Proposition 55K0523

Projet de loi visant à modifier la législation relative à l'euthanasie.

General information ¶

Authors

Ecolo Laurence Hennuy, Séverine de Laveleye
Groen Barbara Creemers

Submission date

Oct. 2, 2019

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

administrative formalities euthanasia patient's rights

Voting ¶

Voted to adopt

Groen Vooruit Ecolo PS | SP DéFI Open Vld LDD MR PVDA | PTB

Abstained from voting

CD&V VB

Party dissidents ¶

• Marie-Christine Marghem (MR) abstained from voting.

Contact form ¶

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Discussion ¶

March 5, 2020 | Plenary session (Chamber of representatives)

Full source

The rapporteurs Mr Rigot and Mrs Tillieux refer to their written report.

In 2002, Belgium was a pioneer in euthanasia. The law that was then adopted made it possible to choose a worthy death under strict legal conditions.

Over the past 18 years, the practical boundaries of that law have been made clear several times, by patients, citizens, active associations and doctors. Certainly the legal framework for the declaration of will today is far from perfect and adapted to the needs. We therefore found it necessary to correct and improve the law already on this point.

The declaration of will is valid for five years from the moment it is drawn up. Many patients and doctors, including us, find this not logical. His vision of a worthy death has nothing to do with deadlines. It is about a belief, a desire, a well-considered choice. It cannot be placed in deadlines.

It is just as illogical as limiting a marriage in time and, for example, mentioning in the ja-word that it would only be a commitment for five years. If one is convinced at the age of thirty or forty-seven that one does not want to live anymore if one falls into an irreversible coma, one may still be so ten or fifteen years later. Unless you think about it. Of course, it can always be.

The figures show us that in the last ten years 382 people have withdrawn their declaration of will regarding euthanasia. This is what we meet, because one can modify or withdraw his declaration of will at any time.

By no longer sticking a deadline on the declaration of will, we make the most logical choice the default option.

Is this change needed? and yes. For the figures of the FOD Public Health show that of the ⁇ 130,000 Belgians who have drawn up such a declaration in the last ten years, of almost 30,000 still living Belgians, the declaration of will has fallen. Last year alone, more than 7,000 Belgians had to renew their declaration of will.

A decayed declaration of will means that doctors can no longer meet the patient's wish if he falls into an irreversible coma. We want to solve this problem with our bill.

On our original bill on the unlimited validity of the declaration of will, colleagues from Open Vld and PS submitted amendments to key the conscience clause. We had constructive conversations on this subject in a spirit of open cooperation, for which I thank you. Therefore, I leave it to the colleagues from the committee to explain their contribution to our bill itself.

A declaration of will gives us a voice about the end of life at the moment when one is no longer able to do it. This has been in the law for 18 years. That voice, in my eyes, must not depend on the day, month, or year in which one falls into that irreversible coma. Therefore, it makes no sense to impose an administrative obligation for this purpose, which requires an extension of the declaration of will every time. In this way, one respects the patient’s wish for the end of life that he or she had planned in advance.

Mrs. Speaker, colleagues, the position of the N-VA on this topic and the debate that is held here or not, is not a precursor to the broader debate about euthanasia, which has long been in demand. This is a debate that I sincerely hope will take place with the necessary solidity and social influence.

I say this because the present bill is not an advance for the N-VA group. There is no conservative corner that would be against declarations of will, even though this seemed to be pushed in that direction in the committee. The approach chosen and used to get this bill into the committee is not an example of how it should be for the N-VA group. Hopefully this has been the last time that an ethical debate has to take such a rough path to the plenary session.

It was a fairly strange path. It actually started with the proposals that suddenly came on the agenda, while in the previous legislature there was a broad majority for a change in the system around the declarations of will to ensure that people could also put them down forever. In short, the possibility to express and lay down a declaration of will and to make it valid forever already existed. That law should come into force today. Only the KB of the Cabinet-De Block is missing.

I have never fully understood why a KB was never drawn up, allowing people today, yesterday, or in the last few months to have chosen a declaration of will that lasts for more than five years. I still find that very strange. This is a debate that, in my opinion, should not have taken place.

The previous proposal also had some additional advantages over what is present today. There was much more freedom of choice for the citizen. The citizen could choose between a declaration of will for five years, for ten years or for as long as he wanted. In addition, the government took on an additional task that, in my opinion, only benefited the citizen. In fact, the previous approved proposal stated that the government would inform people with a declaration of will every ten years that it exists and would inform them about the possibilities to make changes to it in the meantime or not.

There is a reason for that. This is, by the way, what the State Council confirms in the report on this bill. Imagine that you submit a declaration of will at age 18, and this only comes into consideration at age 98. It is then not entirely wrong to think that some will not even remember that they ever made this piece of paper, let alone that an opinion in eighty years of life can sometimes change.

The discussion in the committee has begun. In the beginning, this word “debate” or “discussion” was simply not even worth it. There was no discussion, there was just drumming. Amendments were submitted where no one knew exactly what they stood for or which arrow was removed and replaced with a new arrow, and what it really meant. The majority parties in this proposal also had a very difficult time with this. They had to suspend the committee for a very long time in order to move very quickly to the vote that could not have happened with all the political groups because we simply did not know what to vote on.

It is a normal question in such legislation to ask in the committee for an opinion from the Council of State. Nevertheless, it has come to the point that this must be done in the plenary session rather than in the committee, and this under pressure from our party, from CDH, from CD&V and from Vlaams Belang. That was good too. Even the parties that have submitted the proposal will have to admit it. Eventually, there was a fair debate in the last committee and the necessary amendments were made there on the basis of the opinion of the State Council. That was a lot. Therefore, I suggest that in the future the advice of the State Council should be sought already in the committee, rather than pushing such legislation quickly. This is how the debate went.

Finally, what is there today? The Council of State was largely welcomed. There is one point where the advice has not been followed. Our group has always supported the CDH amendment on this subject and if they do not submit it again, I think we will do it. The State Council also calls for citizens to be given a choice. I still do not understand exactly what one can have against it and will therefore support this again. Nevertheless, I must admit that the most important thing is that there is finally an implementation of something that was already rightly decided in the previous legislature. After all, there was a problem with declarations of will and with people for whom those five years were too short, and who had not been informed that it had actually expired. There is no discussion about this.

On what comes ahead today, my group, as is always the case in ethical discussions, will vote in all freedom. However, there is ⁇ something to say in favour of the argument that the declaration of will can be easily withdrawn or amended at any time. This will also be shown in the KB. In itself, this can provide sufficient guarantees as long as the public opinion is sufficiently informed about it.

