During 2024 and 2025, the Belgian Federal Commission for the Control and Evaluation of Euthanasia (CFCEE) recorded 8,478 deaths caused by euthanasia representing a 14.5% increase relative to 2023, according to its biannual report published on 2nd October 2026. For 2025 alone, euthanasia accounted for almost 4% of deaths in Belgium. Twenty years after the legalisation of euthanasia, the number of cases declared yearly continues to grow. This increase goes hand in hand with a change in the type of people being euthanised.
The proportion of patients whose death was not expected in the short term continues to rise, and the requests motivated by multiple pathologies are ever more prevalent. Moreover, 73.1% of those euthanised in 2024-2025 were over 70 which throws doubt on the conditions for the accompaniment of the elderly as well as the vision held on the subject of ageing, vulnerability and dependence.
Cancer remains the main pathology leading to requests for euthanasia, especially when death is expected in the short term, but the proportion is on the decrease. Conversely, multiple pathologies are on the increase and now represent the second most prevalent medical cause for euthanasia.
The continuing increase in euthanasia associated with multiple pathologies
Defined by the Commission as a "combination of several refractory chronic affections", multiple pathologies represent 28.3% of the deaths caused by euthanasia recorded in 2024 and 2025. In 2022, the Commission recorded slightly under 600 deaths by euthanasia for that reason, representing 19.6% of euthanasia. In 2025, 1,327 people resorted to euthanasia due to multiple pathologies, i.e. an increase of some 55% in a mere 3 years. This rise shows the increasing proportion of situations combining several chronic conditions, often associated with ageing, among the requests for euthanasia.
Moreover, the proportion of patients suffering from multiple pathologies whose life expectancy is not threatened in the short term has continued to increase in recent years, reaching close to 50% in 2025.
The Commission also highlights the fact that the proportion of patients whose life expectancy is not threatened in the short term has been increasing steadily since 2010, increasing from 10% to 25% of the deaths by euthanasia in 2025. Among those patients, those suffering from multiple pathologies now constitute the main group concerned, representing 57% of cases.
Focus on those tired of living
The Commission has devoted a focus on those tired of living which it identifies as "problematical" being regularly mentioned in the registration documents. 532 patients stated they were tired of living, among which 313 were suffering from multiple pathologies including when they were not life-threatening and that their death was not expected in the short term. Even if the report specifies that "Only if the tiredness of living is the result of multiple pathologies can the request for euthanasia be evaluated favourably", the very consideration of such a notion illustrates the gradual evolution observed over several years regarding the interpretation of the 2002 law.
Whereas the initial law restricted euthanasia to those suffering from serious and incurable diseases, generating "constant, unbearable and unappeasable physical or psychic suffering", an ever-increasing proportion of people are resorting to euthanasia in Belgium not because they are at their end of life, but because they are suffering from a combination of pathologies associated with their age, affecting the way they consider their quality of life.
Euthanasia of patients suffering from psychiatric disorders
In 2024 and 2025, the yearly number of deaths by euthanasia of those suffering from psychiatric disorders also increased: 55 in 2024 and 74 in 2025. Although 73.1% of those euthanised in 2024-2025 were over 70, euthanasia for this type of condition concerns both very young patients and very elderly patients. Eleven of them were under 25, seven were between 25 and 30 and twelve were over 80.
Those under 25 were suffering from swings in humour, neurotic disorders due to stress, behavioural disorders and autism. Among the 12 patients over 80, 4 patients exhibited persistent complex grief (pathological grief), 8 a persistent humour disorder resistant to treatment (depression) of which 5 also stated they were tired of living.
In 2025 the announcement of the euthanasia of Siska De Ruysscher rekindled the debate around the consideration of psychic conditions and the limits of a psychiatric system confronting a chronic lack of means, without however questioning the resort to euthanasia as a response to certain psychic conditions considered to be refractory.
Towards a broadening of the conditions for access to euthanasia
In Belgium, euthanasia can be administered to an unconscious person (coma or persistent vegetative state) whose situation is irreversible even if they have not made any express request to their doctor, providing that they have completed advance directives in the legally approved format. In view of the falling number of deaths by euthanasia based on directives, the Commission is recommending extending the applicability which it considers too restrictive.
For those whose inability to express their wishes develops slowly due to a neuro-degenerative disease such as Alzheimer's, the Commission regrets they cannot apply for euthanasia since the disease is too advanced. According to Belgian law, the patient must still be able to express his/her wishes in order to submit an application for euthanasia whilst anticipating the risk of subsequent loss of such capability. 77 people in such type of situation were euthanised in 2025 compared with 23 in 2020. But according to the Commission "this number remains low in relation to the prevalence of dementia in Belgium and the data reported in some neighbouring nations."
Holland, for example, where 427 deaths by euthanasia were recorded in 2025 of patients suffering from dementia; Dutch law allows euthanasia on the basis of advance directives for patients suffering from advanced dementia who have become incapable of expressing their wishes. The Commission is therefore recommending the introduction of legislative clarifications regarding advance directives in particular concerning governmental declaration 2025-2029 which clearly mentions the intention "to broaden advance directives to include those incapable of providing their consent in the case of dementia".
It must be said that voices are challenging the absence of true independence of the control Commission and the obvious conflicting interests of some of its members. Its president is also the president of the LevensEinde Informatie Forum (LEIF) and one of its members is the president of the Belgian Association pour le Droit de Mourir dans la Dignité (ADMD). These two associations militate for an ever-wider legalisation of euthanasia and assisted suicide.
Twenty years after the legalisation of euthanasia, the continuous increase in the number of cases, the broadening of the situations concerned and the intended extension around advance directives show the gradual drift away from the framework established by the law in 2002. The Belgian experience shows how it is difficult, nigh impossible to durably maintain strict limits once euthanasia is admitted as a response to suffering.
At a time when France in turn has just legalised assisted suicide and euthanasia, the Belgian example demonstrates that once the prohibition against killing is lifted, the limits initially established are gradually reconsidered and discarded