heard them and heard them again.

I will therefore recall that during the parliamentary work carried out, questions were asked at each stage and decisions were made by the members of the committee. Repeating on the same subject is like crying over spilled milk.

Votes were held at each stage: did joint committees, hearings, the opinion of the State Council need? No requests were submitted. The Senate also did not issue a request for opinion from the State Council.

A request has been submitted here for the Council of State! So then here!

Mrs Fonck, stop: if there was a request, was it formulated correctly, was it supported?

Did you say it was rejected? There is no request to the State Council.

I think someone can intervene and give their opinion. That opinion may then be contradicted, after which the other may still give his or her opinion. Between hooks, the question regarding the Council of State is correctly asked. Then she was voted out. We have said so, and I think we have the right to say so.

We won’t repeat it until the end of the night.

More and more fast, faster, faster!

Would I dare to tell you what I intended to say? Or is it anyway, when we disagree with you, you don’t let us express ourselves! Mr. Speaker, I wanted to tell you that as President, I would have appreciated – especially since you received a few days ago, this new letter from pediatricians – ...

I interrupt you. Listen to ! It was not a few days ago. It was yesterday afternoon!

It is even better!

A few days, it was not yesterday. It was yesterday afternoon that I met with the two representatives of the signatories of this letter and I met with them in the afternoon because they had wished it to be Tuesday afternoon, after their morning press conference! I could not meet them before. They had not asked to do so. I met with them for an hour and a half and in the hour that followed, the group leaders received the document!

This is the reality. Do not distort it.

The request was made on Friday for the meeting to take place this Tuesday afternoon!

It is even better.

I think that from that moment on, it would have been good if we could hear all these people or at least their representatives. You received them yesterday. Today is another day. We could have had the decency to listen to them. It was nothing! Let us pass!

I interrupt you again.

They did not make a request to be heard. They simply asked to give me the letter symbolically. I heard them; I listened to them and I offered them to pass their letter to the heads of the group and this proposal satisfied them.

You might have, at some point, as a group leader, formulated the request. You have not formulated it.

It is true, but we had firmly expressed in commission the will to audition pediatricians.

I have a lot to say about the petition I have been referring to. I read this petition with great attention. We have received many of them in our mailbox. I have full respect for the arguments.

However, there are 1,300 approved pediatricians in our country and all pediatricians in our country have been asked several times to sign the petition. But here the power of the number does not play, Mrs. Fonck. I do not even want to abuse the fact that the vast majority of Belgian pediatricians have not signed the petition. There are only a small two hundred of them. I fully understand their argumentation.

In fact, however, the petition adds nothing to the work a people’s representative has to do in this regard, namely, make an ethical choice. The question is whether we extend the difficult balances contained in the 2002 euthanasia law to minors. That is the ethical choice that lies before us today.

Your reference to a petition and the request to hear certain people still, I begin to interpret more and more as it does not want to listen to the arguments. You use the petition to delay working on a file that you disagree with. This is a falsification of the debate. I invite you to talk more about the arguments than about the procedures.

Everyone can express their opinion. Everyone can argue. Everyone can also recall the framework in which the work was done. That is why I started.

Let me now go back to your bill. I see a positive point in this: you have avoided supporting a possible form of assisted suicide, as the 2002 law permits. It is true that the recent example, mediated by Prof. Distelmans, of 45-year-old blind twins, who had no other disease and no incurable disease, is in this regard enlightening. Here, you have limited to minors suffering from an incurable disease, whose death is expected in the near future and who suffer in an unremitting and constant way. On this point, I agree with you.

On the other hand, while you announce that you are going to clarify the situation (some have said that we are going to improve the end-of-life situation of children; the expressions of each other were sometimes a little different but went in the same direction), you actually create legal uncertainty, or even more: you add difficulties to the already terrible suffering of the child and his loved ones.

What strikes me most is the legal uncertainty you create in the event of divergent opinions from parents. You have not provided a procedure in the law. You cannot, of course, predict all cases. It is impossible, in essence, to provide for cases of figure in the law. I repeated this at the beginning of my speech when I gave you my personal position on euthanasia. We are not here in a debate as caregivers.

Mr. Minister of Justice, you even taught us, following our repeated questions, that Justice would then decide. In those situations, when there is a divergent opinion of the parents, you prefer a law that organizes the possibility that a judge chooses instead of the persons concerned and caregivers. You organize the possibility of judicializing such important decisions, especially personal and medical. I think you add violence to suffering.

We came to the committee with a number of other elements. I would like to emphasize again the proposals we made in the committee through the amendments. I would like to propose five further improvements to the law.

What are we asking? First, we ask that the law provide for the involvement of parents from the beginning of the procedure and not only at the end of the course, after the pediatrician or psychologist has given their opinion on the discernmental capacity of the child. Second, we ask that it be the multidisciplinary team that, in the first place, ensures the discernment of the minor and not just the psychiatrist or psychologist. This is an essential and extremely delicate point. It is this multidisciplinary team that often knows well the child for a long time and is able to evaluate this discernment ability best. Third, we ask that it be a child psychiatrist – not a psychologist – a child physician, trained for this, who gives his opinion on the discernmental capacity of the child. This is a delicate point. Even pediatrists who deal specifically with adolescents say it will be extremely difficult, in a very large number of cases, to know whether or not the adolescent is considered to have this discernmental capacity. Fourth, we request that parents and relatives be provided for psychological support, including after the death of the child. Fifth, we demand that the palliative care teams be strengthened. Dear colleagues, did you know that pediatric home palliative care teams have been waiting for years to be strengthened by a pediatrician? You have refused it. We’ve gone past the essential: really improving life goals and supporting caregivers.

All of these proposals are supported by field professionals and medical academies who gave their opinion last January. You have rejected all these advances in the committee. We will vote for them again tomorrow, but I have no illusions. You are going to sweep these amendments with a back of your hand, as you did in the committee. All you are interested in today is to vote this bill in the House, door or window, as soon as possible, to be sure you can hang the pen on your hat!

I will end my speech by telling you that caregivers have not waited for the vote of this bill to listen to the suffering child, who is facing the illness and to respond to his suffering, and that is happy.

Mr. Speaker, Mr. Minister, I would like to thank my colleagues still present for continuing the debate at such a late hour.

As usual, I will intervene without pathos and going straight to the goal. I am speaking here personally. I will vote in my soul and conscience against this bill.

Life has taught me that suffering is strictly useless and that it must be fought wherever it manifests itself. I am, of course, a representative of the people, attentive to the demands of the citizens, but I will not be the spokeswoman of any camp, lobby or pressure group.

The world is not always divided into two, and I ask myself what brings us together here. What unites us is that we will all die one day, dear colleagues, whether we want it or not. Now, we are fortunate, because of our age and our mandate, to be sufficiently adult and loaded with experiences to reflect together on the question that is asked to us.

As I have mentioned, there are not, on the one hand, people more ⁇ sensitive to suffering, especially that of children, and on the other, people totally insensitive, or even almost torture. We all have the same concern for suffering children and we pay special attention to their parents.

Nor are there persons willing to guarantee a death in dignity or in freedom, and on the other hand, people blind and deaf to human distress in the face of death. We can all agree on these points.

I would like to ask a first question regarding the bill on which we are supposed to vote. Why this law? Why now ?

If one is in good faith, it cannot be disputed that the promoters of this text have arranged so that the latter can advance relatively quickly and be adopted preferably before the end of this legislature.

Obviously, if amendments were to be voted here, the text would go back to the Senate and it would be voted a little less quickly. There have been pressures, even if they are not unlawful. So why such an urgency? In general, there is urgency when facing a disaster, when an extraordinary social demand is expressed by citizens, when it is necessary to bring clarity after controversial judicial decisions, or when there is a total lack of alternative to facing an intolerable situation.

As far as I know, none of these are present. No court has appealed and has not yet ruled. We do not know of a complaint that would be under investigation or a case pending before a court. I have also not heard, if the problem is so important in our society, a strong social demand emanating, for example, from parents who would be in this dramatic situation, which nobody of us obviously wishes to live, and who would organize petitions and demonstrations or who would let their representatives know that we must face and end this kind of voidness of the law.

It turns out – I read it in the hearings reports that took place in the Senate – that the request was formulated, on the basis, by some doctors. This is their right because they are faced with the situation in the first place. I absolutely do not challenge them the right to want to pressure, so that a legal framework be established for practices in which some are already engaged today. But I consider that even if legal certainty is necessary, it does not automatically result in the arrangement envisaged by this bill.

I also note that only one country – and that intrigues me – has legislation on euthanasia for minors. It is a neighboring country: the Netherlands. However, during the work in the commission – Ms Becq recalled – there was no need to bring and listen to people from the Netherlands, who are involved in legal processes in that country, and who have practiced, moreover, since they are men and women of art, a number of interventions.

So we have neighbors who have legislation and apply it and we don’t even ask them what the problems are, if that legislation is the right one, if it has gaps, if it can be improved. No, no questions were raised and could not be expressed.

I am not a doctor and I analyze this text with the eyes of a lawyer, but to say that nothing has been done for suffering children in Belgium, it is a little loud. I imagine that through everything that exists, alternatives can be chosen. That some members of the commission could have interpelled, it is their right: they are in the House. They read the Senate hearings, of course, but they could have also questioned Dutch doctors who participated in this process to ask them the questions according to their wishes.

We are free: the phrase has been repeated.

Mr. Speaker, I don’t think it has been said that in Belgium, until today, no one cared about the pain of children.

We have voted for a law on palliative care, provisions are being put in place – and I am the first to ask for strengthening them – regarding algology in order to take better into account the suffering of children. Euthanasia refers to a category of specific cases. Despite all these steps, sometimes we may not encounter a demand, suffering, or experience too difficult in relation to these sufferings.

