Kim Leadbeater’s bill boasts “strict safeguards in the world” and has been described by Ms Leadbeater herself as “very robust”. Much debate has, hitherto, largely focused on abstract legal analysis debating the efficacy of those apparent safeguards. However, this debate need not focus on hypotheticals; we can observe the very real consequences of very similar laws only a short distance away in Belgium and the Netherlands.

Belgium was one of the first countries to legalise assisted suicide and euthanasia in 2002. The bill was also introduced with the promise of ‘strict safeguards’, consisting of a very similar three-stage test to Kim Leadbeater’s proposed legislation. By law, every euthanasia must be approved by two doctors who agree the patient’s condition is “medically futile” and “of constant unbearable physical or mental suffering”. After the fact, the case must then be reviewed by the “Federal Control Commission”, a body set up to oversee the practice of euthanasia in Belgium.

A former member of the commission, Dr Robert Rubben said in 2020:

The Commission never decides that something wrong was done. The Commission merely has to determine whether the rules were observed and whether there are no reasons to doubt. My fundamental dissatisfaction with this was that even in case of doubt, it was nevertheless always approved by the Commission. And secondly, and this is a statistical reality, that out of the first 10,000 evaluated cases, not one was referred for further investigation.

Since 2002, there have been 33,602 recorded cases of euthanasia in Belgium, with the annual figure increasing almost every year, starting at 235 in 2003 and growing to 3,423 in 2023. Despite these extraordinary numbers, there has only ever been a single prosecution in the history of Belgian law.

The tragic case was that of Tine Nys, a 38-year-old woman with depression and a recent diagnosis of autism. Whilst she had a history of psychiatric illness (having tried to take her life when younger), her sisters were adamant she was not incurably ill and that she had not had any psychiatric treatment for 15 years. Rather they maintained that her recent episode of depression was attributable to the breakdown of a recent relationship. She had been diagnosed with autism two months prior to her death and had not yet received treatment. Despite the purported rigid safeguards, the patient was able to convince two doctors her condition was “medically futile”, that it constituted “unbearable suffering that could not be alleviated”, so much so that it made sense to end her life. The basis for the prosecution was that any patient undergoing euthanasia must have an “incurable” condition and that Tine’s family insisted that hers had not been.

The sisters alleged that Dr Van Hove had acted unprofessionally, claiming he had “likened her death to that of a pet that is in pain and having a shot” and had asked their father to hold the needle since he’d forgotten the bandage. Ultimately Dr Van Hove was acquitted. Flemish Media reported that the judgement of the court was that “there was reasonable doubt… and if there is reasonable doubt it is to the benefit of the accused”. His acquittal was upheld in 2023.

Statistics from The Netherlands demonstrate a similar trend. Since legalisation, the number of deaths by euthanasia has climbed consistently year-on-year from 1,626 in 2003 to 9,068 in 2023. Despite the large number of deaths, there has only ever been a single prosecution, euphemistically known as the “coffee euthanasia case”. Here, a 74-year-old lady with dementia had stated that she would choose euthanasia were she ever admitted to a care home. This came to pass, and she gave mixed signals as to whether this was still her wish. With the consent of her husband, her doctor agreed to end her life. He put a sedative into her coffee and forcibly administered a second dose when the first was unsuccessful. After she was apparently sedated, the doctor injected the needle and did not interpret the frightened look or attempts to remove the needle by the woman as an indication she didn’t want to die. The doctor was prosecuted and found not guilty on the basis that a written declaration four years ago by the patient sufficed in establishing consent. This verdict was upheld by the Dutch Supreme Court.

The trends are clear. When countries go down this path, the number of state-sanctioned deaths inflates rapidly — and no amount of “safeguarding” can protect the vulnerable from negligence and abuse. We would be deeply foolish to ignore the warnings of our neighbours in passing Leadbeater’s reckless bill.