‘Tot altijd’ by Nic Balthazar

Tot altijd tells the story of Mario Verstraete, a Flemish man whose life – in the 1980s and 1990s – initially unfolds quite ordinary. He marries, has a son, and divorces. In 1995 he goes to his general practitioner and good friend Thomas with eye complaints. Thomas refers him to a neurologist. Mario turns out to have multiple sclerosis, and his condition deteriorates over the course of a several years. Not only does he struggle with physical issues, but he also experiences mental decline. Mario joins the advocacy group Waardig sterven (Dignity in Dying), that makes a case for the legalization of euthanasia and medically assisted suicide in Belgium. Mario writes an opinion piece in a newspaper advocating for the importance of dying with dignity at a self-chosen moment and gives a personal testimony in the Belgian Senate. Eventually, in 2002, the euthanasia law is passed and comes into effect within the same year. Just a week after the law’s implementation, Mario dies by medically assisted suicide.

Although the film contains some historical footage of the proceedings in the Belgian Senate, Tot altijd offers a fictionalized and dramatized version of Mario Verstraete’s life. It connects his personal history with the Belgian legislative trajectory regarding euthanasia and assisted suicide. At the beginning of the film, Mario is shown protesting against cruise missiles in the 1980s; that same activist attitude characterizes his involvement in medically assisted suicide. While the film primarily highlights Mario and his supporters’ viewpoints and arguments (focusing on autonomy and the freedom to choose), it also explores other perspectives. Mario’s father represents the religious standpoint that life is sacred and humans should not have unrestricted control over it. Mario’s close friend and physician, Thomas, grapples throughout the film with Mario’s stance. Thomas holds a different opinion on the role of doctors, believing they should serve life. Contrasting Thomas’s professional view is doctor Frank Valaeys, a vocal advocate for euthanasia and assisted suicide. Valaeys uses the comparison of ‘dying like a dog’ to describe the negative consequences of not having the option of medically assisted suicide, while Thomas himself has expressed the fear that his son might end up with ‘a vegetable for a father.’ These negative figurative expressions are accompanied by a reflection on the role of medical technology that prolongs people’s lives in the twentieth century.  The film provides a good impression of the Belgian legislative process, the arguments used in that process, and the role of Mario Verstraete. The connection with reality is further explored in a book of the same name released concurrently with the film. This book emphasizes the value of euthanasia as represented in Tot altijd. The film has been referred to in positive ways by advocates of euthanasia, such as noted euthanasia physician and professor Wim Distelmans, but has also been shown at debate nights about euthanasia (e.g., the disABILITY film festival in Leuven, 2019). Critical comments could also be heard: for example, the MS League Flanders argued that the film’s link between multiple sclerosis and euthanasia caused many patients to have a sense of doubt about their quality of life. Tot altijd was adapted for theatre in 2024.