The rest of the system exists. If we want to strengthen it, we will all approve. This is not a proposal against others. I never heard that we had not taken into account the suffering of children until now.

Mrs. Gerkens, you immediately understood that I didn’t want to argue. I can agree with you, but up to a certain point.

In relation to the effect of urgency, to the rapid advancement of this file, under this aspect, you have ⁇ your knowledge of the file; I do not have your knowledge and I would have liked to be able to interrogate people specialized in this matter to make me aware of the thing.

I will not return to the arguments put forward at the time and in the committee – Ms. Boulet was there – according to which in the Senate, the Health Committee and the Justice Committee systematically deliberated together on the ethical level. Why does the House Committee of Justice not request to work with the Health Committee or does not request its opinion? That’s all I want to say, but I wanted to remind you.

When a framework is created, it has a self-realizing effect. However, it should not be treated in an imprecise manner; on the contrary, since requests may enter this framework.

I now come to my fundamental concern: the arrangement established by the bill. If one makes the economy of the obligations incumbent on the treating physicians and on those who must be consulted – all words matter – the request for euthanasia expressed by a minor will not be admissible, admissible and not yet accepted, only if four conditions are met: the minor is endowed with the capacity of discernment, his legal representatives sign their consent in writing, physical suffering is constant, unbearable and unbearable and, finally, the fatal outcome is near and nothing can prevent it.

So we can see that the entire architecture of this device – I stand there and I see it with my eyes of a lawyer because I enter the bottom of the text – revolves around the discernment capacity of the minor. But who establishes the ability of discernment? The text is clear on this subject and answers it without ambiguity in first intent. Your amendment had some subtlety and relevance, but it is unlikely to be supported, as was the case in committee. It is a pediatric psychiatrist or a psychologist called in consultation by the treating doctor who must specify to him the reason why he appeals to him. A priori, it is a guarantee but everything then rests, in the first intention, on the judgment of a single specialized person outside the child, which can be both an advantage and a disadvantage. And the whole process stops if the child does not find the ability of discernment of the child.

I have a reflection on civil rights and the right of responsibility. All the lawyers present in the room know that the discernment capacity that is the subject of analysis in the context of liability proceedings involving minors receives from the jurisprudence a fairly diverse amount of analysis. In our law too, we have a discernment capacity which is used by family judges, more precisely before the youth courts, when, under the age of twelve, for separation conflicts occurring between the parents of a child, there is an assessment of this capacity by the magistrate on matters relating to alternate accommodation or other arrangements within the framework of the separation of parents.

Furthermore, in my experience, I have seen many times psychologists and psychiatrists interviewed on profiles have opinions so divergent that one still has the right to be circonspect about how things will go according to the law and about the capacity thus granted to a single person, however qualified it may be.

I recently heard my colleague, Ms. Fonck, say that there is sometimes a lot of divergent opinions and that most of the time, even for teenagers – especially for teenagers, if I heard right – it was extremely difficult to determine with certainty that the child had the necessary clairvoyance in his judgment on the object that occupies him, namely the end of his own life.

This is only a first question.

I would like to reiterate that the ability to discern must, in my view, be attested by a psychologist or pediatrist. This is a medical act. The ability to discern or not to discern is determined on a medical level. Furthermore, even if the discernment ability is written and attested by the paediatrist or psychologist, the doctor in charge of practicing or not the act of euthanasia can still say that he considers that the conditions are not met!

This is the real responsibility of the doctor who, in the end, will be the accountant of the accumulation of the criteria.

This is and always has been the spirit of the law. Euthanasia for the elderly is like that.

The [...]

Of course yes! It is written in every letter.

The care team that follows the long-standing child could also indicate to the doctor who is in charge of practicing euthanasia that it believes the discernment faculties do not exist. What will the doctor do?

He will not practice it.

and exactly.

It is not certain.

Therefore, it is not the opinion of the pediatrist and psychologist that is necessary and sufficient. It is necessary but not sufficient.

I don’t think a psychologist is a doctor.

Mr. Bacquelaine, you’re a doctor and I don’t have your science because I’m just a poor provincial lawyer. I would like to be explained what the medical act of assessing a minor’s discernment is and how this assessment is different from what a judge does for a minor under 12 years of age heard in a family case or what another judge, through experts, can do in relation to a minor involved in a liability case. For me, this is not obvious and I have not had that explanation.

I would like to trust you, but, unfortunately, the text does not say so. The text could have expressed things differently, as it is done for the major, where it is said that there is a repeated request, which needs to be enlightened, etc. You can therefore objectivize a concept a little better. However, since this is an exception to a criminal law, it is necessary to require a great deal of precision in the drafting of the text. It is not enough to say that we are giving ourselves to the lights of the medical body, towards which I have no typical or characterized suspicion. Mr. Bacquelaine, we had the opportunity to talk, I was very questioned about what you report to me about the daily life in the hospitals, where I really had the impression that a lot of things were being done in a hypocritical way, without giving the necessary guarantees ...

So why is there no action in court? People are not stupid!

Mrs. Marghem, on the one hand, I hear that there is a lot of practices that are done after discussion. You acknowledge that there are practices that take place in our hospitals without legal framework, without label, without counter-expertise, without legality. This interpelled me! I prefer to have the choice, freedom and legal certainty, without the obligation to do so. You are talking about doctors.

I didn’t say that, I heard it.

I would be surprised that Mr. Bacquelaine returned the medical body in question!

The essence of a debate is that. I hear things I have never heard!

I never said that. On the contrary!

You told me this recently, in a singular colloquium!

Even in singular colloquium, you do not understand!

I am imperfect! I do not have the ability to discern.

What I said is that terminal sedation in palliative care is a fairly widespread act. Terminal sedation is nothing more than an act of euthanasia, in fact, since it shortens the period of life and makes it possible to bring the moment of death closer. This is the terminal sedation, otherwise we don’t agree on anything at all! And I know that the many pediatricians who wrote to us in November did so because it posed them a problem! Because the terminal sedation act was not legally framed. But it was still shortening life and bringing death closer, and thus it is a problem. I would like to reiterate this, because it is important to know that at present, there is no legal framework in this regard. This is not an anodin act.

And how!

And, of course, it is committed in order to ease suffering. This is not a malicious act, but it is practiced outside of any legal certainty. This is a problem that is not banal. Also, when we want to give a legal framework that presents more security, this requires more restrictive conditions, of course, but that can be fulfilled with the collaboration of the patient and his parents. Overall, this is a progress that is not small.

Colleague Marghem, I can follow you when you say that sedation is not necessarily the same as euthanasia.

I did not say that.

You want to clearly distinguish between sedation, palliative sedation and then, a step further, disproportionate sedation. This is sedation in which both in terms of depth and duration of sedation, one goes beyond what is medically necessary. This happens in everyday practice and is actually equivalent to euthanasia. Only it is not so appointed and in those cases not always – I blame no one – the consent of the patient is asked. When you are acting medical and you are dealing with a judgmental minor, you should actually also seek his consent for sedation, palliative sedation or the step further, for which there is no legal framework. If on that level one can judge whether or not one is judgmental and one can make peace with his consent, even if we are talking about palliative sedation, why would it not be possible in cases where euthanasia is really requested? If one can give consent in one case, for the purpose of palliative sedation, one must also be able to assess whether one is judgmental, when it comes to palliative sedation or euthanasia.

I know that all these concepts are complex and their definition can sometimes vary from country to country. However, we have agreed on a legal definition of euthanasia. This is what is important today in the context of the discussion of a law text. And the legal definition of euthanasia has nothing to do with terminal sedation, absolutely nothing! It is an act that is made with the intention of administering death at the request of the patient. We are not at all in the case of terminal sedation. And if we take your definition, which is not the legal definition, should we conclude that for cases of terminal sedation, we will have to follow the procedure we are defining today?

If the current law on the rights of patients is applied, it is indeed what we are obliged to do.

This has a huge consequence.

If it was about taking your definition, which, once again, is not the legal definition, do you imagine all the procedures that should be put in place?

There must be a demand, of course.

The patient’s consent for the care provided to him.

Is it care or is it something else? This is the question.

Mr. Bacquelaine, in the committee, we had already talked about the fact that amalgams are made between fundamentally different notions: discontinuation of treatment, therapeutic deescalation, palliative sedation or the act of injection, i.e. the injection of pentobarbital for euthanasier, evoke very different situations.

Palliative sedation only aims to relieve pain, but is not intended to accelerate death. While a child is on morphine or in combination with morphine and central neurological drugs, it may become mandatory to increase doses; therefore, his illness – I insist: his illness – leads to loss of consciousness, but the only goal of the operation is to relieve and not accelerate death. In contrast, injecting a cocktail containing pentobarbital into a sick child is an act that results directly in death.

These concepts are very different, Mr. Speaker. Since we have addressed the topic, I thought it was important to clarify it; otherwise we risk creating a melting pot of these fundamentally different notions from the act of euthanasia.

Mr. Speaker, I have a question for Mrs. Fonck.

Mrs. Fonck, I have heard you say that a clear distinction should be made between sedation, palliative sedation and euthanasia. Can in cases where there is more than necessary in terms of the duration and depth of the sedation, agents such as morphine be administered, in short, in the case of disproportionate sedation, whether or not euthanasia is spoken of?

Do you think, Ms. Fonck, that in all cases before switching to sedation one must have the consent of the patient, yes or no?

Do you know if in practice the consent of the patient is always asked before one moves to sedation, whether or not disproportionate? Do you want to recognize that reality or do you want to close your eyes?

There is no need to have eyelids. This is not controversial. If caregivers were present, they would explain things as they are clearly defined, including in evidence-based medicine. I am not in the process of inventing a concept here, far from there. These are clearly defined concepts.

Is palliative sedation an euthanasia? No to No! By administering a little more morphine in response to pain, you can’t know in advance if the child will go into coma. After all, you know; but there are children who will not necessarily, with that dose, because of the serious illness, the situation, fall into a coma.