I would like to conclude my speech with this. However, I again call for the next ethical debates to be conducted with a little more thoroughness and fairness.

As regards the declarations of will, I believe that there is absolutely a need to ensure that they can be made forever. People must be able to decide for themselves. That was our opinion in the previous legislature and it is still so today.

On 28 May 2002, Belgium passed the law decriminalizing euthanasia, thus fulfilling the will of a large majority of Parliament and of the public to allow all those, faced with relentless suffering, to die in dignity.

This law of freedom, of respect for everyone and of responsibility has given the word to those who suffer, and allowed doctors to put what I personally call the ultimate act of humanity.

Ten years later, we still had to fight to get this legislation extended to minors.

Today, we can put forward an additional legislative and civic act. An act that reflects the struggle that my group has been waging for many years: removing the validity of the early declaration of euthanasia.

My group, listening to the associations, doctors and patients themselves, keeps advocating for this removal. As proof, last April we had submitted and adopted an amendment in this direction in the Justice Committee. Unfortunately, at the end of debates, despite our determination, this deletion had been accompanied, at the time, by an information to be made to the declarant every ten years.

Our colleagues at Ecolo-Groen have returned to charge by proposing a change to the law similar to the one we originally advocated, for which we would like to thank them. It is therefore now a matter of a mere deletion of the period of validity of the advance declaration, without any other conditions. This is an important change. However, let’s be clear, we are not expanding the possibilities of resorting to euthanasia, we are carrying a technical, but essential adaptation.

Let us also be clear on another point: we firmly defend the freedom of choice, at every moment, for each and every one, to freely withdraw or reintroduce a request in the course of their experiences, doubts or assurances and the evolution of their will.

Let's be clear, we can't be clearer: with this bill, we obviously and totally retain the right to withdraw.

Dear colleagues, we will support this text because it reflects our deep conviction of the necessary individual freedom to choose to die in dignity. We will also support it because it allows us to take three strong measures for more freedom granted to the patient. Indeed, as we said, in the framework of our committee discussions, which were strong, rich, intense and constructive, the PS Group wanted to go further and take additional steps by submitting three amendments that were supported by many colleagues. We would like to thank each and every one of them.

Our goal is clear: to prevent any obstacle to euthanasia. As such, I am proud that my group led the struggle for us to include in the law the prohibition of collective clauses. I am proud to put an end to practices that undermine the right of every patient to die in dignity. Again, some will reject that we see problems where they do not exist, that no health care institution prohibits practice, and that only individual clauses of conscience prevail. I will remind them that the press has highlighted, just a few weeks ago, the pressure of Catholic hospitals in Flanders, which impose palliative care instead of accessing requests for euthanasia.

I will also recall the case of this rest house which, in 2015, had refused to welcome a doctor to practice the euthanasia of a seven-year-old in the terminal phase. The patient was then forced to return home, with all the damaging consequences that can be imagined for her and all her loved ones. I can’t help myself to reconsider the statements made at that time by the primate of Belgium who, referring to Catholic hospitals, proclaimed: “On the institutional level, we also have the right to decide that we will not practice euthanasia or abortion.”

If we defend the individual conscience clause of doctors, it is therefore intolerable that healthcare institutions take a moral position, while they are recognized by public authorities and therefore must allow the legislation to be applied, in this case: that access to euthanasia is guaranteed if the conditions are met.

The PS Group has also made two other fundamental advances to guarantee that anyone who wishes to see a doctor will have access, in the best conditions, to euthanasia and to die in dignity. Yes, without a doubt, we recognize every doctor’s right to exercise his individual conscience clause but, no, it cannot be used to prevent a patient’s access to euthanasia.

First fundamental advance: the determination of a maximum time of reflection for the doctor requested. From now on, he will have seven days to make his decision on whether or not to carry out euthanasia.

I would like to clarify once again, as clearly as possible, that it is therefore not a time limit for the doctor to decide on the respect of the conditions for receiving or not this medical act, but rather a maximum time limit for making a decision on whether or not to perform this act within the framework of his therapeutic freedom and his freedom of conscience.

Second fundamental advance: the obligation to guide the patient in case of refusal.

The doctor now has this obligation to transmit the contact details of a center, an association specialized in the right to euthanasia (the Association for the right to die in dignity, for example) so that the patient or the person of trust can be guided in the steps to be taken in the context of this request.

Dear members of the House of Representatives, it is not my responsibility to convince you on this ethical question that appeals – I have no doubt – to your deepest personal values. It is my responsibility to remind you that it is the dignity of everyone who will appeal to your vote in your soul and consciousness.

Gilbert Hottois once said, “Treat others not as you wish to be treated, but as they wish to be treated.”

Mr. Speaker, colleagues, when the cat is away from home, the mice dance. The debate about euthanasia, or at least the more questionable appearance in the Health Committee, is a good example.

We have a government in ongoing affairs. On the left side of the hemisphere, one benefits from putting the ethically raised finger "we know what is good for you" even extra high in the air, even though ethics and morality sometimes seem to be a little search there. In the debate about abortion, that even led to the comparison of an unborn child of 18 weeks with, yes, a knee disc. Understand who can understand. The debate about euthanasia also suffered under the ethical profiling urge.

Colleagues, I can’t get rid of the impression that the proposal in its original form was quickly and quickly joined together in the hope of still being able to submit something on an ethical level. The proof of this is the fact that in the committee almost every question in first reading – the colleagues will testify – resulted in suspensions of five minutes, ten minutes, a quarter, sometimes even more than half an hour, and that only because the applicants could no longer explain what exactly was in their bill.

The number of repairs, sub-amendments, amendments and ⁇ above all the way they were submitted, can nevertheless convince anyone that the original bill was a fine legal workpiece. It made me involuntarily think a little bit of an episode of Help, my husband is a worker.

A battery opinions later, opinions that were largely converted into amendments, we are here now with that bill. A first question that we must ask, colleagues – Ms. Van Peel has already asked them – is whether the bill should actually be there. If we are very honest, the answer may be no.

More than a year ago, when I and many other colleagues had not yet been elected, there was a similar bill in which not the law, but the citizen himself could determine how long his declaration of will would be valid.

The citizen could therefore as an individual decide on the duration of validity, while in this proposal Vadertje Staat will do that for the citizen. The choice of the individual is clearly reduced here.

How they combine that with the colleagues of Open Vld with liberalism is a question for me. No, Mr. De Caluwé, I will not teach you lessons about liberalism.

At the beginning of December, I still thought that everything had to do with keeping Ms. Rutten’s chances cool at the premiere.

