A recent study published by the British Medical Journal (you can read a synopsis here and the actual study here) showed that half of the euthanasia being administered in Belgium, where euthanasia is legal, goes unreported. The law requires that every instance of euthanasia be recorded and reported according to specific guidelines and procedures. The law defines euthanasia very strictly and requires that every incidence of it be reported.
According to the study, 77% of physicians who did not report euthanizing a patient withheld the required paperwork because they believed that what they did was not "euthanasia" as defined by Belgium's law -- yet, it was "euthanasia" in the broader sense. The study, based on a questionnaire, makes it difficult to draw conclusions as to why those physicians did not consider killing their patients to be euthanasia. For instance, only 37% percent of the incidents were reported when the euthanasia was perceived to shorten life by less than a week, whereas 74% of the incidents were reported if the patient were expected to live longer than a week without being euthanized. Perhaps a fair number did not think it "counted" the closer the patient was to natural death.
The reality is, doctors in Belgium are killing patients based on their own judgments and outside the scope and monitoring of the law. And the reality is, when people believe what they do is wrong or if they fear some sort of retribution, they will try to hide it. The law, however, was enacted to take euthanasia out of secrecy so that it can be adequately monitored for abuse, and to take away threat of retribution.
So what is the next step for Belgium? Deregulate euthanasia altogether so that what these doctors are doing becomes legal?
The bigger question is, though, did Belgium's law make euthanasia to be a good thing to do to begin with? Legalization of euthanasia does not change what it is, the intentional killing of an innocent person, the surrender of any attempt to provide care and comfort in the last stages of disease, a capitulation to the notion that life in some cases is not worth living, and a step onto that slippery slope where the definition of "a life not worth living" can be incrementally changed.
The law cannot make euthanasia to be other than what it is, but it nonetheless changes people's hearts and attitudes and makes them susceptible to sliding down that slippery slope. It can alter the thinking and attitudes of whole societies. In that sense, it can define reality even if it can't change the nature of things.
We can today define "a life not worth living" in narrow terms, but tomorrow the definition will change. Today it is the terminally ill meeting certain criteria in Belgium, and tomorrow it may simply be the terminally ill (irrespective of any additional criteria), and after that, those not terminally ill but chronically ill, and after that.... who knows? The Holocaust has its roots in Nazi euthanasia programs that did not begin nor end with the Jews even if the extermination of the Jews was the goal the Nazis were heading toward by intent. In another post, I look at the same idea regarding forced sterilization of the "unfit." "Unfit to breed" is just a step away from "unfit to live."
The Holy See's permanent observer at the UN recently warned the General Assembly against the phenomenon of "rule by law" as opposed to "rule of law." The law must reflect justice that is higher than the law. It cannot define justice to be whatever society legislates. It cannot define realities. It can make euthanasia to be legal, but it can't make it to be good. "Rule of law" means the legal code conforms to Law Itself: Justice, the natural law to which euthanasia advocates attempt to appeal whether they know it or not, the objective order of right and wrong. "Rule by law" means people are living in a dream world where reality changes based on what the legal code says.
Those who support the legalization of euthanasia where it is not permitted appeal to a sense of justice that is not reflected in the law -- they perceive a disjunction between what the law says and what seems good and right to their minds. I believe their minds not to be seeing well on this issue, but their manner of advocacy is important to note: By trying to change the law, they affirm that the law must reflect an eternal justice that is beyond the law.
"Rule by law" results in lawlessness, because the principle enshrined by "rule by law" is a rejection of the authority of the natural law, which exists as the rational being's sense of justice and right and wrong, and which is prior in time and in importance to any law ever passed by any ruling authority. Rule by law places the ruling authority over natural law. Insofar as it contradicts natural law, it gives injustice the force of law. And where rule by law exists, the people follow its example and set themselves above the legal code and they do what they want. Rule by law creates a reality of anarchy and injustice.
The natural law says it is always wrong to kill an innocent person intentionally and it is always good to comfort and care for the sick and suffering. The underlying principle of Belgium's law says it is useless to provide some people with comfort and care and that killing those people is good. Ironically, the doctors breaking the law agree with the law by expanding the scope of the underlying principle. And that is the reality of things in Belgium.