“They are also required to consult with other specialists, to spend time and better the communication among all concerned. Physicians found this difficult because they did not receive adequate training” Indeed, the importance of palliative care as communicating with patients is a core skill of palliative medicine and palliative psychiatry. But a recent study shows that 12% of nurses inFlanders administered the drugs, mostly without the physician co-administering (86%)… Another study concerning patients who were euthanized despite not having made an explicit request to die shows that inalmost half of these cases (6 of 13)the final drug was given by a nurse. “Nurses should not perform acts of ending lives even if physicians explicitly order them to do so. Especially worrying is the high number of incidents where nurses administered lethal drugs to patients who did not explicitly wish to die; this was done mostly without the physician co-administering (82%). One may assume that this was no coincidence and that physicians wished to shift responsibility from themselves, by imposing it on nurses who could not refuse the order.” “These answers raise many concerns: physicians did not understand the letter of the law; physicians disagreed with the law and were willing to knowingly violate the law; physicians failed to understand the place and the importance of the law in society. They were taking the law into their own hands when the patient’s best interests (privacy, confidentiality, trust between physician and patient) or their own best interest (not filling the burdensome forms) seemed to be more important.” Notification of euthanasia to the Federal Control and Evaluation Commission is obligatory, yet 82% of all reported cases came from Dutch-speaking physicians while only 18% came from French-speaking physicians. All-together, half of all euthanasia cases were not reported. “You are right to say that many euthanasia cases are not declared. I myself have practiced euthanasia very many times, and I never declared them. It is too personal and a matter between the patient and his doctor. No need to publicise it” “Indeed, across sectional analysis of reported and unreported euthanasia casesshowed that unreported cases were generally dealt with less carefully than reported cases: a written request for euthanasia was more often absent, other physicians and caregivers specializing in palliative care were consulted less often, the life ending act was more often performed with opioids or sedatives, and the drugs were more often administered by a nurse, not a physician as required.” The Belgian population should be aware of the high level of paternalism among their physicians. One study shows that sixty percent of the surveyed physicians think that they should be able to decide to end the life of a patient who suffers unbearably and is incapable of making decisions.