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The World Should Follow Belgium's Lead In Granting Prisoners the Right to Die

The assisted suicide of a convicted murderer and rapist raises questions about assisted suicide, mental illness, and the barbarism of death penalties.

by Natasha Lennard
Sep 17 2014, 12:45am

Photo by Herman Ricour/AP

An imprisoned 50-year-old man, serving a life sentence since the 1980s for rape and murder, will be put to death this week. That's nothing remarkable for the United States, where 29 people have already been put to death in 2014. But Frank Van Den Bleeken's death has been sanctioned by a court in Belgium, where capital punishment has been banned since 1996.

Van Den Bleeken is not being executed — he is being allowed to die. In a landmark case, the inmate was granted the right to a physician-assisted suicide, which means his death will come under the imprimatur of mercy, not punishment. The prisoner's attorneys successfully argued that Van Den Bleeken faced ongoing years of mental anguish with no chance of relief or of release from prison, since both he and his lawyers acknowledge that his violent sexual impulses are uncontrollable.

He will be the first prisoner to be euthanized since Belgium legalized assisted death 12 years ago. The case thus sits at the intersection of ethical questions about the right to die, mental illness and incurability, and the very function of prison and punishment.

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Belgium's liberal euthanasia laws, broad enough to encompass mental anguish and the imprisoned, in some ways stand as an illustrative counterpoint to a US system that maintains an archaic enforcement of barbaric death penalties and (for the most part) a refusal to grant an individual's liberty to end his or her own life, even in cases of terminal disease. But it's not so simple as liberal Europe striding progressively ahead of backward American justice. Van Den Bleeken's case presents quandaries for death penalty abolitionists and euthanasia supporters alike.

Within its Belgian context, the prisoner's access to euthanasia is precedent-setting — but not necessarily surprising. He will not be the first person in the country to be granted the right to die due to mental anguish deemed unfixable, as opposed to terminal illness. After a set of 45-year-old deaf twins, who worked together as cobblers, learned they were also going blind due to a genetic disorder, they were granted the right to physician-administered lethal injection last year. Nathan Verhelst, 44, committed legal, physician-assisted suicide following botched gender-reassignment surgery, citing "unbearable psychological suffering."

Whether Van Den Bleeken's violent impulses are truly incurable is a crucial question, and one that should lead to scrutiny of Belgium's mental health and prison system.

Contra Thomas Jefferson's proclamation that all men "are endowed by their Creator with certain unalienable Rights, that among these are Life," the right to life should be alienable. An individual should be able to alienate herself from her own right to life, granting the corollary liberty to allow that life to be ended. Mental illness confuses the equation because it raises the question of whether an individual is possessed of sufficient clarity of mind to autonomously and rationally choose to alienate her own right to life. Euthanasia-permissive and death penalty-enforcing nations alike assert that soundness of mind is a condition for the legal ending of life.

Belgium thus makes the distinction between mental illness and mental anguish, which in and of itself enters the fraught territory of psychological pathology.

Iain Brassington, a senior lecturer in bioethics at the University of Manchester's School of Law, makes an important point about collapsing the distinction between physical and psychological turmoil when it involves grounds for euthanasia. He doesn't suggest that the categories are defunct, but rather that psychological distress, more so than physical reasons per se, always in some sense determines right-to-die decisions. He notes, "the arguments about physical distress seem to me to rely — to at least some extent — on a notion of psychological distress anyway. After all, a person who was terminally ill but unmoved by that fact would — presumably — be less likely to seek assistance than someone for whom it did make some kind of emotional impact." In other words, there's nothing obviously morally problematic about assisted suicide based on ending psychological suffering, since in some sense, that's the function of all assisted suicide.

Which brings us to the question of incurability — an issue, in Van Den Bleeken's case, intractably connected to the fact of his incarceration. I see no moral ill in an individual taking his own life, regardless of whether he can be said to face terminal or mutable suffering. Poor players can fairly choose how many hours to strut and fret upon this stage. Assisted suicide, however, brings the added complication of implicated parties, left behind in the world of the living, burdened by the possibility that they may have acted wrongly in abetting someone's chosen death. Terminality and incurability ease these ethical dilemmas with the inevitability they imply of a painful, miserable death.

With this in mind, Van Den Bleeken's euthanasia can arguably be more closely aligned with US death penalty cases in which a prisoner chooses to forego appeals and accept capital punishment. Whether Van Den Bleeken's violent impulses are truly incurable is a crucial question, and one that should lead to scrutiny of Belgium's mental health and prison system.

Suffice it to say here, the Belgian court system and its medical authorities have deemed that the inmate would never be viable for release — grounds alone for his mental anguish (not that he is a figure who attracts much sympathy). The point being, Van Den Bleeken is condemned to die in prison. Given that he has spent 30 years behind bars already, claims that the man would be evading justice in death — or that his case sets a precedent for doing so — are spurious. Legal slopes are not so slippery.

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Van Den Bleeken's case can be seen to exemplify Belgium's increasingly liberal euthanasia policies. But it also reflects an archaic relic of criminal justice that condemns the psychologically disturbed without chance for rehabilitation; as such, the case fits comfortably in the pantheon of American-style criminal justice. Indeed, former US Supreme Court Justice Thurgood Marshall, who opposed the death penalty, argued in 1979 that death row inmates should not be allowed to forego their appeals, as this would render capital punishment in such instances akin to seeking "the State's assistance in committing suicide."

Like Van Den Bleeken, death row inmates who forego appeals are often hoping to avoid the turmoil of living life in a cage with no possibility of release. The justice systems in all such cases have already condemned persons to death or eternal incarceration. Granting suicide, therefore, is no denial of life.

Follow Natasha Lennard on Twitter: @natashalennard

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