This week Belgium is expected to become the first country in the world to allow terminally ill children to choose euthanasia.
Belgium legalized euthanasia in 2002 for those 18 and over, and the number of adults choosing a doctor-assisted death has been rising annually, reaching 1,432 in 2012.
But a bill before Parliament would lift age restrictions and allow terminally ill children to ask to be euthanized if they are in unbearable pain and treatment options are exhausted. In addition, their parents and medical team would have to agree.
Belgium's Senate passed the bill by a wide margin in December and the House of Representatives looks set to do the same in a vote planned for Thursday. In discussions about the proposal, some members of Parliament say they think that 10 to 15 gravely ill Belgian children annually will invoke the law and ask to die.
Neonatal pediatrician Olivia Williams has spent her career trying to save the lives of desperately ill children in one of Brussels' best critical-care wards.
"I've seen children ask to die," she says, "children with terminal cancer, suffering, children who refuse another operation that might give them another three months. They ask to die; they don't want it. Not all of them, but [it does happen]."
Williams says kids should have the same options as adults in ending their pain and suffering.
"If you go to a geriatric ward, patients with the same quality of life and the same life expectancy as a 6-year-old with bone cancer, you wouldn't let them suffer," she says. "When they ask you to go, you'd let them go."
Kids Don't Grasp Implications, Opponents Say
But Els Van Hoof, a senator with the Flemish Christian Democratic party, strongly opposes the legislation. She insists children can't possibly understand the implications of such a request.
"They can't [legally] drink before they're 16. They can't smoke before they're 16. They can't vote before they're 18. They can't marry before they're 18. They can't be punished because they don't have the competence," she says. "But when they talk about life and death, they can decide? It's not coherent."
Van Hoof worries overstretched parents will be the ones asking for their children's euthanasia or manipulating vulnerable kids into asking for it.
Beyond that, she believes the law is simply unnecessary, since Belgium already allows what's called palliative sedation. That allows doctors to increase pain medication to the point of eventual death when a patient's end-of-life suffering can no longer be alleviated in a conscious state.
Religious leaders also oppose the measure. A group representing several faiths issued a statement saying the law risks trivializing the sanctity of life and sets a dangerous path for society.
Catholic bishops have also condemned the measure. Decades ago, that would have carried a lot of weight in this heavily Catholic country.
"The Church has the opinion that life is a gift from God and that we don't have the right to throw it away," says religious commentator Rik Torfs, a former parliamentarian and current rector of Catholic University of Leuven.
He says that the huge public support for the bill is another mark of an erosion of religious faith.
"In the past, people were very Catholic and they thought, 'OK, we are not living nice days over here, but after our death, everything will be beautiful,'" he says. "Now they are saying, 'OK, nothing will happen afterward, so try to construct a happy end, which means a death controlled by ourselves.' "
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