To the Editor In their Viewpoint, Dr Siegel and colleagues1 reflected on the recent extension of the Belgian euthanasia law to include competent minors. As members of the Belgian End-of-Life Care Research Group, we think it is necessary to respond to their views to provide a more nuanced context and explain the prevailing perspective in Belgium.
The authors claimed that minors cannot possess the capacity for “a sophisticated preference” or “the experiential knowledge and sense of self” necessary to entertain the choice of euthanasia.1 The question is whether this is true for all minors. In the experience of pediatricians, terminally ill minors tend to mature more rapidly than their healthy peers as a consequence of their illness.2 This finding is reflected in the legislator’s rationale: in a context of legal euthanasia under criteria of strict due care, the age barrier for euthanasia is perceived as arbitrary. The prime qualifier for a valid, well-considered and competent request should not be chronological age but mental age and maturity. These views were supported by the Belgian Royal Academy of Medicine in a unanimous recommendation to government.
Chambaere K, Roelands M, Deliens L. Euthanasia for Minors in Belgium. JAMA. 2014;312(12):1258-1259. doi:10.1001/jama.2014.9873