Archer Madeleine, Willmott Lindy, Chambaere Kenneth, Deliens Luc, White Ben P
Australian Centre for Health Law Research, Faculty of Business and Law, Queensland University of Technology, Brisbane, Australia.
End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel, Ghent, Brussels, Belgium.
Med Law Rev. 2025 Jan 4;33(1). doi: 10.1093/medlaw/fwaf003.
Euthanasia has been legal in Belgium since 2002. Despite extensive research exploring Belgian euthanasia practice, investigations into its governing regulatory framework are limited. Existing studies that consider regulation take a 'siloed' approach, generally considering sources of regulation individually, including euthanasia legislation and euthanasia policies. This study obtains insights from providing health professionals on how the Belgian euthanasia regulatory landscape influences their euthanasia practice. We conducted semi-structured, in-depth interviews from September 2022 to March 2024 with eligible physicians and nurses and analysed them using a reflexive approach to thematic analysis. We generated three overarching themes describing the influence of regulation on euthanasia practice: the Act is a valuable, boundary-setting instrument; but the Act is limited, leaving space for gap filling and other forms of regulation; and relying on professional judgment can make practitioners feel vulnerable. Key findings include that practitioners respond to the Act's non-prescriptiveness and regulatory lacunae by relying on their professional judgment, and that the efficacy of the retrospective euthanasia oversight model depends on physicians' good faith participation. Policymakers in Belgium and internationally are encouraged to reflect on the implications of Belgium's euthanasia regulatory model for the consistency, quality, and control of euthanasia practice.
自2002年以来，安乐死在比利时一直是合法的。尽管有大量研究探讨比利时的安乐死实践，但对其管理监管框架的调查却很有限。现有的考虑监管的研究采用“孤立”的方法，通常单独考虑监管来源，包括安乐死立法和安乐死政策。本研究通过向卫生专业人员了解比利时安乐死监管环境如何影响他们的安乐死实践，从而获得相关见解。我们在2022年9月至2024年3月期间，对符合条件的医生和护士进行了半结构化的深入访谈，并采用反思性主题分析方法对访谈进行了分析。我们生成了三个总体主题，描述了监管对安乐死实践的影响：该法案是一种有价值的、设定界限的工具；但该法案存在局限性，为填补空白和其他形式的监管留出了空间；依靠专业判断会让从业者感到脆弱。主要发现包括，从业者通过依靠专业判断来应对该法案的非规定性和监管漏洞，以及追溯性安乐死监督模式的有效性取决于医生的诚信参与。鼓励比利时和国际上的政策制定者思考比利时安乐死监管模式对安乐死实践的一致性、质量和控制的影响。