Meanwhile, however, I have found that those opportunities and ambitions have been euthanized, with the cause of a complete political life.

Our good colleague Fonck submitted an amendment, allowing the citizen himself again to make the choice between a declaration of will with a certain duration or a declaration of will with an indefinite duration. That amendment did not succeed, despite the undoubtedly appreciated support of the Flemish Interest. Colleagues, that amendment failed, while it was very simply stipulated that the declaration of will would be a standard of indefinite duration, unless the patient or the citizen does not want it and that explicitly specifies otherwise. That sounds logical, especially if one knows that during the debate in the Health Committee every five minutes we were beaten to the ears with the note that one must respect the will of the patient, of the citizen.

Colleagues, that logic seems to be in our house here is not spent, because one of the arguments for voting the amendment away – put it right, I want you all to sit down so that you do not fall from your seat – was that by expanding the number of options the freedom of choice would be restricted. I must honestly admit that I do not understand this very well. My mind is too small for that.

To this day, I have still not received an answer to the question of why, by letting someone choose between a declaration of will of unlimited duration or a declaration of will of limited duration, and thus expanding the choice, one would restrict the freedom of choice. I have asked this question several times in the committee, but I am still waiting for an answer.

Another argument to reject Ms. Fonck’s amendment was that the option of choosing between a declaration of will of a limited duration and a declaration of will of an unlimited duration would make – I hope you are still down – that people should think in advance. I promised my group chairman that I would not become too cynical, but suggest that people should think, that they should think about their own life and death. Where would the world go if we could no longer decide for the people? My mind is literally too limited for that.

The unregistered declarations of will are also the subject of the bill. It was argued that it is difficult, if not ⁇ impossible, to contact people with an unregistered declaration of will. That is true, colleague De Caluwé, there is no spell between them. In that context, you also cited that it was very difficult to bring older people to the municipality house to register their declaration of will.

I dare to doubt that, but that was not my point and I have said that in the committee. I wonder if with such arguments the bill is the right path. Wouldn’t it have been more logical if you wanted to fix the problem, for example, to simplify the way of registration? For example, would it not have been more logical to allow the registration through the general physician, the notary, the pharmacist and which other official functions you can list? Wasn’t that a trail that was worth exploring? I ask myself this question and regret that we have not investigated it.

Colleagues, I realize – this is a concern, so you do not have to interrupt me – that it is already stipulated elsewhere in the legislation, but with which I personally have a problem, is the fact that the healthcare institutions are obliged to take part in the story. Health care institutions are often established from a certain worldview, a certain ideology, a certain ethics, but the present proposal does not take this into account in any way, on the contrary. Why should we impose euthanasia at all costs on a health care institution that has been established from a definite view of life? Why should we impose the application of euthanasia on that health care institution, when it does not see it for life-proof reasons at all?

As long as it is made clear to the patient, I have trouble with the fact that we want to impose it. The patient has rights, but does a group of healthcare providers – a healthcare institution is after all a group of healthcare providers – have no rights? If they have no right to association, does that association have no rights? That is a question I ask myself in the depths of my mind, and I hope that you will all ask yourself.

Mr. Speaker, Mrs. Minister, colleagues, the Vlaams Belang evaluates each proposal on its content. Despite the fact that we have cited a number of pain points in connection with the proposal and that we have had criticisms on the text, we are nevertheless not opposed to a declaration of will of indefinite duration.

The Flemish Interest is for the freedom of choice of the patient, in the broadest possible sense. We want to fully respect the will of the citizen, of the patient, and not only in this or that direction. The Flemish Interest is for the full freedom of choice. It is precisely because the freedom of choice in the proposal does not fully reach its right that the Flemish Interest cannot fully support the bill. Therefore, the Flemish Interest will abstain at the vote.

Mr. Speaker, dear colleagues, I would like to remind you first of all of the MR Group’s position on ethical issues such as euthanasia: everyone is free to position according to their convictions. As a person, I would like to say that the proposed bill is balanced and achieves its main objective, namely to simplify the procedure in various aspects.

The law of 28 May 2002 provides that the early declaration of euthanasia is valid only if it was established or confirmed less than five years before the beginning of the impossibility of manifesting its will. This proposal removes this five-year validity period because it constitutes an unnecessary administrative constraint. Everyone is free, whenever they wish, to withdraw or modify their early declaration of euthanasia.

I would also like to emphasize that the freedom of conscience of the doctor remains a fundamental principle in this proposal, as it is already in the 2002 Act. Article 14 of the law stipulates that no doctor is obliged to practice euthanasia and no other person is obliged to participate in an euthanasia. In practice, therefore, the doctor always retains the faculty to refuse euthanasia. This refusal may be justified either by a medical reason or by the exercise of his own freedom of conscience in the event that euthanasia would be contrary to the convictions of the doctor. In this regard, it was necessary to guarantee the exercise of the freedom of conscience of the doctor in order to prevent the doctor from being subject to external pressure. This is why the bill proposal discussed today includes the following amendment: no written or unwritten clause can prevent a doctor from practicing euthanasia under legal conditions. Thus, the doctor’s refusal to practice euthanasia can be exercised in full freedom.

Our will is, indeed, to give priority to the superior interest and right of the patient to self-determination. These funds cannot be limited by the choice of healthcare establishments. In other words, the right to self-determination and euthanasia, provided that the legal conditions are met, must be able to take place under the conditions that are most reasonable for the patient and must prevail.

I will not go back in detail on all the other aspects of this text but it is important to emphasize that we have been very attentive to the opinion given by the State Council. We have therefore taken care to make the necessary amendments to the text. I will give some examples of changes made in our work.

When a physician refuses to practice euthanasia for a medical reason, we have provided that this physician is obliged to inform the patient in a timely manner, i.e. as soon as possible, and that he must record this reason in the patient’s medical record.

It also provides that the doctor who refuses to practice euthanasia is subject to an obligation to transmit the contact details of a center or association specialized in the right to euthanasia, without prejudice to his freedom of conscience. We have planned this so that the patient or trusted person can be guided in the steps to be taken as part of the application for euthanasia. These centers and associations exist both in the Flemish Region and in the Federation Wallonia-Brussels.

Here, my colleagues, are a few points on which I thought it was important to return.

Mr. Speaker, dear colleagues, I would like to make it clear that we are not opposed to a declaration of will of an unlimited duration. We are also not against euthanasia that is carried out under careful circumstances. This is now immediately clear, because we are often framed, as if we were against it.