Conversely, when you inject pentobarbital, you don’t wonder what will happen next. You know it. Injection of pentobarbital leads to death. This kills. A sedation that increases, from one child to another, from one situation to another, the child ...

But no, it does not kill. But no, frankly, we are not going, we, legislators, to rewrite the way ...

But yes, the purpose is completely different. Pentobarbital is an act that leads to death. Morphine responds to the need for pain relief. I think it is not at all about the same purpose, the same act, the same notion.

I give the floor to Ms. Gerkens. After that, Mrs. Marghem can continue, if she wishes to.

It is important to say that when you practice or request euthanasia, it is not the same thing, not the same process, not the same type of relationship as in a process of palliative care and sedation to prevent the person from suffering or to accompany him, feeling that it will take two or three days, towards the end of his life.

Euthanasia, it is true that once the product is administered, a few seconds or minutes later, it is over. This is why we are writing a different text. We do not say that it is the same and we do not allow confusion.

It should also be accepted that, regardless of the device, it is a process both of the quality of life of the patient and of accompanying his end of life, until death.

Either the person does not ask for action so that it ends quickly, and then there are all these processes that exist; or the person asks that it ends, and one enters into the framework of euthanasia.

But, in any case, it is the end of life and death. This is equally painful and requires equal attention for the patient and the accompanying person.

Madame Marghem, I invite you to continue.

Mrs. Gerkens, thank you for the clarifications that we missed in the committee, which close this debate and show that the concepts used are far from being known and handled accurately by everyone, and in particular by the promoters of the bill.

So I come to the second point that I wanted to address. At what age is discernment presumed to exist? The bill is silent in this regard, which is not the case with Dutch law, which has retained a pivotal age, namely 12 years. This is reduced to examining the arguments raised by the supporters of the bill, whether or not they are members of the committees that dealt with the matter, whether they have been consulted or whether they have chosen other ways to speak. I will not begin to argue about what can be seen outside our parliamentary halls or what can be read in the Senate hearings report.

It is still that, according to a specialist heard by the Senate committee – so I limit myself to our parliamentary halls to avoid any trouble – I quote: “A four to five-year-old child is able to understand a lot, that’s true, but, until the age of eighteen, children don’t understand the definitive character of death.”

If one follows this view, one is therefore entitled to think that the capacity for discernment can exist, at the earliest once the eighth year is fulfilled, that is, nine years. But things are not so simple. Indeed, it appears in view of the hearings transmitted by the Senate, an argument developed, tonight, by several speakers who, I quote, “Sick children demonstrate a very high maturity. As a result, the mental age is more important than the calendar age.” Such an argument can only be observed.

To explain to you the non-confessional context in which I intervene, namely the confessional thesis of the redemptive value of suffering, I have difficulties accepting the thesis that an extra discernment in the face of death would derive from the suffering of the young child, especially since, as indicated by some interventions, in the absence of clarifications from the promoters of the bill – one is in the vague and this is the eternal problem –, the discernment capacity would consist in the faculty to understand the definitive character of death. But to understand the definitive nature of death in general is not to understand the definitive nature of one’s own death. So, in abstracto, whether death is the definitive end of life and a child of seven, eight or nine understands it, does that child ipso facto have a clear consciousness that his death is the definitive end of his own life?

Who of us knows exactly what representation a seven, eight, nine-year-old child makes of death, ⁇ his own?

It is all the more complicated that a human is not only a being of reason – you know, you said – but also a being of flesh and blood that builds itself in its relationship with others and, for a child in particular, in its relationship with his parents. I see it many times in family matters. There is an exchange that takes place spontaneously and capillarily between children and parents. Who will be able to share, in a child of seven, eight, nine years, between the ability of pure discernment of the reality of death and the response he makes to his parents to put an end to the pain he discerns, sees, experiences on their faces, in their attitudes and in their words. Who, then, can know, dear colleagues, in whose favor the discernmental capacity of the child will play?

It has been said that it is important to give everyone the right, and I also want it, to die in dignity or freedom and to be the decider of their own life. But I can’t believe that a child of this age (nine years old), when he or she is already sentenced to death by a disease or accident, is given a real power to decide over his or her own life.

There is also hypocrisy here.

The last question: what are the effects of discernment?

The text of the project is clear. “The ability to discern is a necessary but not sufficient condition. It is necessary, in order for the transition to the act to take place, necessarily, in all cases covered by the bill (which is not the case in the Netherlands), the agreement of the parents (which is logical) taking into account the parental responsibility established by law otherwise.

Is it consistent to put on the same foot—it has been said, but I repeat it—from the point of view of parental responsibility, a child of seven, eight, nine years (to take the supposed age of reason) who might tomorrow have the necessary discernmental capacity, and a teenager of seventeen, seventeen and a half, for example. According to our laws, at eighteen, a young person can become a member of parliament; he can represent the people, vote laws, appeal and give his confidence to a government. In short, it can participate in the management of the country, of one of its Regions or of its Communities. The same young man, who would be hit at seventeen, shortly before the elections, by a pathology or an accident should ask and obtain the consent of his parents to die, according to some, in dignity.

Is it consistent to place a seven, eight-year-old child and a young person who could be under extended minority status in the same category? On the one hand, an absolute majority is granted to that child who might have the capacity to discern, since he will have the right to dispose of his own life, and on the other hand, the extended minor, the young man is ⁇ ined in the status of complete minor. Is there not a real problem?

by Mr. Philippe Mahoux, also a doctor, himself asked the question to the Senate. What about those who do not have the ability to discern because they have disorders or because it is decreed at a given time by a psychologist or a multidisciplinary team that they do not have the ability to discern? The essence of the project, based on a “attested discernment capacity”, in addition in writing, ensures that there will be two categories. This is the state of necessity, which means that, for the same pathology that would affect, on the one hand, a child who would be proved to have the capacity of discernment and, on the other hand, a child who would be a minor prolonged, therefore a distinction would be established between those who have the capacity and those who do not have it or who cannot properly express it. There will therefore be an inequality in the face of death: on the one hand, the capacitors and, on the other, the needy.

I have a great difficulty in accepting this kind of distinction and inequality, dear colleagues. I would also like to point out that I am not an opponent of the 2002 euthanasia law. On the other hand, I have fundamental objections, ⁇ revealed by the disturbance of the discussion that took place just recently, against the precise arrangement established by the law which, in my opinion, should be much more precise and much more thoughtful in order to ⁇ the goal it pursues. That is why, I repeat, I will not vote in favour of this law.

First of all, I would like to thank you for the rich and almost always serene debate, both in the discussion in the committee and in the plenary session. The word “serenity” has often been sincerely used, sometimes slightly less, but in general we can be pleased that we can conduct this debate as representatives of the people. The freedom and the extent of the debate are important. In our group, as in many groups, I have found, in such discussions there is a freedom of opinion and vote. That freedom is virtuous for the assembly and gives rise to a richer debate. That statement is important enough to mention them.

There was a lot of talk about the procedure. The first thing I want to share with you, colleagues, is that I am comfortable with the procedure. Why Why ? Not because we had a megalong parliamentary discussion in the House; for us, it should have taken a little longer. I just referred to the proposal of our group to build bridges, as regards the Council of State, but we have failed to do so and the procedure in the House has gone fairly quickly.

Nevertheless, I believe that there should be no misunderstanding about the quality of the parliamentary and social debate. The debate is not new, my colleagues. Those who consult the 2002 hearings find that this point was already on the agenda at that time and was an element of discussion. We are now in 2014 and therefore one cannot say that we as a society have gone ice overnight and that it is a new issue.

Second, in order to avoid misunderstandings, it is important to keep repeating that our colleagues in the Senate have done important work. This is not an absolute but an important argument They have heard a lot of people from the field. Many references have been made today to the protest that lives on the subject, and I respect that opinion, but let us not forget that there has been a debate in the Senate, and also elsewhere.

Third, without wanting to be polemical, I sincerely feel that some colleagues who warn or protest against the speed of the parliamentary debate are a bit selective.

Our group very often stands on the floor to request, for example, hearings, where we sometimes ask to complete them in a day. We now propose to ask for an urgent procedure in the State Council, but we face resistance. That does not testify to the openness that colleague Boulet and I have shown in such discussions. Without wanting to be polemical, this comes to me as selective, in the sense that if the result does not please, the procedure is sharply criticized.

Mr. Calvo, first of all, I look forward to the tone you use and the serenity of your words. However, there are two aspects that I would like to address.

The first concerns the debates that took place in the Senate. It is true, there has been a lot of debate, a lot of hearings; a lot of people have been heard; a text has been composed and approved in the Senate. But on the elements of this text, there were very few hearings. There were no basic hearings. This is what annoys us today. That is why we have these debates today on a whole series of concepts.

On Alzheimer’s disease, on dementia, etc., there were, I believe, fourteen bills submitted to the Senate. And it was necessary to clear the ground; this was what the hearings allowed. But on the device of the law, there were not the necessary hearings to form an opinion. This is what we wanted.

The second thing: you actually regret that being in the opposition, some of your proposals are not held. Should it be understood from this observation that the debate that we are occupying today is a majority against opposition debate? I hope not!

Absolutely not. In the end, we may not be so far apart in this regard, Mr. Dallemagne. You yourself indicate that there were several bills in the Senate. There were two series of hearings. What is presented here is the result of that long process. I think the process can be called long, constructive and qualitative. That reassures me. I can take peace with those hearings. As a representative of the people, as a person – because it is clearly an individual issue – I can then engage in the debate based on, among other things, that information. I also referred to the fact that this is not a new debate.

Mr. Dallemagne, there was no work on a draft. Thoughts were exchanged. Personally, I feel ready today to make a well-considered choice tomorrow. I listened to your arguments. You also have enough arguments to make the other choice tomorrow. Whether you are for or against, there is a lot of information on the table. Many stakeholders have been heard. As for the procedure, we can be reassured.

