Niels De Nutte is affiliated with the history department and the Secular Studies Association Brussels research group at Vrije Universiteit Brussel as a guest professor and postdoctoral researcher. He serves as an associate director to the International Society for Historians on Atheism, Secularism and Humanism and editor to the Secular Studies journal (Brill). Niels’s research interests include post-war organised non-religiousness and unbelief, with specific expertise in church-state relations,  the history of bioethics, and end-of-life in Belgium and abroad.

Much of the public and academic discourse surrounding euthanasia tends to frame the practice as a fundamentally secular concern[i] — a rallying point for humanists, atheists, and liberal-minded progressives. Yet, this framing is not only historically simplistic but also obscures the deeper, more entangled social, moral, and even religious and worldview genealogies that shape the right-to-die movement. This contribution shortly displays some key findings from my PhD project on the entangled history of the right-to-die in Belgium. For my project, which was graciously funded by the Fonds Wetenschappelijk Onderzoek (FWO), several archival collections – which included organisational documents, egodocuments, legal document and newspapers – were analysed.[ii]

Far from being a strictly secularist crusade, euthanasia advocacy in Belgium for instance, emerged from a complex constellation of ideas, anxieties, and institutional actors that defy easy categorisation. This complexity is especially apparent when one moves beyond legislative milestones, such as the 2002 law decriminalising euthanasia,[iii] and examines the decades-long evolution of public attitudes, philosophical undercurrents, and socio-political dynamics.

Beyond the Secular–Religious Binary

It is true that humanist and freethinking organisations — particularly the Humanistisch Verbond (HV – Humanist Association) and the Unie Vrijzinnige Verenigingen (UVV – Union of Secular Associations) — played key roles in Belgium’s euthanasia debate.[iv] These groups were vocal proponents of individual autonomy, often framing their arguments in terms of zelfbeschikkingsrecht (the right to self-determination) and critiquing medical paternalism and what they perceived as “therapeutic tenacity.[v]” However, even within these secular circles, the justification for euthanasia was far from monolithic or exclusively rooted in anti-religious sentiment.

Many of the early discussions on euthanasia in Belgium — dating back to the 1930s — were not advanced by advocacy groups, and predate them significantly, but emerged through journalistic inquiry, literature, and courtroom drama. Letters to the editor in socialist newspapers like Vooruit in 1950, for instance, reveal a surprisingly receptive attitude among the secular (vrijzinnig) populace toward euthanasia as mercy killing, long before it became institutionalised within the humanist sphere or dedicated end-of-life advocacy groups.[vi] These expressions of support did not always originate from irreligious motives; rather, they reflected evolving ideas about suffering, dignity, and the limits of medical intervention.

Moreover, while secular humanist organisations were pivotal in advancing the right-to-die cause, they were responding to — rather than initiating — wider shifts in cultural sensibilities. From the 1960s onward, an increasing awareness of overmedicalisation, coupled with dramatic advances in life-prolonging technologies, prompted both religious and nonreligious individuals to reconsider what a “good death” meant.[vii] This mirrors Philippe Ariès’ influential critique of “therapeutic tenacity,” which lamented the erosion of natural death in favour of endless medical intervention — a critique not bound to secular thought.

Entangled Histories, Not Isolated Ideologies

The claim that euthanasia was solely the domain of secular advocacy also ignores the transnational and cross-ideological nature of the movement. Belgian right-to-die societies were deeply influenced by foreign counterparts, such as the Dutch Nederlandse Vereniging voor Vrijwillige Euthanasie (NVVE) and the American Hemlock Society.[viii] Yet unlike in the Anglophone world, where early euthanasia debates were often entangled with eugenics and notions of social utility, Belgian advocacy was largely disconnected from such problematic legacies. This detachment allowed Belgian organisations to frame euthanasia more clearly as an issue of compassion and choice, rather than social engineering.

Importantly, religious responses to euthanasia in Belgium were not uniformly hostile. While official Catholic doctrine continued to oppose euthanasia, some Catholic opinion groups began to express sympathy for limited end-of-life autonomy by the late 20th century.[ix] In fact, elements of Catholic moral reasoning — especially the emphasis on intention and discernment — overlapped in practice with certain secular arguments for pain relief and palliative care. This moral convergence suggests that the secular–religious dichotomy fails to capture the full ethical landscape in which euthanasia advocacy operated.

The Role of Bioethics and the Medical Profession

Another key insight from my research is the role of bioethics as a potential mediating force. The emergence of bioethics on the continent in the 1980s brought with it a new language for discussing death and dying that transcended traditional worldview boundaries. Discussions about living wills, patient rights, and medical consent became central, with both secular and religious voices contributing.[x] It is in this space — not in abstract philosophical disputes about the sanctity of life — that the practical contours of the euthanasia debate were shaped.

Interestingly, early medical resistance to euthanasia was not primarily religious in nature. Many doctors feared legal liability or saw euthanasia as an admission of professional failure. As medical confidence in palliative care grew, however, so too did the openness of some physicians to end-of-life autonomy. This shift highlights the importance of professional ethics and scientific culture in shaping euthanasia debates — realms that do not map neatly onto religious/secular lines.