I regret for several months that there is no mature debate on ethical issues. There is no answer to our arguments, to the matters we raise, because this does not fit in the framing of progressive versus conservative, which is now also proposed by the applicants. I do not feel at home there. I wish we could have consulted in this debate, where it is all about technical matters. This did not happen after the opinion of the State Council, because then only the applicants were sitting together. However, it is very clear that we could also have done certain contribution and that we could have done this in a mature debate.

We remain today in that framing of progressive versus conservative, while we are well aware that there is a support for euthanasia and that that possibility must absolutely exist. We do not serve the citizen, the legislation, or the patient who is in difficult circumstances.

That is why last year we were still in favour of the declaration of will on euthanasia, which, unfortunately, has not entered into force and which actually allows citizens to make their own choices. Why is it so difficult to let citizens really choose, to see what really matches their current will? This is important, after all. This is what the State Council says. The further that declaration of will lies from the execution, the more uncertain one is about the actual will of the citizen. The law passed last year fully matched what the citizen could really want. No one can oppose that, right? It also gave, in my opinion, very little confidence to Minister De Block, who had to execute the royal decree and could include in it the various possibilities, from certain deadlines to indefinite duration.

The legislation proposed today has gone a long way. We had a number of principled and a number of legal-technical objections. The meeting in the second reading was ⁇ chaotic. This has already been mentioned several times. It was a real kindergarten class that we should be ashamed of. Our aim was to make proper legislation.

Had we not asked for advice from the State Council here, we would have had a bad legislation. You have finally acknowledged this by submitting numerous amendments. The advice was ⁇ critical. In fact, the proposal looked like a holderdebolder legislation. It was also helpful to consult with us.

Naturally, the purple-green parties, like us, have studied the advice. They submitted a series of amendments that favored them on certain points. We also submitted a number of amendments, which were fully consistent with the opinion of the State Council. However, the purple-green parties did not find it difficult to follow us in this.

Therefore, we will again support those amendments submitted by Ms. Fonck. We will also submit two amendments. If they are not accepted, we will abstain in principle. We want proper legislation.

First, what are we having trouble with?

The State Council considers it important that every citizen has the freedom of choice. This has been emphasized here by the previous speakers of the N-VA and the Flemish Belang. Citizens should be able to decide for how long their declaration of will is valid. This is an important principle.

However, arguments are cited, such as the question of what happens when a patient is no longer able to change his will statement. That reasoning can easily be reversed. The declaration of will cannot also be revoked if one is no longer able to do so.

This argument is therefore not entirely correct. Leave it to the citizen and observe the precautionary principle. Let the citizens choose for themselves how long their declaration of will is valid and give them the opportunity to take responsibility for the matter themselves.

The purple-green parties assume that no one will choose a declaration of certain duration and that everyone will agree to an indefinite duration. I dare not leave that position. This, however, creates a discrimination between a person who wishes to make a declaration of indefinite duration and a person who wishes to make a declaration of certain duration. We absolutely want to avoid that.

We do not want to impose a choice on anyone. Every citizen is equal and must have the freedom to choose. This is our view in the current debate, but also in other debates. This is especially true of euthanasia. Therefore, I naturally support the amendment that we have jointly submitted in the committee. Even today, our group will support it in order to allow free choice.

Second, the State Council has given clear guidelines on the obligation of referral, when a doctor refuses on grounds of conscience.

The Council of State stated that if the legislator wishes to develop a scheme in the event that the patient or the trust person himself does not want or can designate a doctor, it could be provided with an obligation for the doctor to provide a general information brochure with a summary of the various end-of-life decisions or to refer to a source where the patient can find the necessary information. This is very important and we would like to see it in the law. That has not happened.

It actually requires the doctor to refer only to centers specialized in euthanasia, while the State Council says that that choice should be left to the patient. After all, that patient is able to choose which center he wants to move to. If one puts that into law today, if one gives only one choice to which the doctor must refer, then one actually forces the doctor to participate in euthanasia, which is prohibited by law. This undermines the freedom of conscience, which is contained in Article 9 of the ECHR. This article clearly states that every doctor may act on the basis of his conscience.

The amendment submitted by the purple-green parties on 18 February and approved in the committee is entirely contrary to the opinion of the State Council. I would like to emphasize that in the bill it is stated that in every refusal to apply euthanasia, whether it is on conscientious or medical grounds, the doctor must transmit to the patient the coordinates of a center or institution specialized in euthanasia law, for example LEIF.

This means in practice that if a physician considers that the conditions for euthanasia, for example in the case of mental suffering, are not met or that it is a completed life and therefore refuses on medical grounds, he will also have to pass the coordinates of LEIF, while he is sacredly convinced that the euthanasia is not in accordance with the legislation. In this way, the doctor is actually treated as someone who has to participate in euthanasia. He must forward patients to a center that does not think neutral about this. This is even more extensive than the text sent to the Council of State and therefore we absolutely disagree with it.

Finally, the doctor who has conscientious objections should never be obliged to facilitate euthanasia. In this regard, the State Council clearly states that this would be contrary to the freedom of conscience of the doctor. A referral to LEIF is really not neutral and goes a lot too far. Therefore, we re-introduce the amendments we had already submitted in the committee to address them.

Colleagues, I sincerely hope that one looks at the content here and not only takes into account the emotions. We need to provide patients and doctors with a clear, balanced and legally secure framework, so that everyone has the freedom to make honest and conscientious choices in life care.

Finally, I would like to reiterate very clearly that my party is not against euthanasia. However, we believe that this should be done under careful circumstances. We are also in favor of the possibility of will statements with an unlimited validity period, in addition to those with a limited validity period. This was approved at the end of the previous legislature.

However, the text presented is less balanced and not completely correct from a legal point of view. With legislation so delicate and crucial, where it is about life and death, one does not do cherrypicking. One must ensure that it is completely correct and that everyone’s freedom of choice and conscience is respected. If our amendments are not adopted, we will abstain from voting.

Dear colleagues, with regard to the bill that is submitted to us today, I will not extend long, as my colleagues have done, on the amendments that have been introduced or on the work carried out in committee. In fact, I think they were well conducted and allowed that the bill, which, at the beginning, when it was filed, only included the fact that the validity of advance declarations became indefinite, added two interesting elements, namely the obligation to return a patient who requests euthanasia if the doctor refuses to practice it and the prohibition of an institutional clause aimed at preventing the practice of euthanasia. Contrary to what has been said here today, I think that commission work has really enriched this change of the law.

As a general practitioner, I often talk about the end of life with my patients. This often happens very late when you are already faced with a wrong diagnosis. We change paradigm with the patient and then we enter a phase where, with him, we will examine his wills in a thorough manner. Together we make the decisions so that he can have the end of life that is as close as possible to his will.