Moreover – this may be a pragmatic consideration – the dossier deserves to be discussed all but in pre-electoral and electoral times. The debate threatened to run out of hand from time to time, but it would have been much more difficult in a couple of months. I think it is good that we can judge this matter tomorrow in honour and conscience and in the highest personality.

Overall, the debate has been quite serene, but at certain moments I still got an uncomfortable feeling due to the zeal of a number of proponents and opponents of the bill. I like an assertive political debate. However, the current case deserves, even on the floor, restraint and modesty.

There should be no misunderstandings about what is ahead. I have noted a number of statements by colleague Becq. There has also been a lot of pressure tweeted on the issue. I am also a furious twitterer, but it is not immediately a file that can be summarized in 140 characters.

It was suggested that supporters of the present bill believe that euthanasia is the only worthy way of ending life. This was suggested at some point in the speech. This is not the case, and I think it is very important to clarify that. If one is in favor of the bill, it is not said that euthanasia is the only way to end life.

I have seen, in addition to Mrs. Van Cauter’s intriguing comments, another suggestion from you, Mrs. Becq, in the parliamentary debate and on social media, and I would like to disprove it.

You have suggested on social media, Ms. Becq, among other things, that supporters of the bill would find it almost irresponsible if parents didn’t choose that one track. Let it be very clear that this is absolutely not the case. You also suggested quite a bit, but I assume that this happened in the emotion of the debate, that the supporters of the bill would find it the most courageous choice. In such situations, Mrs Becq, there are only courageous choices and there are only courageous people.

As a supporter of euthanasia for minors, I say very clearly in the public that in such situations there are only courageous choices. Whether it is euthanasia or anything else does not matter. There are only courageous people at this time. Please do not make any misunderstandings about this. Also, do not put words in our mouth that we have absolutely not spoken, neither our group, nor Mrs. Van Cauter, nor Mr. Bonte, nor Mrs. Lalieux.

I will not put words in your mouth that you have not spoken. When you say that all thinking tracks are courageous choices, I am very pleased with that. But I can later give you some texts from which it is very clear that the new law is identified with progress and called progressive. We all need to be well aware of the message we transmit. We must not give the impression of emphasizing one choice, that the other choice is inferior. This is our concern, which we want to express.

The fact that you can’t explain so much on social media isn’t my fault. Apparently, just the short explanation is much more important than the nuanced explanation in ten sentences.

I thank you for that clarification.

I would especially like to be very clear. If I press the green button tomorrow, like a large part of our group – others will make a different vote, which I equally respect – it’s not just to force that one choice. I do not want to promote euthanasia for minors. I just want to give mothers, fathers and children a choice. If one does not accommodate that choice and does not create that framework, then one actually says that that one option is inferior in that particular situation. As a legislator, I do not want to make such a claim.

I want to give people the opportunity to weigh against each other those different possibilities that, in my opinion, are equally courageous and equal. That is the situation that does not exist today, neither for parents, nor for children, nor for the caring staff.

There is often reference here to the caring staff, one claims to know the sector and the people and one wants us to look at the open letter. If we look at the reports of the hearings, then there is also a question in the field of obtaining a clear framework to be able to weigh the real situations that one is facing. That’s what I mean: people have the choice to make. If I press the green button tomorrow, that doesn’t mean that as a father I may – I hope I’ll never be confronted with it – make just that one choice. This is a different discussion, a different choice. What one makes possible as a legislator and what happens in a concrete situation, what one would do himself, are two different things for me. I think that is an important distinction. Mrs. Becq, I would not like there to be a misunderstanding about this.

Another point concerning the age aspect. Can minors consider it or not? Is one strong enough, judgmental enough as a minor to give the difficult signal that one would choose euthanasia? What I regret somewhat in this regard, again without wanting to engage in the polemic, is that you say – I have not the ambition to quote you – that this may happen under pressure or under the influence of the parents. I think you’re going on ice there. No parent will put pressure on their child to make that choice. No parent can do that. These extra days or hours are inexpensive for them. I agree that the situation for minors is different than for adults. At their age, the situation is different. However, if you say that there will be pressure from the parents, then I think you are taking a walk with the seriousness with which parents will jump into that situation. As if that would be an easy decision for those parents.

I do not want to be misunderstood here. I give you absolutely right, there is no single parent who will put pressure on his child or say he wants it to die because he can’t cope with the situation. On the contrary, I see parents who do not want them to decide instead of their child that it should stop. Parents want to keep their children as long as possible. However, something different is the feeling of the child. That is our concern. A child feels what lives with his parents.

Just as decisions as an adult take place in interaction with the other, in interaction with the environment, so is it with a child. It is ⁇ not my intention to say that parents will do this consciously, but I am not sure that subcutaneous, from the feeling of the child of the situation, of that care and of that suffering of those parents who sympathize with that child, there will be no pressure. That is something different from the conscious pressure that parents would give.

It is good that you clarify this, because this was one of the passages in the debate that were less pleasant and less pleasant.

It’s just the interaction you’re talking about that makes it possible for me to say that this framework is good. It is precisely through that interaction between parents and children, between children and the caring staff, between parents and the caring staff that I am convinced that minors are also able to take an active part in that process. If that decision, which is made very personally for everyone – and it is not my responsibility to judge whether this is a better or worse decision – takes place in interaction, in environments where one is incredibly sensitive to what is going to happen or should happen, I think that minors are also able to actively participate in such a decision-making process. Without that interaction, I would feel much less comfortable. It is that interaction, embedded in the legislation, that provides sufficient safeguards for the decision to be made informed. I am convinced that a decision about life and death is always made well-considered, if one can take it, if one has the freedom, that freedom of choice that we wish to leave.

Finally, colleagues, a debate like this is never over. There may be a new legislative framework tomorrow. It is also our task to look at what this means in practice, whether it comes into trouble or not. We need to be very vigilant as legislators. Our group has submitted other, broader bills to the Senate. We were the requesting party for a global system on life-end termination. We have not reached that today. Our group is also a requesting party to be able to conduct the debate on the termination of life of dementia. Regardless of any concrete aspects I’m just suggesting, it’s important to be vigilant and play our role as legislators.

There has been a lot of reference to the protest that is there today. But there is also a support in the field. Per ⁇ this is the debate in which we have been the most popular representative of all, this legislature, because for one time we can decide ourselves rather than as a group. If there is sufficient support in this Parliament, I am convinced that there is sufficient social support to take this step. I will not say: a step forward, but it is an important step, a choice that we must make in very difficult situations.

by Mr. Vanackere had signed up, but he had already expressed himself. He already told us what he thought... skillfully!

Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, I will be brief given that many arguments have already been exchanged. So I will come to the essential. I would like to say, in my soul and conscience, since we are invited to do so for this vote, what I think of this text.

You understand, I will not support this text. I will not vote for this law. I think this is not a good law. All the arguments developed by the other members of my group were, for me, sufficiently enlightening. Furthermore, the more progress is made in the debate in society – and this debate is somewhat deferred from the one we had in parliament – the less I feel there is a social demand, a medical demand.

In any case, I did not receive a single message from a family, a doctor, a lawyer, or anyone. I must very sincerely, very honestly say that I have not received a single message to say to myself, "Mr Dallemagne, it is urgent to vote this law! It is urgent to act! There would be a desperate situation in Belgium that you have not responded to so far.”

It is important to hear it, to see that there is no social demand, that more and more doctors ask us to stop the machine, to stop the train while there is still time, to continue our debates, our discussions. This must be heard! They are not lobbies. These are people who are simply, daily, in their practices, faced with the end of life, with patients and who feel that this law does not suit them.

The overwhelming majority of us say that a law is superfluous. Others are not opposed to a law, but do not want it and ask us to postpone the vote. I hear this from people who work in both public and private hospitals, who are of one or another confession or affiliation or network. And I hear Professor Sariban, who is very tough. I know him well for sitting in the board of directors of the Children’s Hospital. He tells us that this is an ideological law, precipitated, which is useless and made for the glory of some.

I do not believe that it is necessary to sweep from the back of the hand what so renowned doctors say, who have such functions and such charges. I heard yesterday Professor Clément de Cléty, while 650 students were gathered in the Lacroix auditorium. It is impressive to say that the future doctors meet, unfortunately a little late because we know the logic of our parliamentary work, to debate these bills. Professor Clément de Cléty, chief physician of the pediatric unit at the Saint-Luc Hospital, said to these doctors: “In thirty years, I have not received a single request for euthanasia from children.” “No one child has been euthanized and all those who died have died in dignity.” This must also be heard. The message these doctors send us is to say, “We do not accept, we reject this idea that we would not take care of the sick.”

You did not say it, Dr. Bacquelaine, but some have said it very clearly. This was ⁇ seen in the Senate hearings. Some of our colleagues in the Senate have been to say that there would be a suffering to which we do not respond, unbearable cases to which we do not respond. If you tell me that no and that we take care of children very well, what do I believe, then what is the use of this law?

I hear these pediatricians, these teachers tell me that they have the drugs, the techniques and the teams and that it is no longer as it was fifteen or twenty years ago. I understand the struggle of certain associations, twenty or twenty-five years ago, because medicine was quite different and there was the medical arrogance that made the doctor decide on his own. Things have completely changed. I welcome the work and advances that have been made through the Patient Rights Act, the Cancer Plan and a series of arrangements on palliative care. We are no longer at all in the cases of figure that we are told or imagined but that I do not feel and hear personally and that are not addressed to me. We are no longer inside. We are largely in a form of fiction compared to what we think we can answer through this law.

I see this letter addressed to you. I don’t think it’s so common or usual that so many doctors send you a mail. In my parliamentary life, sending so many letters is ⁇ even a first, at least here in the House. I would therefore find it appropriate and interesting that they may be heard.

