The State Department on Tuesday released its annual International Religious Freedom Report, and the grim upshot was that people of faith face persecution around the globe. This year’s report, the first under President Trump, called out usual suspects such as China, Iran, North Korea, and Saudi Arabia. It also notably used the “G” word–genocide–to describe Islamic State’s crimes against Christians, Yezidis, and other religious minorities in Syria and Iraq.

Authoritarian regimes and jihadists aren’t the only ones who mete out anti-religious repression these days. Nominally free societies, particularly in Europe, are increasingly guilty of it as well. Yet because it is less visible, carried out by governments with impeccable liberal credentials, such persecution receives far less attention, including in the State report.

Consider tiny Belgium, which has been roiling with controversy this month over whether Catholic hospitals can be required to permit euthanasia on their premises. Belgium’s pro-euthanasia lobby and its political and media allies seek to bring to heel the country’s last bastion of opposition, the Roman Church.

Belgium legalized the practice in 2002. Proponents had vowed that it would only be applied in very few terminal cases. But since then, the number of patients who have been euthanized has steadily grown (some 13,000 so far). So has the list of conditions that qualify. Now dementia, chronic depression, and various other forms of mental or behavioral anguish can get you an appointment with the country’s busy and prosperous Dr. Deaths. In the 2014-15 reporting period, 15 percent of cases were nonterminal.

Typical of today’s aggressive liberalism, it wasn’t enough to have legalized euthanasia and expanded it to once-unimaginable situations, such as a patient who was dissatisfied with the results of a sex change. No, even euthanasia’s most ardent opponents must love euthanasia.

Proponents set their sights on the Brothers of Charity. The Catholic medical order runs psychiatric hospitals worldwide, 15 of them in Belgium, where it was founded in the early 19th Century.

When euthanasia was first legalized, the Brothers assumed their consciences would be safe. As Brother René Stockman, the order’s superior-general in Rome, told me in a phone interview last week: “We had always maintained that the Brothers of Charity, as part of our charism and calling, would accompany the mentally ill and seek to heal them, but never perform euthanasia, because we also want our services to be in line with Catholic teaching. And when euthanasia got going in Belgium, there was at first no talk of euthanatizing the mentally ill.”

But pro-euthanasia pressure mounted. It began with a civil ruling last year against a Catholic nursing home that had refused to permit doctors to euthanize a 74-year-old resident. The woman’s adult children sued, and a court in Louvain ordered the home to pay €6,000 in fines and damages.

Then, early this year, the board of the Belgian Brothers issued a statement authorizing physicians to euthanize non-terminal, mentally ill patients on the order’s premises. The statement asserted that euthanasia is a routine medical procedure, and that patient autonomy and the protection of life are equally important values–in direct violation of the Catholic view, which is that the protection of life at all stages is absolute.

Shamefully, three religious on the board apparently went along with the majority-lay trustees. Br. Stockman told me he suspects the three religious “are overwhelmed by the lay members as well as the professional staff.” The Belgian Brothers declined to comment.

Br. Stockman in the spring appealed to the Belgian bishops and to some of the Church’s highest authorities in Rome. Last week, Pope Francis intervened, ordering the Belgian chapter to stop offering euthanasia. The Belgian Brothers have until the end of August to comply.

The response from the political class so far has been to blow a Belgian raspberry at the supreme pontiff. One of the lay trustees, former Belgian Prime Minister Herman Van Rompuy, on Monday tweeted that “the time of Roma locuta causa finita is long past.” The Latin phrase, attributed to St. Augustine, means: “Rome has spoken; the cause is finished.”

If Van Rompuy is right, it would call into question the ability of any global religious organization to set policy for its various national chapters–a grave setback for international religious freedom. It would also be a tragedy for the 5,000 mentally ill patients the Brothers serve in Belgium. As Br. Stockman told me, refusal to comply would cast doubt on the future of the Brothers’ operations in Belgium: “Do we have the capacity, in Belgium, where we can still offer our charism and our vision? Because we are facing severe secularization in Belgium.”

He added: “In 1815 we broke the chains of the mentally ill, who up to that point were literally imprisoned. We were liberators. Now we see that our child is going in a way that is not in line with the parents.”

When dealing with religious persecution in the West, it is easy to count incidents of physical violence: a Jewish cemetery desecrated here, a hijabi woman harassed there, and so on. The State Department and various NGOs do such work with admirable meticulousness. Yet it is much harder to document when, in the name of secularity, entire societies and political classes declare war on private conscience and religious liberty.