I am a proponent of personal autonomy in most situations, but am struggling with this story. If nothing else, it really encapsulates the stark moral choice that exists when it comes to the right to die as well as a physician’s obligations under the Hippocratic Oath:

In a case which has attracted world attention, Belgian doctors have announced that a fortnight before Christmas they euthanased 45-year-old deaf identical twins who were going blind and thought that they had nothing to live for.

Marc and Eddy Verbessem were born deaf. They never married and lived together, working as cobblers. When they discovered that they had another congenital disorder, a form of glaucoma, they asked for euthanasia. According to their local doctor, David Dufour, they had other medical problems as well. “All that together made life unbearable,” he told the London Telegraph. “I have been very surprised but there is so much interest and debate about this”.

He described their final moments:

“They were very happy. It was a relief to see the end of their suffering. They had a cup of coffee in the hall, it went well and [they had] a rich conversation. The separation from their parents and brother was very serene and beautiful. At the last there was a little wave of their hands and then they were gone.”

Under Belgian law euthanasia is allowed if “the patient is in a medically futile condition of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident”.

Critics point out that the Verbessem brothers were not terminally ill nor suffering physical pain. In fact, it took the men two years to find doctors who would agree to help them. A doctor at their local hospital said, “I do not think this was what the legislation meant by ‘unbearable suffering’”.

Professor Wim Distelmans, a right-to-die activist who was the other doctor involved in the decision to euthanase the men, based his own assessment on their psychological suffering.

“It’s the first time in the world that a ‘double euthanasia’ has been performed on brothers. There was certainly unbearable psychological suffering for them. Though there is of course it always possible to stretch the interpretation of that. One doctor will evaluate differently than the other.”

The media learned of the deaths a few days ago but they had actually occurred on December 14 at Brussels University Hospital. A few days later the government announced that it would amend the law to allow minors and people with dementia to be euthanased as well.

In an email interview, Jacqueline Herremans, president of Belgium’s Association for the Right to Die with Dignity, defended the decision and told BioEdge that this was not a case of the “slippery slope”.

“When we opened the debate almost 15 years ago, the first thought was for people suffering from incurable cancers. And it is still the cancer which is at the origin of almost 80% of the cases of euthanasia. But we must admit that suffering may exist in other circumstances. MS, ALS, Parkinson’s are obvious. But what about psychiatric disorders without any possibility of cure? What about ageing persons with several medical affections losing their autonomy and seeing no more sense to their life, knowing that tomorrow is going to be worse than today? What about Alzheimer’s patients? … The decision to ask for euthanasia is not easy. And the decision for the doctor to answer to this request is far from an banal and usual act.”

A report published late last year by the Brussels-based European Institute of Bioethics took a very different point of view. It claimed that euthanasia was being “trivialized” and that the law was being monitored by a toothless watchdog. After 10 years of legalised euthanasia and about 5,500 cases, not one case had ever been referred to the police.

Professor Chris Gastmans, of the Catholic University of Leuven, criticised the deaths as an impoverished response to disability. “Is this the only humane response that we can offer in such situations? I feel uncomfortable here as ethicist. Today it seems that euthanasia is the only right way to end life. And I think that’s not a good thing. In a society as wealthy as ours, we must find another, caring way to deal with human frailty.”

Here is some more information on this tragic story:

But when Marc and Eddy learned they were slowly going blind in addition to already being deaf, the twins feared losing all possible means of communicating with one another. “The thought of only being able to feel each other was unbearable,” Het Laatste Nieuws writes, according to a HuffPost translation.

“Physically, their conditions were strongly deteriorating,” Dr. David Dufour, who treated the brothers, explained to VTM. When the brothers learned their bid for euthanasia was accepted, “a weight fell off their shoulders,” Dufour added. “They were happy and relieved that a date was set to end their suffering.”

As I struggle with this issue, all I can hope for is that these brothers and their family found peace and took comfort in that they died with dignity and their personal suffering has come to a self-determined end.