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BRUSSELS — Belgium took a big step Thursday to becoming the first country to allow euthanasia for terminally ill children, after the upper house of Parliament voted by a large majority to extend to minors a 2002 law legalizing the practice for adults.

Under the amended law, euthanasia would become legal for children afflicted with “constant and unbearable physical suffering” and equipped “with a capacity of discernment.” During a sometimes heated public debate before the vote, religious leaders condemned the move as entering “a logic that leads to the destruction of society’s foundations.”

Philippe Mahoux, a Socialist Party senator, former surgeon and sponsor of the legislation, described giving terminally ill children the right to “die in dignity” as the “ultimate gesture of humanity.” He said the legislation did not seek to define death but to allow young people, with the assent of their parents, to choose the manner of their dying in the event of terminal illness and intolerable physical pain.

Although Europe is generally far more accepting of euthanasia or assisted suicide than the United States, only a few countries have formally legalized medical interventions to cause death. Luxembourg permits euthanasia for adults, and Switzerland allows doctors to help patients die but not to actively kill them. The Netherlands allows euthanasia in special cases for gravely ill patients 12 or older.

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But Belgium — where adult-euthanasia cases number about 1,000 a year — is the first country to propose lifting all age restrictions.

Fifty of the 71 members of the Belgian Senate voted for the measure Thursday. Seventeen voted against. Four did not vote.

Before becoming law, the changes must be voted on by the Parliament’s lower house. The measure seems likely to pass.

Unlike adults, children would not be allowed to choose death on the grounds of “psychological suffering” but only when there was no hope of recovery from an illness that involves extreme physical pain. Parents must give their approval in writing.

Religious groups, however, view Belgium’s efforts to extend its 2002 law to children as a dangerous erosion of moral barriers protecting the sanctity of life. “We mark out opposition to this extension and express our trepidation in the face of the risk of a growing trivialization of such a grave reality,” the leaders of Belgium’s Christian, Muslim and Jewish communities said in a statement.

Els Van Hoof, a Christian Democrat from Belgium’s Dutch-speaking community, said during debate Thursday that paying more attention to relieving the pain of patients instead of allowing doctors to kill them would “allow both old and young to die with dignity.” A 10-year-old, she said, is not in a position to make a life-or-death decision “in an autonomous manner” and will invariably be vulnerable to pressure.

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