From Grassroots to Legal Reform

Belgium’s euthanasia law of 2002 is often portrayed as a triumph of secular rationality over religious conservatism, but this narrative overlooks the decades of “prepolitical” activity that made such legislation possible and a societal consensus that significantly predated law-making successes. From the living will storage facilities established by HV in the 1980s, to the increasing number of public debates, media campaigns, and court cases that normalised the issue, euthanasia advocacy was driven as much by grassroots moral reflection as by formal secular ideology, yet notably with much less mobilising success than the abortion movements.[xi]

Notably, support for euthanasia among the Belgian population grew steadily over time, and not just among self-described secularists. Opinion polls from the mid-20th century already revealed openness to euthanasia in secular and socialist circles and support for the wider idea of euthanasia as a medical practice was almost at 90% by the late 1980s.[xii] Arguments even in the 1950 often lacked theological justifications and were instead motivated by compassion, family consultation, and a sense of moral responsibility — values that transcend religious affiliation.[xiii]

Conclusion: Rethinking the Nonreligious Frame

To cast euthanasia and the right-to-die purely as secular projects is to overlook the rich tapestry of beliefs, experiences, and institutional dynamics that have informed end-of-life debates, Belgium being a good test case. Advocacy for euthanasia did not emerge in a vacuum of unbelief; it developed through the interaction of scientific progress, shifting death practices, political realignments, and human concern — concerns shared by religious and nonreligious people alike.

Indeed, what my research illustrates is that euthanasia advocacy was not a reaction against religion, but a response to the changing meaning of death in modern society. As medical technologies challenged the boundary between life and death, and as traditional rituals lost their explanatory power, people from diverse backgrounds — secular, religious, and in-between — began to seek new ways of dying well.

In that sense, the right-to-die was never solely a secularist project. It was — and remains — a human one.

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[i] For the American and British cases, see: Ian Dowbiggin, A Merciful End. The Euthanasia Movement in Modern America (Oxford: University Press, 2003); N.D.A. Kemp, Merciful Release: The History of the British Euthanasia Movement (Manchester: University Press, 2002). For Belgium, this is exemplified quite early on in an opinion piece: Het Handelsblad, 12/01/1936, p. 10. The author of this lengthy column is Wilfried Broeckaert, a catholic opinion maker and medical doctor.

[ii] I consulted archival material from the following institutions: Centre for Academic and Secular Humanist Archives (Brussels), Felixarchief (Antwerp), Association pour le Droit de Mourir dans la Dignité (Brussels), Royal Library of Belgium (Brussels), Wellcome Library (London), University of Washington Libraries, Special Collections (Seattle).

[iii] Belgisch staatsblad 12.3.2014, Wet tot wijziging van de wet van 28 mei 2002 betreffende de euthanasie, teneinde euthanasie voor minderjarigen mogelijk te maken, https://pha.be/wp-content/uploads/2020/02/45-wet-euthaniasie-voor-minderjaringen-1.pdf.

[iv] Niels De Nutte, “So to live, that one has also at the right time one’s will to death! Humanist euthanasia advocacy in Flanders between the 1970’s and 1990’s. A story of personal choice and therapeutic tenacity,” Essays in the Philosophy of Humanism 28 (2020).

[v] This concept originated in France and, through the Dutch connection of Belgium and the Netherlands found its way into the English language, see: Niels De Nutte, “Lighting the spark? Murder Trials in the 1960s and 1970s in the Liège Court of Assizes and Their Influence on Belgian and International Attention for the Issue of Euthanasia,” Derecho en Sociedad 19, no. 2 (2025) forthcoming.

[vi] Niels De Nutte, “In the face of death. Societal attitudes and popular opinion on medical aid and dying in Belgium 1936-1950,” Secular Studies 4, no. 1 (2022): 71-92.

[vii] This is exemplified by the sheer number of publications that emerge in this period which include ‘good death’ (in Dutch ‘waardig’) in their title. Interestingly enough, the word meant something different depending on who published. For end-of-life advocates it referred to dying without suffering and with medical interventions to hasten death, whereas for religiously inspired opponents it meant a natural death, without any form of intervention.

[viii] Niels De Nutte, The right-to-die in Belgium: A history of societal attitudes, conceptual confusion and advocacy concerning euthanasia between the 1920s and 1993 (Vrije Universiteit Brussels, 2025), unpublished PhD dissertation.

[ix] Notably, the first president of the Association pour le Droit de Mourir dans la Dignité, the first Belgian Right-to-Die Society, was a socialist catholic physician.

[x] For instance, see the entry on euthanasia in the interuniversity governmental report: s.n., Bio-ethica in de Jaren ’90 (Antwerp: Omega Editions 1987):367-369. To understand how these issues related to proposals of law in the 1980s, see: Niels De Nutte, “Dealing with the ambiguity of end-of-life decision-making. Living wills and patients’ rights in Belgian end-of-life advocacy in the 1980s and 1990s,”  in Pieter Dhondt e.a. (eds.), Dealing with medical uncertainty in and through the history of medicine eds  (Leiden: Brill, 2025), 231-252. (Clio Medica Studies in the History of Medicine and Health).

[xi] For the history of the abortion legalisation in Belgium see: Els Witte, “Twintig jaar politieke strijd rond de abortuswetgeving in België (1970-1990),” Res Publica 32, no. 4 (1990): 436-437.

[xii] Institut Interuniversitaire de sondage d’opinion publique, Les soins de santé dans la société belge (Brussels, 1988), 56.

[xiii] Niels De Nutte, In the face of death.