Sometimes we don’t have that time. Sometimes this happens suddenly and we no longer have the opportunity to ask the patient for his will. This is exactly where the early declaration of euthanasia makes all its sense. Euthanasia can then be practiced effectively, as long as the patient has a serious and incurable accidental or pathological condition, as long as he is unconscious and his situation is irreversible, according to the current state of science.

This helps to avoid dramas such as the highly mediated case of Vincent Lambert in France, where family and relatives have struggled with the will of the patient. This statement can also be calming. Knowing that your will will be respected if you ever fall unconscious is, for many people, important. This statement is still quite unknown.

Today, this statement, which must include two witnesses, must be renewed every five years. This is a very difficult process, for example for older people. In 2018, 30,000 applications came to an expiration. Would the will of all these people have changed? Of course not. These are often older people, with reduced mobility, to whom this approach seems to be heavy.

We all heard a few months ago the death of the Flemish wheelchair athlete Marieke "Wielemie" Vervoort. She suffered from progressive tetraplegia and chose euthanasia at the end of October 2019. Her declaration of will, which she had drawn up in 2008, had to be renewed up to twice. That declaration of will and the idea that her will was respected gave her the courage, the strength and the peace of mind to go on for many more years. Today that declaration of will will be valid indefinitely. The declaration of will can also be revoked or modified at any time. Let us not make things unnecessarily complicated. Withdrawing or adjusting the declaration of will remains very easy and can be done at any time. This is an enormous reassurance of the patient’s desire for a dignified end of life.

The second amendment to the law is also important. It stipulates that a healthcare institution cannot prevent any doctor from applying an euthanasia application, of course, in compliance with the legal conditions. This is very important. This is about patients who are incurably ill and whose illness is irreversible. At some point, those people can end up in the hospital. Often this is not the hospital of your choice, but the nearest, where family and friends can pass through. It is therefore very important that the will of the patient is respected, regardless of the health care institution where the patient arrives, especially when we hear that certain hospitals require their patients to follow a palliative care pathway when they request euthanasia. It cannot be that people who suffer and desire a dignified end of life must fight against their will for longer. Failure to comply with this decision of will is a serious infringement on the rights of the patient.

Hospitals, indeed, have the right to formulate their own ethical medical policy, but it is not possible for people to be confronted against their will with, for example, a palliative filter, or that doctors are prevented from executing an euthanasia request if they wish to do so. The opinion of the State Council was therefore very clear: the right of self-determination of the patient and the freedom of action of the doctor must be considered.

In order for everyone to have an end of life closest to their choice, we still have a long way to go in Belgium, even if we are on the right path. We need to raise awareness of the possibility of early declaration among the population. We must invest more in the training of medical staff, in the services of palliative care and move towards a legislative framework that allows the patient to access the end of life as he has chosen, respecting his autonomy. By making the validity of the declaration unlimited, by establishing the observance of all institutions of the euthanasia law, we are taking a step towards respecting the right of the patient and a decent end of life.

Mr. Speaker, dear colleagues, also on my behalf, I thank the parties who have contributed to the implementation of this proposal. It is a proposal by which we respond to a real demand of the people. Euthanasia is a subject that leaves no one untouched. This has also been demonstrated during the committee debates.

In 2002, after the Netherlands, our country was the second country in the world where euthanasia was legally regulated. We are now 18 years ahead. We therefore find it necessary to conduct a thorough debate here.

A first step is the proposal presented today, with which we abolish, among other things, the limited period of validity of the declaration of will. That was, by the way, a concrete request from the evaluation committee Euthanasia, which makes a report every two years and which also asks every two years to make the declaration of will valid for indefinite duration.

The validity period of up to five years in the past sometimes caused shaking conditions. A doctor could not apply euthanasia because the declaration of will had expired.

The Parliament already approved an amendment last summer, through the law containing several provisions of 5 May. Thus, people with a registered declaration of will could determine the validity period themselves, or they could choose a declaration of will of indefinite duration. Three months before the expiration date, or at least every ten years, patients were required to receive a reminder under that law.

However, a lot of people choose an unregistered declaration of will, for a variety of reasons.

Who are we, Mrs. Van Peel, to compel people to register their declaration of will with the municipal administration?

Mr. Creyelman, you have made the proposal to make registration easier by allowing them, for example, to the general physician. This is what an unregistered declaration of will means. It is determined by the general doctor and it is kept there, possibly with a copy in the residential care center. The problem was that this could not be for an indefinite duration.

Any so-called negative will declaration, with which one can refuse, for example, a medical treatment such as probe feeding, can already be indefinitely lasting today. To be honest, that this is possible for such a determination of will, and for others not, I am not explained to the people.

This proposal eliminates this anomaly. Therefore, this proposal is an improvement, also compared to the law passed last year.

Furthermore, the law of 5 May did not contain any transitional measures or transitional provisions. This is envisaged in the new proposal. Declarations of will made before the entry into force of the law fall under the old regulation. From the entry into force of the new law, every new declaration of will or renewal is automatically of indefinite duration. Patients, doctors and other associations are also the requesting party and support this proposal.

Of course, I also ask the Minister to be willing to use all means to communicate about these adjustments, so that it is very clear to everyone. Some in the committee suggested that the law of 5 May provided for a ten-year memorial obligation. They wonder what could be wrong with that. In practice, people today are already regularly reminded of their declaration of will, for example, by the general doctor. Family doctors regularly discuss the declaration of will with their patients. In some cases, a ten-year memory is too short, in other cases, it will be too long. So let us rely on the experts who guide patients and on the patients themselves, who really know how to deal with this sensitive topic.

With this new proposal, those with an unregistered declaration of will receive the same security as those with a registered declaration of will. People also think very thoroughly about an important decision such as the end of their life.

For the Open Vld faction, the free choice of the patient is central. Everyone has to decide for themselves what is a worthy life end for them. A declaration of will for an indefinite duration provides clarity. You cannot forget to extend them. Anyone who changes his mind during a certain stage of his life can modify or withdraw that declaration of will at any time in a very simple way. I am 45 years old and today my position is that in certain situations I would wish for euthanasia. But I don’t know if I want to think about it every year or every five years. Maybe I never want to think about it again. So I find it only logical that this becomes indefinite and that I myself at some point can think about whether I want to change my declaration of will.

The State Council actually confirms that in this way the freedom of choice is guaranteed. They literally write that adjustment is very simple.

What I find strange about the advice is that it is said that there may now be a discrimination between people who want a declaration of will of a certain duration and people who want one of an indefinite duration. This observation was not made before, when indefinite duration was not even possible. At that time, this discrimination did not exist.

