BRUSSELS, Belgium — Since May 2002, Belgium has permitted euthanasia in its secular hospitals. Now, negotiators forming Belgium's new government are considering legislation that would mandate Catholic hospitals as well to permit “medical killing” under their roofs.

Under Belgian law, euthanasia is permitted if the patient is under “constant and unbearable physical or psychological pain that cannot be alleviated and results from a serious and incurable condition.” Doctors do not have a “license to kill.” Rather, it is up to a doctor's conscience and that of the patient who must be conscious when the demand is made.

But this is where some see the euthanasia lobby tripping on their own legislative efforts.

Lawyer Fernand Keuleneer, a pro-life member of the federal commission for the monitoring and application of the euthanasia law said, “If it's a fundamental human right, then hospitals are obliged to permit euthanasia under the law; but it's not, so they aren't.”

According to Hugo Vandenberghe, professor of law at the Catholic University of Louvain and vice president of the Belgium Senate, hospitals can never be obliged by law to perform euthanasia because this obligation would be in contradiction with Article 2 of the European Convention on Human Rights, which “expressly provides in the duty of states to protect the right to life and the provisions dealing with the freedom of religion and expression,” he said.

Vandenberghe is also particularly concerned that the law on euthanasia “fails to have specific sanctions if the conditions of application are not respected.”

Vandenberghe, who worked for six years at the European Court for Human Rights, has vowed to take both matters to that court.

To Derk Achten, political director of the Flemish Liberal Party, the “right to die” in every Belgian hospital is “a question of ethics.” It is about “the protection of doctors' and patients' rights.”

“Let me give you an example,” he explained. “You have a serious accident and you're taken to a Catholic hospital. Under the required conditions you request euthanasia, but because the hospital does not permit it, you would have to be moved to another hospital to have it carried out. Do you consider that human? I don't.”

Achten complains that with about 80% of the hospitals in Belgium being Catholic, the practice is forbidden almost everywhere.

“There've been a few doctors who've practiced euthanasia and then been thrown out,” he said. “There are therefore problems with implementation of the law. Governments have to ensure the law is implemented, that doctors and patients are not unfairly punished, and so that's what we're trying to do.”

But both Keuleneer and Achten say the umbrella organization in charge of Catholic hospitals would “tolerate” such new legislation within its hospitals.

“They acknowledge their right to refuse doctors to practice it on their premises,” Keuleneer said, “but they are very doctor-centered and have now decided to leave it to their own doctors to exercise their conscience. So the problem's not with the secularists, it's with them. Now there's no need for a new law.”

Toon Osaer, spokesman for the Belgian bishops' conference, contended that Caritas, which runs almost three-quarters of the Catholic hospitals in the country, has yet to make a decision. Keuleneer suggested the “Church hierarchy take up the issue” as, so far in the negotiations for a new government, it is looking as though the Christian Democrats will be unrepresented.

How is the Church responding? “It's difficult to have a clear answer because we don't know yet what they really want to do,” Osaer said, adding that the bishops' conference wrote a letter to those negotiating the new government, emphasizing their opposition to new legislation on euthanasia. “We are also opposed to what the former government decided, so it's a very clear point of view.”

But what if the legislation goes ahead? Will the Belgian Church threaten to close every Catholic hospital, as Cardinal John O'Connor vowed to do in New York if the state mandated contraceptive services in all hospitals?

“The position of Catholic hospitals in Belgium is quite different to those in the United States,” Osaer said. “Most of the hospitals are independent of the Church, and the bishops are not immediately involved in the governing boards.”

In fact, many observers agreed that the hospitals are Catholic in name only, and all have permitted abortion for years. Part of the reason is that the government subsidizes 90-100% of all hospital expenditures, so even if the legislation is not passed, the government is likely to impose economic constraints on those hospitals that do not comply with its policies.

The latest rumor is that Belgium will follow the Netherlands in legalizing euthanasia for those under 18. Keuleneer said although this legislation will be harder to pass and “subject to evaluation” for one year, he is “sure it will go through.”

Yet Belgium is a nation in which 80% of the population is baptized Catholic. Achten argues the Church is not central to Belgian society because Catholicism is not a state religion.

“After Sept. 11 I saw a lawmaker praying in the U.S. Congress,” he recalled. “That could never happen here. For centuries the Church was so dominant, but people are relieved it no longer has the power to tell people what to do. Its views are noted — in a way it touches our consciences — but it no longer has an authoritative voice.”

The Catechism of the Catholic Church explains why the Church forbids euthanasia, and distinguishes it from other medical procedures which hasten death. “Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.

“Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “overzealous' treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

“Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable. Palliative care is a special form of disinterested charity. As such it should be encouraged” (Nos. 2277-9).

Edward Pentin is based in Rome.