I just said what I thought of the Senate debates, which were important, but I think some important people weren’t heard.

Yesterday I saw Professor van Meerbeeck, a prominent pediatric psychiatrist, renowned at the UCL; he told me he was totally incapable of making a judgment on the discernmental capacity of a minor at the end of life. He told me it was impossible for him to do such a thing. We need to hear such testimonies. This is not proselytism. It’s about being modest enough, humble enough to hear when personalities denounce the impossibility of the device, the choice of a wrong procedure.

Finally, a little word on a capital element often highlighted: everyone will remain free to do what they want. Indeed, some do not want to practice euthanasia and nothing forces them to do so; others will want it and it will remain their freedom.

I do not believe in that kind of reasoning. It is to forget that the law, and especially the criminal law, has an eminent sociological, pedagogical scope; it carries social, cultural values that impose on all. Far from sending everyone back to their autonomy, it carries an entire anthropology, a conception of man and instills as a collective doubt on the value of certain lives. That is what this law will do. If it did not have this scope, the debates would be far less abundant than today and many other countries would follow us, showing interest in a debate on euthanasia for minors.

I personally fear that we are not the only country to adopt such a law without any age limit. Other countries have understood that it is not merely about returning each to his or her freedom and autonomy, but that the law has a normative, sociological value, that it indicates social and cultural values. Now, gradually, it would instill the idea of a banalized act and that some lives would be less valuable than others.

That is why I will not vote for this bill.

I will conclude with two considerations. The first concerns the fact that I hear some attribute to themselves a certificate of progressism by approving such a law; they consider others to be ringards.

I have not heard it here; I have to say it because I want to avoid any unnecessary controversy.

The [...]

I haven’t heard it here, Madam Lillian.

You mentioned news articles. I can also refer to the general debate within society. I am surprised that you reacted so quickly. Maybe I’m making a fly.

According to some, people would live in a different era and would not accept modernity, a new vision of freedom and autonomy, or, worse, they would accept suffering. I find it unbearable that this topic is discussed. I am pleased that this debate did not take place here. But this debate exists in society and it should not be hidden.

Second, I think we will be a UFO in this field for a long time to the international community. We will not be the first country, we will be the only country!

For all those who are eager to a decent end of life, those who wish to die in decent conditions, for 99.9% of people in our country, I wish that at least as much energy, if not more, be devoted to palliative care and accompaniment, as we have deployed for this bill.

“Children do not belong to their parents” is a phrase spoken in France by the socialist-elect Mrs. Rossignol. I will simply answer that if they do not belong to their parents, our children belong even less to the state and its elected.

Basically, the secularism defended here in Belgium by both left and right parties allows to impose everything that the religion of associators allows. Associators are those who associate God with an image or one or more false gods, idols, or even Satan for the most perverse.

In the name of secularism, you are demoralizing society. You propagate pornography, you banalize homosexuality, you encourage abortion at the turn of your arms, and I don’t even talk about blood crimes that you support or commit around the world in the name of supposed good reasons.

Today, you will authorize the euthanasia of children against the same opinion of many pediatricians who have launched in recent days calls to the political world, calls left unanswered.

Even though not all parties in this Parliament will vote the law, none is truly opposed to the very principle of child euthanasia. I am deeply opposed to the very principle of child euthanasia!

Tomorrow, if we let you do, what will you legalize even worse? The zoophilia? And the pedophilia? of the incest? The sale and ritual sacrifice of children? How far will these satanic delusions lead our society?

After destroying our society, you are now attacking the family and there, I can’t let you do because for me, the family, it’s sacred!

So I will simply say: no. No, we shouldn’t give in and legalize euthanasia for minors. We are here as chosen to protect our children, not to kill them. This is a social and ethical question that I consider so serious – and I find myself the only one to say it today – that it must be submitted to a referendum. I know that the referendum is prohibited in Belgium; it is not included in the Constitution. But we spend most of our time, most of the Thursday in this parliament, discussing unnecessary proposals and spinning on dots. I think we would be much more inspired if we looked at a genuine democratic and civic law that would finally grant the Belgians the right to speak through a referendum. But for that, we will have to get to work. I think this will progress much faster than this project on child euthanasia.

Who are we to think in the place of the people? Who are we to decide for the people? You may think of yourself as gods, but all those who support this law are merely hypocrites of Satan; I am not afraid to say it! You know, in Belgium, there is a very broad group of the population who, if you dare to ask them the question, would not accept that euthanasia be done to minors, whether they are believers, agnostics or atheists anyway. And as far as I am concerned, I oppose it because for me, only God – I know that talking about God in Parliament is normally forbidden, but I do it anyway! Only God has the right to give or to take life. Laity is not my religion, Parliament is not my Church, and you are not my God, even if you think you are all-powerful!

In addition, alongside this spiritual aspect, I am afraid of deviations. Children can easily be influenced by what they live and those around them, children troubled physically, psychologically by an accident, by disease and who, while they could still heal, will no longer cling to life, lower their arms and ask to die, ⁇ even to relieve their parents.

Is it not foolish to give a minor the right to decide to die even when it is forbidden to drive a car, to vote, or when it is imposed on him the school obligation? I have no words to express such lightness, such surrealism.

Let us think a little. Who, in this hall, has not once thought of death, during a heavy trial or during a depression? Will death become, tomorrow, a solution of ease? I already imagine! You can’t pay your debts anymore, it doesn’t matter! Providing yourself an euthanasia. This is, ⁇ , the next slogan of our banks that will offer us – who knows? – a loan at 0% for the occasion.

There is no more morality, no more ethics, in today’s society. The elected are responsible. They are ready to let everything pass.

This bill is discussed in precipitation while there is no urgency. Why such a rush? This question will remain unanswered.

In addition, the terms used in the bill are vague. It is a case of minor patients, with the ability to discern, who are in a medical situation without a way out, of constant and unbearable physical suffering that cannot be calmed and which leads to death in the short term, and resulting from a serious and incurable accidental or pathological condition. But who decides about that? Who is ? The Doctor . What if the doctor is wrong? If he made a mistake, it will be too late, your child will be dead. Medical mistakes, misconduct or misdiagnosis happen. No one will tell me the opposite.

Incompetent or unconscious doctors, even if their number is small, exist. There is a bad diagnosis. There are hasty conclusions.

What does the expression "without the outcome of constant and unbearable physical suffering" mean? I feel like I’m lowering my arms pretty quickly. Science plans to send humans to Mars, but eradicating pain, no, it is not possible, it would be too complicated. Or maybe it is too expensive? This may also be a question. We know it very well: ladies, gentlemen, dear parents, move around and keep silent, the money is to make war, not to save and protect your children.

So I think we must say no to euthanasia and support the “yes!” to stick to life. Any decision that goes in the direction of the destruction of life must be rejected because it is at first detrimental to the part of humanity that unites us. God, in His mercy, gives the martyrs paradise in any way. Suffering, even extreme, can be a step; but everyone can rise up, even miraculously. Miracles are there!

I know a five-year-old girl who is very close to me. She is severely disabled because she lacked oxygen at birth. She does not speak. She does not walk. She does not eat. She does not drink. It is fed by a gastric probe. They suffer from mental and motor retardation. Her body is murdered by the suffering she endured every day.

Such a beautiful little girl, such a nice little girl. It is impossible today to say whether she will be able to walk or simply say “mother”; it is impossible to know whether she suffers – she does not speak; it is impossible to know how she feels on a daily basis. But when you take her in your arms and she makes you smile, it is the most beautiful of all gifts.

Nothing but that smile, this moment of sharing and love is worth living and fighting to give this little girl everything we can give her. The life that is offered to us is too precious to be left in the hands of psychologists who will be charged, according to the principles of this project, to judge the good discernment of our children.

Today is a serious time.

For a while we have only destroyed, not built, while Man, with a great H, is naturally programmed to build. This law aims to destroy, once again, not to build. This is even worse because it is about destroying life.

Instead of pushing us to get the public health sector out of the full grip of the pharmaceutical lobbies so that free and natural medicine develops, in order to finally eradicate cancer and other so-called incurable autoimmune diseases, we talk lightly and without consulting neither the public nor the law professionals to take away lives.

We have already allowed euthanasia for adults. At the time, I was not part of this Assembly to express my point of view; I think this already raises an ethical question, but when it comes to children, it goes beyond understanding. I believe that the Belgian people are not still up, but one day or another they will have to assume the consequences of the decisions that are being made in this parliament.

I will never accept that you play with the lives of our children or that you develop the death market, as our French colleagues develop the child market by pregnancy for others, and its promotion among our neighbors. In these turbulent times, the population is finally beginning to grasp what the intellectual work of Masonic lodges and other elite networks of back lodges is for.

Life is precious, it is given to us and it does not belong to us. The Most High entrusts it to us and takes it back to us. No one can decide on the death of another person, including himself. We should normally do everything to protect life, to preserve it, and not vice versa. In addition, we are now able to perfectly control physical pain, suffocation, and anxiety as death approaches. It’s not me who says it, but 175 reputable pediatricians and specialists, who do not hesitate to say that only incompetent doctors will voluntarily kill children. Unfortunately, I know that the weight I weigh in this vote is minuscule. I know that in my habit, I am one of the only ones who can still incarnate a minimum of common sense in this assembly. Please think carefully of the transgression of morality that you are preparing to commit. This bill will ⁇ give rise to other darkest bills in the coming years. We are only at the beginning, nothing will surprise me in what will follow.

I will therefore vote against this bill introduced by the Socialists and Liberals and supported by the N-VA and Ecolo. If you put yourself on the side of the thieves, know that I will always be on the side of the weakest and of justice, whether it be divine or human. This justice requires me today to protect our children from the madness of the elected members of this country.

My speech has been very carefully prepared, because this topic is very disturbing to me. I have read a lot, both books, various opinions, hearings held in the Senate, debates, the international press and the latest report of the Control Commission. My reflections have led me to question the well-foundedness of the project that is presented to us today.

