Tom Mortier didn’t get a chance to change his mother’s mind or even to say goodbye. On April 19, 2012, his mother, Godelieva De Troyer, asked two friends to drive her to the Free University of Brussels. There, Wim Distelmans, Belgium’s leading euthanasia proponent and provider, gave her a lethal injection. She was 64 and in good physical health. Mortier didn’t find out until the following day. Distelmans didn’t notify him before taking his mother’s life.

Mortier was shattered. His mother’s death transformed the chemistry professor from a mild supporter of Belgium’s ultra-liberal euthanasia law into its most outspoken opponent. In a country where the “right to die” is an article of the national creed, his advocacy has been met with ridicule and stonewalling. Campaigning has forced him to relive, daily, the psychological traumas that marked his life with his mentally ill mother.

But Mortier may finally have a shot at justice. This week, the religious-liberty organization Alliance Defending Freedom lodged an appeal in his case with the European Court of Human Rights (ECHR). If accepted, the appeal could shed much-needed judicial light on Belgium’s euthanasia industry.

I interviewed Mortier in August at his modest home in the suburbs of Leuven, a university town in Belgium’s Dutch-speaking Flanders region. School was out, and two of his three children were watching television in the living room. “Going to a hospital and getting an injection isn’t much different from someone jumping in front of a train,” Mortier told me, his voice rising above the din of cartoons in the background. “Is this humane? I don’t think this is humane.”

A few weeks earlier, local prosecutors had dismissed his complaint against Distelmans, citing a “lack of evidence.” That outcome meant that Mortier had exhausted his legal options at the national level and could now take his case to the Strasbourg-based ECHR. The European Convention on Human Rights requires states to protect “everyone’s right to life.” States have a particular duty of care to vulnerable people: prisoners, children and teenagers, and those, like De Troyer, whose mental condition leaves them unable to protect their own lives.

Mortier and his lawyers contend that Belgian authorities failed to protect De Troyer’s right to life and that the failure was abetted by the country’s euthanasia law. The 2002 law, they argue, provides neither safeguards for the vulnerable nor sufficient accountability for providers. They have a formidable case.

Before it was enacted, proponents assured the public that euthanasia would be rare. Yet the number of euthanized patients has risen steadily since legalization. In 2013, the number of cases rose to 1,807, up from 235 in 2003. By 2015, the total had reached 2,021. That’s according to data from the Federal Control and Evaluation Committee, the body that is charged with overseeing the practice. The control committee suggests that euthanasia accounts for about 2 percent of all deaths in the country.

The real figure may be much larger. A March 2015 Belgian study published in the New England Journal of Medicine found that, in Flanders alone, “the rate of euthanasia increased significantly between 2007 and 2013, from 1.9 to 4.6% of deaths.” The NEJM data came from questionnaires submitted to doctors issuing death certificates, as opposed to the control committee’s self-reporting mechanism for euthanasia providers. The inescapable conclusion is that many doctors are killing their patients without the main oversight body even finding out.

Proponents of the law also insisted that it would only be applied in terminal cases, i.e., patients who were nearing death and could no longer bear the anguish associated with their conditions. Yet the law opened the door to other kinds of cases. A patient seeking euthanasia, the relevant provision reads, must be 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.”

The number of patients euthanized for non-physical, non-terminal ailments has exploded since legalization. By the 2014-15 reporting period, 15 percent of total cases were non-terminal and 3 percent involved people with mental or behavioral conditions. There had been a “notable increase” in dementia cases, according to the control committee. That raises serious questions over whether physicians (or family members of the euthanized) are riding roughshod over the requirement that patients “requesting” euthanasia are “legally competent.”

Sometimes Belgians are euthanized merely because their lives take a sudden dark turn. Distelmans in 2012 authorized euthanasia for 45-year-old deaf twin brothers after they found out they were going blind. The following year, he euthanized a 44-year-old patient whose female-to-male sex change operation had failed. The patient felt that she looked like a “monster.”

Then there was Mortier’s mother. Godelieva De Troyer had suffered from depression since she was a teenager. At age 23, she married a radiologist, who gave her two children, Tom and his sister, Els. When Mortier was 3, his father divorced his mother and abandoned the family. Two years later, he committed suicide.

“My mother was always comparing me with my father,” Mortier told me. “So it was an enormous pressure on my shoulders. And it was a very negative relationship. She saw in me the same monster that my father was. In fact, she hated me. She wouldn’t admit it, but I could feel it. I was the result of her broken marriage with a husband who left her with two children.” Still, Mortier did his best to support his mother. “I was raised really always with my mother coming to me, shouting and crying, and I had to comfort her. It was never the other way around.”

But De Troyer had her ups and downs. As the New Yorker noted in a 2015 feature on Mortier’s case, De Troyer maintained a diary in which she “colored” her daily moods. The diary wasn’t always black.

Depression is an episodic illness, and events in De Troyer’s life noticeably altered her mood. There were good times—when Mortier’s children were born ,when she found a new boyfriend, and so on. At various points, she told her son, she felt like she was making progress. But the progress screeched to a halt in 2010, when her latest boyfriend broke up with her. Mortier found himself in the caretaker role once more. He spent hours with his mother on the phone and invited her to stay with him and his wife. “Please try to be a grandmother like you always said to us you wanted to be,” he would tell her.

