Belgium/Canada: "Euthanasia Developments Raise Questions"

Belgium/Canada: "Assisted Dying Developments Raise Questions"

In nearly a third of cases, multiple chronic age-related conditions were decisive. This is shown by the current euthanasia report for 2024/2025, which was evaluated by the Institute for Medical Anthropology and Bioethics (IMABE). The Vienna-based institute works on behalf of the Austrian Bishops' Conference.

With 1,327 cases, 29.6 percent of all euthanasia procedures in Belgium were attributed to so-called polypathologies, that is, the simultaneous occurrence of several chronic illnesses and age-related ailments. Those affected often suffered from physical limitations and chronic pain. In 640 of these patients, death was not yet medically foreseeable. Their physical condition was considered stable, yet they experienced the sum of their suffering as unbearable. Since euthanasia was legalized in 2002, the number of cases has risen from 235 in the first full year to 4,487 in 2025. The number of procedures involving people without an immediately terminal illness also increased within five years, from 311 to 1,117.

IMABE in Vienna sees this as an expansion of euthanasia practice in Belgium beyond the situation originally associated with an immediately life-threatening illness. The development among older people in particular, it says, raises questions about how society deals with chronic illness and the need for long-term care.

"Concerning Developments" in Canada as Well

According to IMABE, the case of 83-year-old Brigitte Stegemann from Canada illustrates the dangers that can arise when protective safeguards erode. In the province of Ontario, criminal investigators are currently examining whether the dementia-stricken senior was euthanized despite having previously withdrawn her consent. According to her granddaughter, Stegemann was confused before the procedure and stated: "I made a mistake." On the day of her death, she was no longer responsive. Nevertheless, the procedure was carried out.

The granddaughter criticized, speaking to Fox News Digital: "My grandmother was a vulnerable elderly woman who was abandoned, while the doctors and the nursing home circumvented every legal safeguard." The case, she said, shows how crucial reliable consent and the protection of cognitively impaired patients are. Especially in dementia, a wish for death expressed earlier cannot simply be regarded as consent at a later point in time.

In Canada, Killing on Request Is an Established Part of the Health System

In Canada, killing on request has become an established part of the health system. In 2024, 16,499 people died through the procedure known as Medical Assistance in Dying (MAiD), roughly five percent of all deaths. The average age was 78. Canadian family physician Ramona Coelho described the development as a "quiet but profound change in the medical understanding of suffering, self-determination, and one's own mission."

While the Canadian government definitively rejected eligibility for cases involving psychiatric illness alone in October 2026, a new law permits, under certain conditions, an advance agreement to euthanasia in cases of neurodegenerative diseases. This can also be carried out if those affected later lose their capacity to consent. Coelho warns that a wish expressed well in advance need not match later feelings, since people with dementia can still show joy in life despite their limitations.

Care, Palliative Support and Human Accompaniment

For the IMABE institute in Vienna, the developments in Belgium and Canada raise fundamental questions. If chronic complaints and age-related limitations become grounds for killing on request, it must be all the more strongly ensured that care, palliative support, and human accompaniment are sufficiently available, the analysis states.

(kap – sk)

Thank you for reading this article. If you would like to stay up to date, you can order our newsletter here..