According to my conscience and with the respect of my group I thank, I will vote against this bill. I am not, in principle, opposed to euthanasia and I respect the spirit and letter of the law of 2002. But, for me, euthanasia can only be accepted under the very strict conditions established by this law and for adult people who have made a conscious and sovereign choice.

Nor do I want to be a prisoner of the intention trial that sometimes circulates on both sides of the field of opinions, namely, on the one hand, “they want to kill children” and, on the other, “they want to let children suffer.” These allegations are false and malicious. As far as I am concerned, I do not want either but that the law puts strict and properly formulated ethical tags around the accompaniment of the end of life and that patients and caregivers are respected at the best.

My arguments are divided into three points. First, I would like to refer to the implementation of the 2002 law. Why Why ? Because the debates in the Senate were very broad, first, on the application of the law of 2002, then, the issue of demented persons was discussed, then the euthanasia of minors was discussed before issuing this law.

The 2002 law, when you see the reports, is still being applied more and more widely. In 2012, we were 2% of deaths, which is nothing. Testimonials show that there are difficulties in application, that the information and training of doctors is still incomplete, that patients also confuse the notions surrounding the end of life.

Today’s debate has shown that some of us are also not agreed on what this or that word, this or that concept means.

Some doctors also do resistance at the expense of patients.

Furthermore, there are observers who believe that there is a risk of weakening the requirements in law enforcement, a kind of dimming of the norm. I do not know whether they are right or wrong, but this poses questions and requires, in my opinion, a more fine assessment, carried out by independent observers.

There is also this great split between French-speaking statements and Dutch-speaking statements that demonstrates that one manages the end of life in a different way, at least in the words that one put on it.

There are those doctors who openly say that they practice other forms of end-of-life that are not covered by law, whether in palliative care or elsewhere (terminal sedation, pain-related treatments, discontinuation of treatment). Care teams perform remarkable work of dialogue between relatives, professionals and the patient to result in a soothing consensus on the end of life. Sometimes these care teams want the law not to interfere with their medical practices, for fear that it will stiffen what needs to remain flexible.

I’m not saying I’m giving them the right. There are difficulties in implementation.

In the report of the Control Commission, I noticed the following sentence: “The enforcement of the law has not resulted in major difficulties or abuses that would require legislative initiatives.” Furthermore, the committee considers that the correct practice of euthanasia in compliance with the law requires above all an effort to inform both citizens and doctors. So, surprisingly, today’s opponents and the Control Commission find themselves at least on one point, the non-need for a legislative initiative.

All this leads me to think that at present, a more detailed analysis of the application of existing law would be more relevant than a legislative initiative. It is not unnecessary to clarify the tags before going further.

One of the things that would ⁇ need to be improved is the understanding of the concepts surrounding the end of life and respect for their complementarity and the limits of each.

Should the law be extended to minors? Besides the fact that the need for a legislative initiative is not obvious, I have a personal problem with the text that is submitted to us. I will not be long as I agree with many objections that have already been made today.

The concept of discernment capacity remains vague despite discussions in committee. I also do not know how it will be evaluated. I listened and did not get the answer. For me, she cannot be present in the head of a very young child. It is true that fixing an age is always arbitrary, but not fixing it at all seems to me unacceptable. At that point, why does society fix the age of majority? My objections are somewhat similar to those of Mrs. Marghem who expressed them well.

It seems to me – and my group also supports this view – that entrusting one specialist to judge this ability is also unreasonable. I have also signed the amendment of our group which has been re-submitted. This amendment requires that the care team participate in this assessment in addition to the psychologist or pediatric psychiatrist who evaluates it. Our amendment was rejected in the committee but I have some hope that it may be accepted in the plenary session. We will see!

The question of parental consent is unresolved. Why Why ? I find it obvious, humanly, that parents are associated with the decision. Legally, we cannot avoid this. However, this obligation is contrary to the freedom otherwise granted to minors. It follows, in my opinion, a confusion and an enormous risk of causing the actors of the drama to suffer more than necessary.

Then, on a symbolic level, it seems to me that the signal given to young people allowing them to ask for death in case of very strong suffering could be very negative for all those who think of suicide during the fragile period of adolescence.

I know that we are not talking about mental suffering. But the question of the signal was inspired by the testimony of a pediatric psychiatrist who wondered what she could say to suicidal teenagers the day that this law would be passed. You can challenge this hypothesis but I think there is a concern with the given signal.

Does this mean that we will let children suffer unnecessarily? No to No! The testimonies of many doctors, oncologists or pediatricians tell us that in cases without a solution, the evolution of techniques allows to control the pain and that different forms of end-of-life accompaniment are milder than euthanasia, practiced in dialogue with the child and his environment. I think we’ve talked about it enough tonight.

Finally, I will add a somewhat more philosophical point of view. I am conscious of leaving the political and legislative terrain and expressing something deeper within me, probably from a corpus of values that I have developed. For me, it is not obvious that a person can be alone in deciding about his death. When I say “may be alone,” it doesn’t mean that she has permission to decide about her death. It is not obvious that a person may have the ability to decide because I deeply think that we are beings in relationship, child or adult, old or very young. Our decisions always affect our loved ones and will remain imprinted in the deep memory of our children, of our offspring and of our life companions, from lovers to friends. Conversely, our loved ones will influence our desire to die or to live. The request for euthanasia or other forms of end of life will depend on our relationship with our loved ones. The risk of influence exercised by the surrounding, in good or less good intentions, consciously or unconsciously, will always be present. I’m not saying there are bad intentions, I’m not saying it’s good or bad. This is obvious to me. Given our relationship nature, we are always in a situation where we are influenced and influenced.

The type of care and support that the company offers to the patient will also be taken into account. We cannot deny that if the health care system could offer everyone the guarantee of painless end-of-life accompaniment and in good conditions of human accompaniment, requests for euthanasia would remain very rare.

In summary, I do not believe that a person makes a decision on his death independently. It always remains an influence, because the human being never ceases to be in relationship.

To return to today’s question, this aspect remains obviously even more true and even stronger for the ⁇ sensitive child or adolescent. Some have spoken of this child’s capillary proximity, compared it to a sponge feeling the events around him. That is why I think we are going too far.

Beyond the environment, it also remains a significant effect for society as a whole.

In my personal opinion, there is the risk of adding a dose of more mortificant to a society that already suffers from a pattern of development that lacks horizon, which lives under so many threatening clouds.

In the document of the Association of Practitioners of Nursing Art, I found a phrase that corresponds to my ideas, but that I would not have formulated as well. “Beyond its role of formal definition and sanction – permission and prohibition – the law influences citizens on what is considered good and evil. In our society, where the right to play a role as a regulator of behavior is increasingly demanded, what is permitted is quickly considered as good and will then be understood as a right.”

This is my personal position.

I would add that I also felt a lot of frustration over the debate in the House. As a member of the Public Health Committee, I expected this debate to be shared by the Justice Committee with the Public Health Committee, as in the Senate. Moreover, this request was formally formulated at the first session; we voted in favour of this hypothesis, as well as for the request for hearings.

I feel that the debate has been shattered. This is not a matter of past time. It is a matter of lack of reference, of openness to the outside.

Furthermore, I was able to see that we did not want and could not touch the text. Even the amendments submitted by our group, which, however, was part of the alternative majority to vote on the bill, were rejected without discussion.

There was a rush, as this is a very important project. Political issues dominated the human dimension that would have deserved more attention, time and serenity.

Finally, I would like to thank my group once again for their tolerance and respect that presided over our internal debates.

Mr. Speaker, I will make a brief speech.

Indeed, the overall position is to legislate, to provide a framework aimed at facilitating the work of practitioners in the field. It was also about not letting a fuzzy remain that could facilitate practices that could harm individuals, in particular situations.

In my view, it was therefore important that Parliament addressed this question and attempted to develop a text that could address certain situations, even if they are rare or even exceptional.

I will not discuss this. I would most ⁇ like to speak about an element that interpels me, as a legislator and especially as a psychologist: the notion of discernmental capacity.

When we talk about the discernment capacity of the minor, I see first a young child. I think that discernment should not simply be assessed at a certain point during a child’s illness. It is true that a certain clarity can appear in relation to the situation of the disease, to suffering, to the surroundings, to a set of things. We can see this capacity, this lucidity at that moment.

For me, discernment is about the whole personality in its development. Personality changes with time. One has greater discernment at thirty or forty years than at fifteen or sixteen; one has even less at five or eight.

The ability to discern is not an independent box that will mature during illness. Discernment is something that evolves over time and goes from individual to global. The child goes through these stages, and from his life experiences he matures; he becomes a little more able to distinguish between what is his own, his desires, what surrounds him and the situation in the future. These are not things that can happen from day to day. This takes some time.

For me, it’s natural that as human beings, we evolve, we mature. But I think that as adults, even at the age of thirty or forty, we are unable to solve the question of death. So putting the responsibility for the decision-making in relation to the death on the back of a minor scares me.

Therefore, I will not be able to vote in favor of this text.

I know that it is impossible to determine the capacity of discernment, the degree of maturity of an individual from a text. It would have been more sensible to set a minimum age, as it is done in Justice - for example 12 or 14 years - and then allow the management team to participate in the reflection on the discernment ability of the minor, to allow everyone to give their point of view, being aware of the consequences of the decision.

My great fear is that the younger the patient is, the more the decision will fall on the management team. What causes me the most problems is this kind of shift from the responsibility of the child to the management team, which will have to anticipate, reflect or decide, through interviews, whether the child has the ability to discern or not. This is something unacceptable. For me, euthanasia must remain a personal decision, which cannot be delegated to a third party. It is a decision that affects life. Life decisions cannot be delegated to a team, however competent, responsible and experienced it may be.