It didn’t work, for old scars crisscrossed their relationship. Meanwhile, a busy life bore down on Mortier. He had two children, and a third would soon be on the way. In addition to his academic job at the University Colleges Leuven-Limburg, he was tasked with finding a nursing home for his grandmother—De Troyer’s mother, from whom she was estranged. He had had it. There was a rupture, and, for a while, mother and son didn’t communicate.

Then, in January 2012, De Troyer wrote an email to Mortier’s sister that was addressed to both of her children. “Dear Els and Tom,” it read:

I have requested euthanasia for psychic suffering with Prof. Distelmans. I went through the whole procedure, and I’m now waiting for the result. I have been in therapy since I was 19 years old with several psychiatrists. I asked [my regular psychiatrist] what he could do for me. His answer was: “I can listen to you and I can prescribe medication.” After that I have been searching for a way toward a life ending with dignity.

Throughout the years, I have had many sufferings. I experienced a lot of losses. I have known so much pain that I cannot live. I’m sorry that I will cause you some pain. But I can’t continue. Loneliness, and no chance to be cured after years of therapy, leave me with no life-perspective. Dying with dignity is the only option I have left in my life. I fought as hard as I could, and I did my best.

Mortier’s sister, who was living in Africa at the time, replied via email that “it isn’t easy for me to live with the idea that both of my parents will be suicides. But I can’t do more than respect your decision. I am powerless, and I need to protect myself.”

Mortier wasn’t sure how to proceed. “You ask people, ‘What would you do?’” he told me. “Some would say, ‘I would call her immediately.’ But this mother thinks that I’m the same man as my father. So she hates me. What do I have to do?”

He consulted De Troyer’s psychiatrist, who advised him to wait. He also asked experts at his university, and they, too, suggested that he keep his powder dry. One told Mortier: “I know Distelmans, and he will never approve this.” The language of De Troyer’s email was also reassuring: “I’m now waiting for the result,” she had written (my emphasis). That suggested that her request might be turned down, or that there would be an intermediate stage at which Mortier could intervene.

There was no news for three months until he received a phone call at work informing him that his mother had been killed. Hospital officials asked him to come to the morgue to fill out the paperwork necessary for turning over his mother’s remains to the department of experimental anatomy, per her request.

“I have a trauma now,” Mortier told me. “There is no care for me! Nothing! It all has to go here,” tapping his heart.

His first reaction was to start blogging about his situation. What he didn’t know was that criticizing Distelmans—winner of the University of Brussels’s 2015 Award for Humanism—meant taking on one of the most powerful and entrenched forces in Belgian society. The counterpunch came fast and strong. Mortier, an ardent secularist, was accused of being a crypto-Catholic and an emotional weakling.

Mortier “is a teacher at the Catholic University of Leuven, and this makes his [advocacy] more intentional,” wrote one editorialist. “If you can’t deal with it,” Mortier told me, “then you must be a Catholic . . .  If you can’t cope with the fact that an oncologist has killed your mother because of chronic depression, then you must have emotional dysfunctionality. I thought I was a humanist. But if this is humanism, then I’m not a humanist.”

The available legal channels proved equally fruitless. The Federal Control and Evaluation Committee has only referred a single case, out of thousands since legalization, for potential criminal prosecution, according to the Alliance Defending Freedom. Distelmans, who didn’t respond to requests for comment for this article, has been a chairman of the control committee since its founding. How Belgian authorities tolerate this glaring conflict of interest is a mystery, though in the past other committee members have claimed that Distelmans doesn’t weigh in when his own cases come up for review.

There were other conflicts of interest. Under the 2002 euthanasia law, a physician considering a euthanasia request must get a second opinion from another doctor. “The physician consulted must be independent . . . of the attending physician.” Yet in De Troyer’s case, at least one of the physicians consulted, a psychiatrist named Lieve Thienpont, has published academic research with Distelmans and served alongside him as a founding member of the “Ulteam,” a practice dedicated to “death with dignity” cases (“Ul” stands for “ultimate”).

It is unclear, moreover, if the control committee ever examined De Troyer’s full euthanasia record. Every report submitted to the committee contains two portions. The first contains anonymized, general information, while a second, secret file lists the name and other personal details. Two-thirds of committee members must vote affirmative to open the secret file.

“The committee didn’t open it or touch it,” Mortier said of his mother’s report. “Even the prosecutors didn’t open the case. They asked for the files but they didn’t open it, because it’s medical secrecy . . . There is no way to get this in front of a judge.”

Now there might be a way. The real defendant in Mortier’s appeal is Europe’s barbarous culture of death.

Corrections: Tom Mortier teaches at the University Colleges Leuven-Limburg, not the affiliated University of Leuven. His father committed suicide when Mortier was 5 years old. The article misstated Mortier’s age at the time of his suicide. Mortier was never friendly with the editorialist who claimed that Mortier’s anti-euthanasia activism was inspired by Catholicism. We regret the errors.

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