In Belgium the law allows for people to choose to be euthanised if they are deemed to be suffering from “unbearable” psychological, and not just physical, suffering that cannot be healed.

The person must be conscious of their decision and be able to express their wish in a reasoned and consistent manner.

“It is this specific procedure that Mrs Lhermitte followed, with the various medical opinions having been collected,” her lawyer said.

Psychologist Emilie Maroit told the RTL-TVI channel that Lhermitte likely chose to die on 28 February in a “symbolic gesture in respect for her children”.

“It may also have been for her to finish what she started, because basically she wanted to end her life when she killed them,” the psychologist said.

The quintuple murders in 2007, and the subsequent trial, rocked Belgium.

During the trial Lhermitte’s lawyers argued she was mentally disturbed and should not be sent to prison. But the jury found her guilty of premeditated murder and sentenced her to life in jail.

In 2010 Lhermitte filed a civil lawsuit demanding up to three million euros (£2,655,840) from a former psychiatrist, claiming his “inaction” failed to prevent the murders, but she ended up abandoning the legal battle after 10 years.

In 2022, some 2,966 people died via euthanasia in Belgium, an increase of 10% compared to 2021.

Cancer remains the most common reason, but officials said in nearly three out of four requests the patient presented “several types of suffering, both physical and psychological”.

Since 2014, Belgium has allowed children to be helped to die as well as adults, if they are terminally ill and in great pain and if they have parental consent.