Eleven years after making euthanasia legal for adults, Belgium came a step closer to extending mercy-killing to terminally-ill children Wednesday after an intense public debate on the ethical issues at stake.
A proposed draft bill to extend the practice to minors is expected to be put to the vote in the two houses of parliament in the coming months after its approval by the Senate's justice and social affairs committee.
The draft bill was approved by a majority of political parties both in office and in the opposition, with the exception of the centrist Christian Democrats.
A vote in favour would see Belgium follow in the footsteps of neighbour The Netherlands, the first country to legalise mercy killings for people suffering from incurable illnesses, but which allows euthanasia for children over 12.
If adopted, the legislation is expected to concern no more than 10 to 15 cases a year based on statements from doctors and nurses that the practice already exists outside the law for terminally-ill youngsters in physical distress.
"The existence of a law is the best means of guarding against possible malpractice," said the daily Le Soir newspaper, adding that it was "urgent and indispensable" to extend Belgium's 2002 euthanasia bill.
Earlier this month, 16 paediatricians also urged lawmakers to approve the legislation.
"Why deprive minors of this last possibility," they said in an open letter carried in the press, arguing that under-18s were able to make an informed and mature decision when facing death.
"Experience shows us that in cases of serious illness and imminent death, minors develop very quickly a great maturity, to the point where they are often better able to reflect and express themselves on life than healthy people."
The proposed legislation would allow the euthanasia of terminally-ill minors so long as they are judged capable of deciding for themselves and are in pain that is "unbearable and cannot be alleviated".
They would be advised by a medical team and their parents' approval would be required.
A recent poll shows three quarters of Belgians approving the move.
But a group of Christian, Muslim and Jewish leaders have opposed the legal change. "We express our deep concern at the risk that such a grave subject will be increasingly trivialised," said the group.
"The euthanasia of fragile people, be they children or incapable, is totally inconsistent with their condition as human beings."
Christian-Democrat Senator Francis Delperee agreed. Asking a minor to take such a decision when facing death "is a considerable psychological, human and family burden at a time when the person should be allowed to be calm," he said.
After The Netherlands and Belgium, Luxembourg in 2009 also approved euthanasia, but for adults only. In Switzerland, doctors can assist a patient seeking to die but euthanasia itself is illegal.
Belgium logged a record 1,432 cases of euthanasia in 2012, up 25 percent.
Earlier this year, Vermont became the third US state after Oregon and Washington to legalize physician-assisted suicide for people facing terminal illness.
It was the first US state however to adopt physician-assisted suicide by legislative process rather than through a voter-initiated referendum.
A Pew Research Center poll found that 84 percent of Americans support allowing a terminally ill adult patient to decide if they want to be kept alive.