The free choice of the doctor is also important to us. A doctor can never be obliged to perform euthanasia. What is happening in practice today is that doctors wait a long time to announce their refusal to the patient. In this way, they leave them in the unknown. With the present proposal, we solve this issue, because a doctor must now communicate his decision to the patient within a reasonable period of time and forward the file.

We find it even more important that now it is also clearly stipulated that institutions cannot come up with a so-called conscience clause. An amendment has been submitted that would allow hospitals or other institutions to prohibit their doctors and doctors from applying euthanasia. It is very clear to us that this cannot be done. They are funded by the government and must comply with the legislation. Therefore, they cannot prohibit their doctors from applying euthanasia, just as they cannot compel them to do so, for all clarity. Therefore, it is obvious that we will not support the above amendment.

I look forward to a broad support for this proposal.

My father will be 88 next month. He is still alive-and-kicking, which of course makes us very happy.

It is precisely that vivacity and his pleasure in life that he, as the end approaches, wants to remain on the wheel himself. “I’ve made decisions myself all my life,” he says. “If I become incurably sick and suffering, then I want to be able to decide myself,” he says. So he has drawn up a declaration of will, carefully registered with witnesses, everything on and on. You can’t imagine how many times I’ve heard, “Karin, if those five years are over, you’ll notify me, right?” That fear is very real.

Like my father, there are many. I come to the field very often and I am going to talk about such things very often. I constantly encounter people who are concerned about whether that declaration of will is now well registered, whether it is in order and above all, whether they will still be in time to renew that declaration of will. This lives in our society. There is a large support for this. People want to make decisions themselves and only revoke them if they change their own minds.

In the previous legislature, we have submitted a proposal in this regard. That proposal consisted in making a declaration of will, renewing it within three years and then letting it become infinite in time, unless one itself revokes it, of course.

The SPA is ⁇ pleased that it can support this very clear proposal.

That this proposal has been bluntly pursued is an unjust criticism, especially if I compare it with the quick-flight manner in which at the end of the previous legislature an unclear, vague formulation was thrown away in a larger bill. Mr De Caluwé has already mentioned this.

This proposal comes with this. That is a very good thing.

We will, in any case, approve this with conviction. We hope to continue to work together on new, beautiful, ethical proposals in the future.

Thank you to the colleagues for the constructive cooperation.

First, let me make a very personal comment. I hear some of you exclusively associate the right to die in dignity with euthanasia. I am always uncomfortable to hear you present things this way. Everyone has the right to die in dignity. Everyone has the right to be respected for their choices. And every patient, whatever their choice – euthanasia or not – has the right to die in dignity.

I now come to this text. During the previous legislature, we voted on the text that allowed either a validity period of ten years for this declaration or an unlimited duration. This text has never been applied. Some colleagues explained why, I will not repeat it. Today you are destroying this work, this law, and imposing an unlimited period of validity, and this for all, whatever the choices of one and the other.

This text poses two problems. The first concerns the free choice of each person. As much as I understand that some or others choose the early declaration with an unlimited duration, as much I think it is important to respect the choice of people who do not want to change their declaration afterwards, but want a period of validity limited in time.

We sent this amendment to the Council of State, which approved it. Let me quote the State Council: “This possibility has the advantage of not affecting the right to self-determination of persons who want to give an indefinite period of validity to their early declaration, while persons who are less certain about the long-term evolution of their beliefs regarding early declaration and who want to compel themselves to periodically re-evaluate that declaration have this possibility without having to undergo procedures, regardless of the type of procedure.”

We presented this amendment here in the plenary session. For us, respecting each person’s free choice means leaving them a total choice and not imposing an unlimited duration that they should subsequently modify through procedures.

We have a second problem. Who decides on an euthanasia for a patient, for example, 80 years old, who would have made his advance declaration 30, 40, 50 or even 60 years earlier and who would have for this purpose decided to entrust this responsibility to 1, 2 or 3 people with an unlimited validity period? What if these people have died or are no longer able to talk to the doctor and therefore decide and assume the confidence that the author of the early statement had put in their hands?

We had discussions in the committee and you decided that, if trusted people were no longer able to talk to the doctor, the doctor would decide by office alone. This is obviously not to respect the initial choice of the person who, having made an early declaration, had obviously planned to hand over this decision to a trusted person who no longer has the capacity to do so.

We therefore submitted an amendment leaving the choice to the person, in the event that the trusted persons would no longer be able to talk with the doctor or would simply die, either to designate, in its early declaration, the doctor as the decision maker in place of the trusted persons, or to stipulate expressly, in the early declaration, that their declaration is no longer valid. Thus, in my opinion, the choice of patients, people is respected and they are also left with all responsibility at the time of the early declaration because you do not have to choose and decide in their place. This is the true respect for the patient. Respect for freedom of choice is also this.

This amendment is also submitted. It was not supported in the committee, at least on the arithmetic level because I heard that some still had doubts on this subject. We will see what will happen today.

What is, in any case, important for us, is to leave the choice to each person, to respect that choice whatever it is, to allow each person to die in dignity and to choose the accompaniment and end of life that he wishes.

For all these reasons, I will abstain, unless these amendments were now supported by an arithmetic majority.

In our group, as we have already expressed, there is an ethical freedom with regard to the themes that fall within the scope of ethics. In doing so, if I have announced my vote and my position, each member of our group will vote in soul and conscience.

Mr. Speaker, dear colleagues, I am very pleased to be able, today, to support the bill on consideration that is part of the perfect line of the 2002 Euthanasia Act, a law that had been put forward by the progressive rainbow government of the time and which confirmed the place of Belgium as a precursor state in the field of ethics. Indeed, this fundamental law has established a legal framework that – I want to remind you – never imposes anything on anyone but, on the other hand, has the merit of placing the patient and the freedom of choice of the latter at the heart of the device.

A framework that allows patients who apply for it and who are, of course, in the legal conditions, in strictly defined medical conditions, i.e. a medical situation without a way out, constant, unbearable and unbearable physical and/or mental suffering, and a serious and incurable accidental or pathological condition, to die in dignity.

Since 2002, doctors can, at the request of their patients, make a final act of care and let them leave serene, peacefully, surrounded by their relatives and medical staff.

Since 2002, the patient has been able to decide to take his last breath by liberating himself from his illness and suffering.

Since 2002 too, we see France and the judicial saga of Vincent Lambert that unfortunately shaken it, which was evoked by one of my colleagues, with some perplexity, but also some sadness. It is sad to see that some patients, while they are literally plagued by the disease, can still not see their ultimate freedom respected. Approximately 90% of euthanasia is due to terminally-stage cancers.