This is the only point that makes me trouble in this text and that makes me doubt its ability to respond to this situation. In case of doubt, I would rather abstain.

Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker. On this subject, as in other political formations, parliamentarians are free to make their choice in conscience or in soul and conscience, depending on whether one believes in a soul or not. I therefore ascend to this tribune with my questions, my doubts and my convictions rather free-examinist, far from any imperative of higher moral authority or higher religious authority, but being all the more demanding on this text of law.

Like the mr. It is not because the law opens the recognition of a personal philosophical choice that one must, however, ignore the point of view of those who, for reasons eminently respectable, make another philosophical choice or issue reservations as to the conditions of the freedom or the presumed freedom that this text of law would intend to institute.

I would like to remind you first that I voted for the law on euthanasia and the decriminalization of medical acts of euthanasia in 2002. I did it after reflection and after interrogation because I was rather one of those who, like Hervé Hasquin – for those who remember the debates of the time, one cannot say that Hervé Hasquin was the spokesman of the Church in any way whatsoever –, always and rightly, it seems to me, said that the relationship of patient’s trust in the doctor, and a fortiori at this crucial moment of choosing not death – one does not choose his death – but of choosing the end of life, it ⁇ deserved that the legislator be very cautious before intervening, so it is true that this relationship cannot be accompanied by a legal formalism. The legislator will never be able to correctly determine what can be experienced in the most personal, most intimate and most authentic way in the ultimate moments of life. No one has the authority to guide these choices, not even the legislator.

I voted for this law because it opened up what I thought essential in this philosophical debate, the possibility of early declaration. An early declaration that does not concern minors in any way, and for a reason and with right! The authors of the bill obviously excluded the possibility for a minor to make an early declaration before even being confronted with suffering. I had considered that this faculty of early declaration had its reason to be. I would even say that’s what gives all the meaning to the 2002 law. It has been seen with such prominent personalities as Hugo Claus or the Pr de Duve.

We may even admit today that the philosophical choices made by these prominent personalities in demanding the application of the law of 2002 may well go beyond the scope of the law of 2002 and that the consensus of the society – I echo the remarks of mr. From Germany – the fact that today there is an acceptance of this very great philosophical freedom of the end of life among women and men who, having accomplished a long course of life or in any case a certain course of life, are brought, in view of entirely personal circumstances, to make a choice which no one can say in this assembly whether it is relevant or not, since it is eminently personal.

Let us admit that we are in a completely different case: we are talking about minors, and minors with a very large age gap. We cannot say that the law regulates in the same way the 17-year-old and the 9-year-old. In view of such essential choices, this is not true. Therefore, it is because of this question as to how to perceive this diversity of situations that we have sought legal tags that pose a problem to me.

I told you, I am in no way hostile to the very principle of euthanasia, by personal philosophical choice. I can even conceive that, on a therapeutic level, doctors recommend parents to resort to this ultimate choice with respect to children facing the greatest suffering. Per ⁇ it is not only physical when, in this bill, only this form has been retained. I point out that mental suffering has been deliberately excluded while some may not go without the others; this is what would deserve more nuances and analyses than those operated by the authors of the bill.

As I followed the work of the committee, I have long explained the two concepts that I think are problematic, concepts which are the result of the fact that the legislator has faced a difficulty in identifying the legal concepts he must implement when it comes to minors.

I would like to remind you first that we are in a criminal law; this was notified several times during the debate. There is no law that creates a right. I have heard that the right to request euthanasia is created; this is not true, it is wrong.

As in the law of 2002, especially by the early declaration, it can be said that a right to request euthanasia has been created, so in these provisions, we are not at all in the same logic. We are in the strict logic of the exemption from criminal responsibility of the doctor, and of the only doctor who practices the act of euthanasia. In other words, it is logical to prohibit any criminal prosecution at the initiative of the prosecutor’s office, the public prosecutor’s office, at the charge of this doctor, and not at the charge of third parties, of that single author of a medical act that led to the premature death of a child.

It is therefore not to say here that we are in a choice that would devote only a philosophical freedom. That is why I said that I had voted for the law of 2002, because it contained the provisions relating to the early declaration which, in itself, unquestionably devotes a philosophical choice, and that I recalled what some personalities whose end of life has been heavily mediated had done as a personal choice.

I will return to two concepts or two legal principles that have been introduced. Let’s be honest, the authors of the bill proposals did not have these notions in their original text. This is the result of the debate in the Senate Committee. I respect this debate and I do not seek to know whether we have more support among the medical circles than others, I do not seek to know whether the opinion of the State Council would have been more or less favorable to us. All this could possibly have helped us in our deliberation, but I’m just doing an analysis of the text. Because, ultimately, my only way to appreciate the choices of the legislator is to do the analysis of the text.

The analysis of the text raises a lot of questions. Ability to discern is an introduced concept that there is nowhere to be defined. I have sought, even by carefully reviewing the work of the committee, to have from those who are in favor of this text even a convergent opinion on this notion. Please read the article, you won’t find it. Why Why ? Because this is a notion that comes terribly complicating the assessment of the law. I would like to point out, and I give Mr. Right to that. Bacquelaine – that there is the cumulation of all the conditions of the law, including the conditions relating to the repeated, thoughtful and voluntary request by the patient who wishes the doctor to practice the act of euthanasia. I would therefore like to know what the notion of discernment capacity brings in addition to the repeated and thoughtful request. "Reflection" already implies a certain awareness of the individual on the part of the applicant.

This is obviously not enough in the sight of the legislator, of those who advocate this text. They want an additional notion, beyond the thoughtful and repeated request, they ask for a discernmental capacity, which is therefore legally distinct. In this sense, I stand aside from mr. Bacquelaine says that this is not a legal notion. Yes, it is a notion that has legal effects. I would like it to be appreciated from a medical point of view, but it has legal effects. It comes as an additional condition to the repeated and thoughtful request of the patient. I would like to know in what it differs from this request and what it covers as an appreciation to the pediatrist or psychologist. We have no data.

This is already the first cause of great uncertainty and legal uncertainty.

The second problem that arises when reading the text is that the operating times are not clearly defined. I read the text. The 2002 law is supplemented in paragraph 2, which is the paragraph that includes all the conditions for the doctor's criminal liability not to be engaged. That is always the logic. It says: "In addition, when the patient is minor, not emancipated, consult a pediatric psychiatrist or a psychologist specifying the reasons for this consultation" - it is the physician who should do so. "The consulted specialist takes knowledge of the medical record, examines the patient, ensures the ability to discern the minor and certifies it in writing." I am not referring to the concept of discernment. "The treating doctor shall inform the patient and his legal representatives of the outcome of this consultation." This is interesting: it is not the pediatric psychiatrist or psychologist who reports the results. This goes through the doctor’s filter. We will talk about who the doctor is treating in this case.

"The treating doctor shall inform the patient and his legal representatives of the outcome of this consultation." Together or separately? It is not said. I suppose this is left to the judgment of the treating doctor. The result of this consultation; the result and not the consultation. What information does the treating doctor transmit to the patient and his legal representatives? The only conclusion that the pediatric psychiatrist or psychologist decided that he had the capacity of discernment, saying "yes, he has the capacity of discernment", no more? Motivation and Clinical Analysis. Listen to Mr. Bacquelaine is a medical act. Where is the duty of confidentiality of the pediatric psychiatrist in relation to the patient examined after clinical analysis. All this has not been examined. All this was not appreciated.

Finally, the treating physician, always, talks with the legal representatives of the minor, providing them with all the information referred to in paragraph 2, 1°, and ensures that they agree to the request of the minor patient. Very curiously, we do not refer to the 7th that I have just read: the treating doctor requires the opinion of the legal representatives only on a part of the conditions that must be met and not on the whole in order for the act to be practiced. It also does not say when the treating doctor will have to do so. He could do it before consulting the pediatric psychiatrist. All this is possible in the terms of the text of the law, as presented to us. Let us admit that, when all these questions are asked, we do not seek to hinder a work of the legislator. It is sought to understand whether doctors are placed in the conditions of legal security so that they can practice their act in full personal responsibility. I must note that this is not the case.

The notion of discernment, as Ms. Marghem pointed out, raises another debate, since it is an additional notion compared to the notion of thoughtful and repeated request. All children who do not have the ability to discern can therefore not benefit from a therapeutic treatment that would conclude with an act of euthanasia. Therefore, there is a distinction between children who can benefit from it and those who cannot benefit from it.

I have often heard the argument that children should not suffer. Should a child who does not have the ability to discern suffer? The answer is then the state of necessity and thus we come to the obvious conclusion. Is there today a problem of legal uncertainty, while it is known that the prosecutors also perceive the evolution of mentalities in society. They also know that the notion of state of necessity allows to exclude any criminal responsibility of the doctor. Why should therefore legislation be made when the legal arsenal in force today offers a certain or at least relatively certain legal answer to the risk of criminal prosecution of a doctor who has practiced an act of euthanasia on a minor, regardless of his ability to discern? Of course, there is always an assessment of the courts that I will return to.

Sorry, but I fear that, in tense and difficult family contexts, with disagreements of legal representatives such as parents, the doctors, who have well perceived that the family climate does not always allow to find the agreement of both parents, in some rare cases, perform the act of euthanasia without having formally and legally the written consent of the parents. If tomorrow the doctors faced with these particular situations (which I do not say are frequent, for I dare to believe in fact that when a child suffers the parents reconcile, though sometimes one is surprised), must stick to the strict formalism of the law, will not have the consent of both parents, not only will they not be able to perform the act, but they will ⁇ not be able to invoke the state of necessity if they were practicing it. And so, for what could be based on in terms of legal certainty, there is a retreat rather than an advance.

That is why, analyzing this text in a totally free way and without a priori unfavorable — on the contrary — I conclude that this text does not give the answer. No one has ever been able to provide me with a legal analysis contrary to the one I have just presented – I have done it several times in a committee.

