This article was published by Bioedge on January 26, 2020.

By Michael Cook

The three doctors on trial /Belga

The criminal trial of three Belgian doctors for assisting in an allegedly illegal euthanasia of a woman in 2010 is under way. It is the first time that doctors have been charged with an unlawful death since the legalisation of euthanasia in 2002. The accused have been named in the media: the doctor who administered the lethal injection, Joris van Hove; the general practitioner, Frank de Greef; and the psychiatrist, Godelieve Thienpont.

Tine Nys (center) with her sisters.

The parents and two sisters of Tine Nys have succeeded, after nine years of harassing the bureaucracy, in having charges laid. The prosecution alleges that the defendants did not follow the prescribed guidelines for euthanasia in Belgium. Tine was 38 when she died, surrounded by her family, in 2010. The doctors aver that she was suffering from a “serious and incurable disorder”. In her case, it was said to be unbearable psychological suffering.

The life of Tine Nys grew sadder with the testimony of each witness. She had been estranged from her family for years. She experienced violence in her relationships, she had an abortion, she had worked as a prostitute. “Everything in her life was a failure,” said Dr Thienpont, who diagnosed her as autistic not long before the death. 

The main lawyer for the parents and two sisters of Tine was forced to step down over a bizarre conflict of interest.  The head of Belgium’s euthanasia evaluation commission, Wim Distelmans, revealed that Fernand Keuleneer had been a non-voting member of the commission when her case was approved.  He has been replaced by Joris Van Cauter.

How the doctors broke the Belgian euthanasia law became clearer. Tine had asked Dr de Greef for a letter authorising euthanasia, but he refused. So she went to LEIF, a euthanasia agency, and found Dr van Hove. Dr van Hove dropped by Dr de Greef on the evening of April 27, 2010 at 8pm and asked him to sign a paper. Apparently de Greef misunderstood,  because he recalled being aghast when he learned that Tine had been euthanised.

This occasioned two breaches of the conditions which shield doctors from prosecution for murder. First, Dr van Hove falsely listed Dr de Greef as the first doctor confirming that Tine was eligible for euthanasia. Second, the paperwork arrived at the euthanasia commission nearly four weeks late.

This worries euthanasia doctors. One told the Belgian newspaper De Morgen, “As a doctor, will you still run the risk of performing euthanasia if you know that with that you run the risk of being prosecuted for premeditated murder? Just because your euthanasia certificate did not arrive at the committee within four days?”

Dr Joris van Hove’s seedy background was highlighted in the media coverage. He has been in court before for various offenses, including drink driving and forgery. In 2017 he was convicted of sex offences with young male patients. 

However, Dr. van Hove told the court that the euthanasia procedure had been carried out within the law. He protested that the very fact that the case had reached the stage of prosecution was a victory for the “hidden agenda” of the Catholic Church.

He admitted that he had never done a euthanasia for psychological suffering before and that he had been clumsy. He had not completed his “end of life” training and he failed to administer the lethal injection properly. He did not have a stand for the infusion and the bag plopped onto Tine’s face as she was saying goodbye to her family. 

The general practitioner, Dr Frank de Greef, painted himself as the victim of a charming but manipulative young woman and her angry relatives. When she was diagnosed as autistic by Dr Thienpont, he was thunderstruck. “When I saw that diagnosis, I thought: What kind of stupid person have I been? Look at its history, everything could be explained by that autism. Tine was engaging and intellectual, but also manipulative and looking for conflict.”

The trial continues.

Michael Cook is editor of BioEdge: bioethics news from around the world.