What Belgium’s increase in euthanasia cases says about legalising assisted dying

Euthanasia has been legal in Belgium since mid-2002, and in the past two decades, the number of reported cases has risen sharply. In 2003, only 236 cases were recorded, but by 2023, this had increased to 3,423. This means that euthanasia now accounts for around 3% of all deaths. But what explains this increase? And does it suggest a worrying trend, as some critics fear?

In a new study published in Jama Network Open, my colleagues and I analysed trends in all reported euthanasia cases between 2002 and 2023. Our findings show that the rise in euthanasia cases can be attributed to two factors: “regulatory onset” (the time required for both the medical community to adapt its practices and protocols to the new law, and for the public to become informed about its availability and implications) and demographic change, including population ageing.

We saw a sharp rise in cases during the 15 years following the law being introduced, followed by a period of stabilisation. About one-third of the increase can be explained by demographic changes – mainly population ageing. Euthanasia is indeed most common among people in their 70s and 80s, who often suffer from terminal cancer or several conditions. The number of people in those age categories has steadily increased.

A common point...

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