We can therefore be proud to have, in Belgium, a law that humanizes the end of life, which allows patients to reappropriate their bodies, their medical decisions and their death.

It is still that almost eighteen years after the adoption of this law, we now have the necessary retreat to find that the current law can sometimes, in some aspects, pose practical difficulties to these patients at the end of life. Difficulties to which the bill intends to respond with correctness, seriousness and dignity.

We have also seen, through the recent court trial in Ghent, that doctors need to be more protected in the context of their practice, since they only respond to the ultimate will of their patients. First of all, I would like to thank the authors of this bill.

The first major amendment proposed by this text aims to remove the validity period of the early declaration, that is, that form by which the patient still capable and conscious expresses his will to resort to euthanasia on the day when he would find himself unable to formulate this request (in case of coma, for example) and when he would be in the legal conditions to benefit from it.

The five-year validity period has recently been increased to ten years, we have been rejected by several parties in commission. Except that in the absence of a royal enforcement decree, the period of validity ultimately remains five years. The extension continues to constitute a very heavy administrative procedure, sometimes too heavy for the sick, and this was again recalled by the State Council in its opinion. As for the Federal Commission for the Control and Evaluation of Euthanasia, it also highlighted the anxiogenic nature of the requirement to renew this early declaration. Patients are afraid to forget this five-year deadline. The sick are also afraid to no longer have, over the years that pass, a sufficiently provided environment to find witnesses and trusted persons, an indispensable condition to be fulfilled in order for the early declaration to be valid.

The [...]

I thank you for doing what is necessary, Mr. Speaker, because it is extremely unpleasant to work in such conditions on such an important topic.

I am continuing. Even worse, this requirement makes euthanasia impossible for patients who would meanwhile suffer from advanced brain degeneration. Indeed, this degeneration deprives them of a consciousness that is necessary – and it is normal – to renew this anticipated statement. This period of validity should therefore be removed.

However, it should be noted that the advance declaration can be withdrawn or modified at any time, like a will or advance declaration concerning therapeutic hardening. This statement is limited in time.

To return to our work in committee, I heard that the Law for the All-Four of May 5, 2019 had resolved this issue. It is hard to see that there is nothing. As I said, the law of 5 May 2019 did not enter into force because the royal enforcement decrees were not adopted.

That’s why patients, doctors and associations that fight for the right to die in dignity – and my socialist colleagues have recalled the considerable work provided for decades by the Association for the right to die in dignity – all confirm to us that the only acceptable and patient-respecting solution is to remove the validity period of the early declaration. Indeed, when one is plagued by the disease and it ultimately prevents us from living, any administrative simplification is welcome.

In this regard, amendments have been submitted in committees by some parties, following the opinion of the State Council, and are still so today even within our homicide. One of them aims to allow patients to fix, if they wish, a validity period limited to their early declaration. The problem, dear colleagues, is that it would result in several types of early declaration, with the effect that the steps to be undertaken at the end of life would become increasingly complicated. This is not acceptable when it comes to people already heavily weakened by the disease.

To justify this limitation, it has also been advanced by some that some patients would eventually not submit an advance declaration because they fear to forget, after a few years, the requirement to renew it as well as its limited character in time. This argument does not hold either. Indeed, if certain declarations are not filed or renewed, it is precisely due to the administrative burden of their renewal – a burden that this proposal just tends to remove.

Finally, it was also argued that the possibility of limiting in time the statement would allow for equality between patients – between those who would like this limitation in time and others. Sorry, but this argument still does not hold. First, as I said, any patient can, at any time, withdraw his early declaration. However, this is a much simpler administrative declaration than the one intended to renew it.

And, secondly, because today patients are not on an equal footing. Indeed, only those who have the strength and the possibility to renew their early declaration have the chance to see their will to die in respected dignity. For these reasons, and in order to be able to carry out its approach regarding the right to die in dignity as serenely as possible, this amendment has been rejected in the committee and we will also reject it today in the plenary session.

I also heard, in the commission and today in the mouth of Mrs. Van Peel, that we were acting in the precipitation. This is definitely the flagship argument of opponents of any progressive advance in ethical matters at this beginning of the legislature. An argument that is all the more picky - this was recalled by my colleague Sofie Merckx in the case of euthanasia, as well as by Mrs Jiroflée - that it is advanced by representatives of parties who defended this famous four-all law of 5 May 2019, which modified the provisions relating to the euthanasia law just before the dissolution of the chambers without any debate on the very specific issue of euthanasia.

Two weights two measures, but also of bad faith. This debate, thanks to my colleagues authors of this proposal, we have finally been able to have it in the Health Committee. We were finally able to explain why this change was indispensable for patients, especially for those who do not dare to fill out an advance declaration precisely because of this obligation to renew. Today, only 2% of euthanasies are performed on the basis of early declaration.

The second major amendment brought by this text is to better frame the objection of conscience by emphasizing its personal character, but also by providing that the doctor will have a maximum of seven days to make his decision and, in case of refusal to practice euthanasia, a maximum of four days to transmit the patient's dossier to a colleague who will have to examine his application. Examining his application is not practicing euthanasia as such: there is a big nuance.

I would like to emphasize that this is therefore in no way a revolution since the ratio legis of this law of 28 May 2002 is fully respected. Indeed, the present proposal of law only specifies what should go of course but which unfortunately, in the facts, is not respected. The objection of conscience is by definition personal, unique to a single doctor and the law of 2002 proposed a just balance between the therapeutic freedom of the doctor, the freedom of conscience and, on the other hand, the freedom of choice of the patient.

However, it happens today that medical institutions – even if they are funded by public money – or rest homes brand a so-called conscientious clause to prohibit all their employees from practicing euthanasia in their womb, even if a patient meets all legal conditions and the treating doctor has given his consent. This prohibition, which is sometimes expressed in a veiled or entirely assumed way – on a website for example – is completely contrary to the therapeutic freedom of the doctor. It is also contrary to the right of the patient to die in dignity. In fact, it cannot be considered that if a patient wishes to be euthanized, he ultimately only has to choose to go elsewhere. You are perfectly aware of the fact that it is not so simple at the end of life. Then, it is not respectful of patients who are already heavily weakened by the disease.

The choice of an institution at the end of life is very rarely made for ideological reasons. It is most often done by the family for reasons of proximity, convenience or for financial reasons.

Fortunately, these practices are minority. However, they are disturbing and therefore deserve our full attention. It is our role as a legislator to show solidarity with these patients because they have not been able to see their freedom of choice respected. It is also our role to ensure that all patients are treated equally. It is also our role to avoid what François de Closets described in his book The Last Freedom as "two-speed death."