This text does not provide the certain legal advance that some want. This deserved an extra time of reflection and debate, at least for all those who, like me, want to find the certain legal framework that allows to take into account these very particular situations.

There is no urgency either. I asked Mrs. Minister to see if there were complaints, if there was a criminal context that made... No, of course!

I do not reproach that this is an ideological law, nor the reproach that one would have wanted to force the debate to force the debate. I simply say that, when the legislator wants to assume the fullness of his competence, as we do today, free from any political authority or government authority, free from any party disciplinary authority, we might still win in favor of this freedom of legislator by making sure to vote texts of law, if not imprinted with the greatest legal certainty, at least with the smallest legal uncertainty.

Mr. Speaker, dear colleagues, at the end of the House Debate on Euthanasia, an important topic for which the Government has chosen to leave it to the wisdom of Parliament and for which the Senate has done a great deal of preparatory work, I take the opportunity to shed light on the bill as Minister of Justice and, above all, as a person.

Today’s plenary session and tomorrow’s vote will end a long debate. The adoption of the bill will be the first amendment of the euthanasia law in 12 years. The Dutch Parliament approved the bill on 10 April 2001 and approved the Act on Ending Life on Demand and Assistance in Suicide.

Unlike the Netherlands, our country abstained from a scheme for minors.

Article 2 of the Dutch Act of 2001 stipulates that a physician, subject to a set of care requirements and after consulting at least one other physician, may, at the request of an adolescent from the age of twelve years, proceed to termination of life if the adolescent concerned suffers invisibly and unbearably.

Until the age of fifteen, the consent of both parents is required. During the sixteenth and seventeenth years of life, adolescents can in principle independently make the decision to terminate life. Parents must be involved in decision-making.

Twelve years after the Netherlands, our country now wants to include the possibility of euthanasia in minors in the law.

The discussion of this possibility in the House and in the Senate has lasted almost a year. Seven hearings were held in the Senate, in which a total of thirty-three experts were heard. On the actual bill, which is now under discussion, the Joint Committee for Justice and Social Affairs in the Senate held five long meetings, in addition to which the opinion of the professors was obtained.

Of course, this is a difficult debate, which needs to be conducted thoroughly.

It is a reform that intervenes in what is most dear to us, our children, and in the most difficult moment of our lives, that of the approaching death. Nothing is more difficult than making legal decisions about adolescents, whose doctors must unanimously decide that they can no longer cure.

I confirm that the debate on a group of senators’ bills has been thoroughly and thoroughly conducted. I confirm that it was time to consider whether a majority could be found for a similar legislation to that which has been in effect in the Netherlands for twelve years.

In addition, there are criticisms that the bill would be futile legislative work. I think the opposite is true. No one can deny that the authors of the bill run on eggs, quite rightly, given the extremely delicate issue.

That sensitivity, that justified hesitation and caution, however, should not prevent us from letting the advantages of a supplementary and legally regulated option weigh more heavily than the understandable uncertainty about the small expansion of the unknown territory, which is still euthanasia.

Dear colleagues, I would like to address, now, the substance of the debate. I have listened and carefully examined the criticisms of the members who will vote against this project. I have also analyzed with more than a mere attention the criticism that has been formulated outside this parliament.

This is not a question of party politics, nor a debate of fundamental antitheses. Today we have had – in any case, I hope it – a debate with opinions formulated with caution and caution on a complex and delicate problem.

With this bill, we create a legal framework in which euthanasia for minors is defined as a possibility and therefore decriminalized in circumstances described very specifically and under very clear conditions.

Furthermore, this proposal does not deprive anyone of any right. It only adds one possibility. We are expanding the choice of a practice that, now, has entered into the customs since the legislation on euthanasia came into being, now twelve years ago.

Everyone should be able to decide about his life and death according to his own values, preferably in consultation with family and relatives. This is a choice, not an obligation.

The conscience clause provided for doctors in the 2002 law remains fully applicable in this project. This clause is individual and must be respected. No doctor will ever be forced to practice euthanasia. No doctor can be forbidden to practice it if he himself wants to make that choice.

In addition to the two doctors who, on the basis of the 2002 law, will have to establish that there is a situation without a way out and unbearable suffering, a pediatric psychiatrist or a psychologist will also have to confirm whether the teenager, who could apply for euthanasia, is effectively endowed with the ability to discern. Even at this stage, the desire of the adolescent cannot be realized without the consent of both parents.

Contrary to what is planned in the Netherlands, this remains also necessary during the sixteenth and seventeenth year. Unlike the Netherlands, the Senate has chosen not to impose a minimum age. The concept of discernment capacity is provided in place.

The concept of appreciation by the minor is not new. The Patient Rights Act of 2002 already provides that, depending on their age and maturity, they are associated with the exercise of their rights. The rights may be exercised independently by the minor patient who may be considered capable of reasonably assessing his or her interests.

To do this, the doctor will resort to the expertise of a pediatric psychiatrist or a psychologist. These experts assess case-by-case, by age and maturity, the reasons for the application, the experience of the disease, the ability to understand the disease and estimate its consequences, etc. Practice shows us that minors facing a serious illness mature earlier than other young people of their age. Additionally, experts make their assessment based on the medical record that contains all relevant information. If necessary, they may consult all the persons concerned for additional information.

Colleagues, in the present bill there are therefore special safeguards against a hasty decision.

We must first and foremost ask ourselves where we threaten to translate our understandable fear of making mistakes at a very delicate moment into a too tightly formalized process that by itself could then once again become ⁇ painful. I therefore give confidence to the parties concerned, once their responsibilities are defined.

I think, by the way, this corresponds to the reality, namely, a cautious capture of the opinions of patients and parents by the medical corps. It is always about thoughts that grow and are polished, that are never white-black affirmative and where the accompanying healthcare providers undoubtedly play their role in avoiding conflict situations. They do this every day and they are responsible people.

The text also requires the consent of both parents. Therefore, if there is a conflict or if one of the two is unable to give consent, then there is no agreement and the euthanasia cannot be carried out.

Although this bill will be applied in practice only in exceptional cases, however small in number, for young people who are faced with nothing but suffering and for whom there is nothing but unbearable suffering, this bill is of importance.

I have a great confidence in our healthcare sector and I am confident that suffering and dying children will be taken care of in the most imaginable circumstances, even today, without euthanasia. Everyone wants to keep it that way. Nevertheless, as an adult, mouthy man in the twenty-first century, who is faced with that inhuman suffering, there is the feeling that I want to know the options a little more accurately and that I want to know when I have which alternatives. As a parent, I want to be more involved in the child’s behalf. Can a sick adolescent, if he can cope with it, be consciously involved in it, or do we keep that in the sphere of informal appointments with many unspoken words? Asking these questions, of course, also means answering the questions.

Let me take the euthanasia law of 10 years ago as an example. I see today how many people consciously make the choice without compulsion. Even the skeptics, the fiercest opponents in 2002, had never thought the legislation would be so broadly embedded twelve years later.

Is this, as it was said in 2002, a Pandora’s box? I can only conclude that the original euthanasia law of 2002 made the same comments as today and that no abuse has been established so far.

This bill is also very cautiously seeking – as it concerns minors – an expansion of the possibilities in the ever wider transition from life to death in the hope that we will deal with it more consciously.

I do not even want to take the word self-determination into my mouth. It is about the fact that, thanks to medical advances, we have reached a point where we have shifted the boundary between life and death to such an extent that the concept of natural death has become obsolete and more and more choices are emerging.

Then, as a legislator, one must also create the legal protection for moments and processes where patients and their surroundings can think and decide on choices, if they want to. Then one must continue with a modest effort to make our lives a little more human, so as to become a little more human.

This bill does not impose any obligation on anyone. This bill creates an additional opportunity in the most difficult moment of our lives, the approaching death, and in the most difficult category of people, young people.

Mr. Speaker, Mrs. Minister, your speech today is similar to your speech in the committee: many questions have been asked, many uncertainties have been expressed by several colleagues from various political groups, some of whom are members of this law, and, again today, you do not provide any answers or clarifications. I take note of it.

I will not repeat what we have said before. You referred to the 2002 Act. I regret that the extension of the scheme to minors did not take time to review that law. This has not been done.

When you say that no abuses were found, I would like to believe you, but you did not intend to provide for an evaluation. Members of the Senate did not intend to do so either.

In fact, we also find that no case has been postponed in the audit committee, or the question has been raised whether anything has been done correctly. This is also due to the fact that a two-thirds majority is required and that apparently no abuse has been found in the committee.

How does that come? Has it been investigated? Has it been viewed? Does this have to do with the composition of the committee? No questions are asked about this.

Mr Vanackere also referred to what was said in the Senate and to the amendment submitted in the House. The Basic Law on Euthanasia states that a second physician must be consulted, but there is no guarantee for the independence of the second physician from the treating physician or the physician requested to perform euthanasia.

Finally, we have not received an answer to all the questions. You say that you think it is important that the legal framework is not too strict, because you have confidence in the doctors. Then you could have that confidence in the doctors today, even in the full medical team.

The Law on Patient Rights now also covers the conscious involvement of patients, whether they are minors or adults.

Mr. Speaker, I don’t know if we should call it a success that there have already been so many euthanasia requests that have been effectively responded. The committee that has to check this is totally receptive, therefore unreliable.

Furthermore, we notice that in this society many families are under social and economic pressure, that many people live in debt, that many people live in isolation, that many divorces take place, and that the number of suicides is very high. Are these not the questions that we need to answer? Does all this not prevent euthanasia? People who feel alone in the world, people who feel no longer understood, this also needs to be considered further.

I know that this goes beyond the political process, but the loss of value that we suffer in other areas of coexistence must also encourage us to reflect.

We started the discussion at 16:45. It is 23h20. There were more than 20 speakers. I think it happened in serenity.