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Why a nine-year-old has been legally euthanised.

There is just one country in the world where children under the age of 12 can be legally euthanised. That country is Belgium.

It was recently revealed that two children under the age of 12 were euthanised in Belgium, one in 2016 and one in 2017. One was aged nine, and had a brain tumour. The other was an 11-year-old with cystic fibrosis.

Luc Proot is a member of the commission that approved euthanasia for the children.

“I saw mental and physical suffering so overwhelming that I thought we did a good thing,” he told The Washington Post.

Belgium legalised euthanasia in 2002 for people who were in “constant and unbearable physical or mental suffering that cannot be alleviated”. It was originally proposed that euthanasia should be legal for people of all ages, but due to political opposition, it was restricted to people over 18.

In 2014, the right to euthanasia was extended to children. A group of 16 paediatricians had written to lawmakers, asking them to support the legislation.

“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 letter read.

But there were extra conditions imposed. The child would have to understand what euthanasia meant, the parents or guardians would have to give their consent, and doctors would have to verify that the death was expected “in the near future”.

Watch: Andrew Denton wants to change the law around euthanasia

The child would have to make his or her wish known in writing, and then psychiatrists would have to examine the child, to make sure that he or she was capable and not being influenced by anyone. Finally, a six-member commission would have to give approval.

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It was two years before the first euthanasia of a child was approved. In that case, it was a 17-year-old with muscular dystrophy.

The head of Belgium’s euthanasia commission, Wim Distelmans, said at the time that the teenager was suffering “unbearable physical pain”.

The euthanasia was carried out by doctors, who first used “palliative sedation” to put the teenager into a coma.

“Fortunately there are very few children who are considered, but that does not mean we should refuse them the right to a dignified death,” Distelmans said.

Senator Jean-Jacques De Gucht was one of the Belgian politicians who supported the legislation.

“I think it’s very important that we, as a society, have given the opportunity to those people to decide for themselves in what manner they cope with that situation,” he said.

Mia Freedman speaks to Andrew Denton about his quest to legalise voluntary euthanasia in Australia.

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The Netherlands also allows euthanasia for children, but they have to be aged 12 or over. Children aged from 12 to 16 need the consent of their parent or guardian. Those aged 16 and 17 need to consult their parent or guardian, but that adult doesn’t have the right of veto.

In 2016 and 2017, 4337 people died by euthanasia in Belgium. People in their eighties were the age group most likely to request euthanasia, closely followed by those in their seventies and sixties. There was a small number over the age of 100, and just three under the age of 18.

“There is no age for suffering,” Distelmans said.