We also observe that some conscientious doctors delay in communicating their patient’s medical record to another doctor, which can have dramatic consequences for that same patient. Most often, this situation leads to a break in care but also an anxiety related to the search for a new doctor, who is not known and of whom one hopes that he will be able to respect his freedom of choice, or rather his freedom of choice of life but also of death. This is a ⁇ heavy and difficult situation for patients who are already out of power.

For all these reasons, my group will enthusiastically support this bill.

I finally wanted to clarify one fundamental thing: euthanasia will never be a banal act. This is an act that will always present a very important emotional load for the doctor. It is also an act of great humanity because it concrete the right of the patient to this ultimate freedom to decide how he will take his last breath, ending an incurable disease and suffering that is unbearable.

Choosing his death is a freedom but it is also a right that cannot be hampered, both for administrative and ideological reasons. That’s what founded the 2002 law and that’s what I hope will be the basis for this new law. I thank you.

There is another second round of speakers, with Mr. De Roover and Mrs. Hennuy.

Ladies and gentlemen, I am removing my coat of chairman. This has a very obvious reason. We also respect freedom of party in such matters.

Now I immediately wear my coat of chairman to say that I am very pleased that after a very thorough discussion on the subject in my own group, several group members have indicated that they will wait for the debate before determining their final vote, which indicates sufficiently with what openness to the argumentation and with what lack of prejudice they are following the debate. I have to admit that I am proud of this position as President of the European Parliament.

I continue my speech as a member of the House. I take a break so that everything is clear.

Since I cannot hide myself behind the group discipline here, I would like to state very clearly that my voting behaviour must be interpreted in a certain way. After all, to be honest, my heart balance.

I will approve the proposal. I will approve it because – several speakers have referred to it – the issue was addressed seriously during the previous legislature.

Simbolism has served as a driving force for the initiators. A number of speakers have also pointed out that voting behaviour other than approval could not only be, but will also be interpreted as a negative attitude towards freedom in the euthanasia debate as such. I do not wish that this suspicion rested on me in any way.

In essence, the freedom, the freedom of choice of the citizen in the present proposal remains intact, although more freedom would be possible. The submitted amendments still provide an opportunity to make that improvement.

The reluctance of a number of political groups to the amendments submitted by a number of CD&V and CDH members is, in my view, very strange, since they are the ones who rely on the free choice of the citizen, while the amendments concerned are actually aimed at expanding that freedom.

I will limit myself to the amendment that led to point 3.1 of the present proposal in the Committee.

It was our conviction that point 3.1 is superfluous, because the provision in it does not actually add anything new in comparison to the existing state. That is why we were not in favour of this.

When an amendment is submitted to insert something that is actually superfluous, it is never unreasonable to think at once about the motivation of the applicant of that amendment. It is not up to me to look in the minds of others. In that amendment, a certain smell of sluggish decision-making can be noted.

I am therefore pleased that the proposal was submitted and also approved, as it allowed the State Council to consider the scope of that point 3.1. I was very happy to vote that the Council of State gave an interpretation that contradicts the reading of the colleague of the Flemish Interest happily manifestly. I will read two passages from the State Council opinion on this subject.

For all clarity, point 3.1 says: “No written or non-written clause should prevent a doctor from applying euthanasia in compliance with the legal conditions.” After all, why should an employer prevent an employee from acting according to his or her conscience? However, this passage has caused some commotion in the public opinion.

I quote from the State Council report: “The proposed measure does not imply that the institution loses its freedom to develop its own policy on euthanasia and medical decisions regarding the end of life and to inform its patients and residents about that policy. Nor does the institution lose its freedom to conduct its own personnel policy for the rest. The proposed measure only means that the institution may not include a clause in the agreement with the doctor that prevents the doctor from applying euthanasia under the statutory conditions." Furthermore, the State Council says that it considers the text "not disproportionate": "This would be different if the proposed provision would include that the healthcare institutions would be obliged to actively respond to euthanasia requests from users."

Thus it is through this form that I can not only live with that passage in terms of content, but that I am also reassured that my yes-vote unambiguously fits within the interpretation of the Council of State. This is an important factor in assessing the scope of legislation. I am therefore grateful to the one who submitted the amendment, no matter how unnecessary it is, because in this way, through the Council of State, a readiness has been created that can still be useful in the future.

There has been a logic that began with the treatment of euthanasia legislation by our colleagues at the time, who at that time unanimously followed that same position. We are talking about the rights and freedoms of citizens. There are rights and freedoms of citizens who are patients. There are rights and freedoms of citizens who are doctors here. There are rights and freedoms of citizens who provide care. Three times it is about citizens who have rights and freedoms that we cannot challenge. The Council of State also refers to the highest legal principles. The State Council also says that these freedoms, fortunately, should not conflict with each other.

Dear colleagues, I will approve the bill. I will ⁇ support the amendments I talked about, because I think they bring a remarkable improvement. However, I will vote in favour of the very clear interpretation given by the Council of State of point 3.1.

In May 2002, Belgium was a pioneering country in the field of euthanasia. Since then, the law that has been voted allows people who wish to choose a milder death, a determined and dignified end of life.

The framework is very strict and balanced but it was far from perfect and suitable. In 17 years, this law has shown many practical limitations experienced and denounced by patients, citizens, active associations or doctors. It had to be corrected and improved. This is how the environmentalists filed a text aiming to remove the renewal period of the early declaration of euthanasia, initially planned every 5 years.

From now on, the early declaration will be valid for an unlimited period. This protects persons from forgetting the deadline and their will will be respected, especially since everyone remains free at any time to withdraw or modify their declaration without any formality.

Our proposal goes in the direction of protecting the choice of the citizen. Filling out an euthanasia application form is an individual choice and falls within the private domain. Adding a validity period only exacerbates and unnecessarily slows down this approach. It was time to clarify the procedure in the interest of the citizen and the patient.

Additionally, thanks to the amendments introduced by our colleagues in the PS group, now doctors who do not wish to perform euthanasia will have a maximum of seven days to inform their patients and will have to direct them to structures that can provide them with useful advice. Environmentalists are obviously delighted with this progress that advances the right to euthanasia.

Finally, I will conclude by saying that this is my first text and my first experience as a parliamentary. I will retain the wealth of exchanges with colleagues. It was very educational and exciting. I would also like to thank my two Ecolo-Groen predecessors, Anne Dedry and Muriel Gerkens, who have carried this text unremittingly over the years. I am not too proud to carry this text to the end today. A great thank you for this.