In Belgium, someone legally ending their own life is an everyday occurrence.

In fact, it usually happens more than once a day.

That’s because the northern European nation has the most liberal euthanasia laws in the world.

Since 2002, competent adults and emancipated minors there have been able to end their lives simply by asking a doctor to inject them with a lethal drug.

The request must be in writing and it must meet two criteria. The person needs to be in “constant and unbearable” pain and the condition must be “incurable.” The pain can be physical or emotional.

In 2014, Belgium extended the practice. It approved a law that allows terminally ill children of any age to receive a lethal injection if their parents agree with the child’s wishes.

People appear to be taking advantage of the laws.

More than 1,800 people in Belgium died by legal lethal injection in 2013. That’s an average of about five a day.

So, it wasn’t a big surprise in Belgium when reports came out last week that a wheelchair-bound athlete might end her life after the 2016 Paralympic Games in Brazil.

However, the report created quite a stir in the United States and elsewhere. So much so that 37-year-old Marieke Vervoort held a news conference over the weekend to announce she wasn’t planning on ending her life.

Not yet anyway.

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Countries’ opinions differ

Brazil is among a host of nations across the world that don’t allow assisted suicide.

In the U.S., only four states allow people in certain circumstances to end their own lives. Those states are Washington, Oregon, Vermont, and California, whose law took effect in June.

Montana does not have “death with dignity” statute, but a state Supreme Court decision in 2009 cleared the way for physician-assisted dying.

Peg Sandeen, the executive director of Death With Dignity, told Healthline that European countries and the U.S. don’t see end-of-life decisions the same way.

She said Europeans have a more pragmatic view of death while views in the U.S. tend to be more emotional.

“We have an extremely youth-focused culture,” said Sandeen. “Americans’ attitude toward dying is to think we never have to do it.”

Stan Goldberg, a cancer survivor and professor emeritus at San Francisco State University, agrees.

Goldberg, who was a Hospice volunteer for 13 years, told Healthline that Americans’ views on assisted suicide tend to get caught up in spiritual arguments.

He noted that in Taiwan and other Asian countries the opposition to assisted dying laws is more rooted in duty. Their societies believe that children are obligated to take care of their parents. That includes extending their lives when they are old.

“Right to die laws are an expression of a country’s values,” said Goldberg.

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The case for assisted dying

For Goldberg and Sandeen, the reason to support death with dignity laws is pretty simple.

They believe it’s a decision people should be allowed to make.

“Everybody has the right to decide when their life will end,” said Goldberg, whose latest book on cancer patients is due out this fall.

Sandeen added that the option should be available to people who are in severe emotional pain as well as physical pain.

She noted that allowing someone to continue living under those circumstances isn’t always a kind thing to do.

“Letting nature run its course in some cases is cruel,” she said.

Sandeen added that modern medicine has made great strides in prolonging people’s lives. Now it must provide a solution when a long life is not the best option.

“Medicine needs a remedy for something it has created,” she said.

For Vervoort, the remedy offered by Belgium’s right to die law is a welcome relief.

She suffers from a degenerative spinal condition and was given approval for assisted suicide in the country in 2008.

She hasn’t used that permission yet.

However, the athlete said at her Sunday news conference the approval does give her peace of mind, knowing she can end her life if her situation becomes too unbearable.

Vervoort told reporters she probably would have killed herself by now if she didn’t have the legal option in her back pocket.

"I think there will be fewer suicides when every country has the law of euthanasia. I hope everybody sees that this is not murder, but it makes people live longer," she said.

"When the day comes — when I have more bad days than good days — I have my euthanasia papers," she said. "But the time is not there yet."

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