Belgian prisoner Frank Van Den Bleeken attending a hearing to determine if he will be allowed to be euthanised,
"My life has now absolutely no meaning. They may as well put a flower pot here."
For many years, Frank van den Bleeken has spent 23 hours of every day in a Belgian prison cell, roughly 2 metres by 5 metres.
The 50-year-old has had a long time to come to terms with his terrible crimes. He raped and killed a 19-year-old woman, Christiane Remacle, strangling her with her own stocking in an Antwerp forest in 1989.
It was not his first crime – he was first imprisoned at 21 for sexual offences. And it was not his last – when released from prison seven years later he attacked three people within weeks – one an 11-year-old girl. After that he was locked up indefinitely.
By his own admission, there is no chance of rehabilitation.
"I am a danger to society," he confessed in a recent documentary. He recognises the evil within him, and has no desire to re-enter the world.
Indeed, he wants to leave it. And any day now, he will – assisted by doctors under Belgium's controversial, world-leading euthanasia laws.
Last week van den Bleeken won a three-year legal battle to allow him to choose that option – leaving prison for a hospital where he will spend his last 48 hours before a doctor administers a fatal drug.
But some people – even leading euthanasia advocates – worry that his case is a sign euthanasia in Belgium has gone too far. Already made uncomfortable by a 27% year-on-year rise in reported euthanasia cases, they fear that too many of those were "borderline" and did not pass the strict tests required by law for physician-assisted death.
Until now, van den Bleeken has not been allowed to die. He has been on suicide watch  since he said in a TV interview that he was considering killing himself – he is monitored every 15 minutes to ensure that he doesn't have the chance. 
But in that interview van den Bleeken expressed his frustration with the life he was forced to continue living. 
"What am I supposed to do? What's the point in sitting here until the end of time and rotting away? I'd rather be euthanised," he said.
"I am a human being, and regardless of what I've done, I remain a human being. So yes, give me euthanasia."
Someone who commits a sexual crime should be given help, he complained, not just locked up – which does not help the person, the society or the victims.
He has a point – Belgium's penal system is notoriously bad for inmates with mental disorders, who are held in old, overcrowded and understaffed prison wings.
His lawyer, Jos Vander Velpen, said two prominent psychiatrists had confirmed that his client was "suffering in an unbearable, enduring way and that his mental condition can never be treated properly". 
 "It's a medical question that is very, very, very delicate and very difficult," he told the Globe and Mail.
"I could never say that euthanasia is a good option because it's the end of life, but it has to be a humane life."
For four years he had felt he "couldn't stand to live like this any longer and could no longer accept the pain".
 "He knows he could live for another 30 years – he's in a good state physically – but in his mind he is very much dead," he told the Mirror.
Journalist Dirk Leestmans, who has been following van den Bleeken's story for years and first met him more than a decade ago, wrote last year that van den Bleeken has only  left the prison once – for his mother's funeral.
"Should we just respect the request of a man who says he has unbearable psychological suffering and therefore wants to end his life?" Leestmans wrote.
"Sometimes I am happy to be a journalist… because my job is to ask the question, not give the answer."
But one person to give a firm "no" to that question was, surprisingly, the man nicknamed Belgium's "Dr Death" – Dr Wim Distelmans, co-chairman of the commission set up to examine every case of assisted suicide.
The commission is supposed to refer cases to prosecutors if the proper legal hurdles have not been cleared – although in the 12 years that euthanasia has been legal in Belgium, not one case has been referred.
But Dr Distelmans was quoted in the Sunday Times predicting that van den Bleeken's case could be the first.
Dr Distelmans performed the world's first double euthanasia for twin brothers – Marc and Eddy Verbessem were born deaf, and learned at the age of 45 they were going blind. He said that caused "unbearable psychological suffering" for them.
And he also helped Nathan, born Nancy Verhelst, 44, after a botched sex change operation left her feeling like "a monster".
But  Dr Distelmans says the test of "unbearable suffering" should not and could not stretch to the experience of van den Bleeken – and he told the prisoner that himself, visiting him several times, assessing his case, then refusing his request to perform euthanasia.
"It is a failure of the system if euthanasia is allowed instead of therapy," he said.
Van den Bleeken found another physician who agreed to give the lethal injection.
 Dr Distelmans told De Standaard he knew 15 more prisoners who wanted euthanasia.
Belgium and the Netherlands legalised euthanasia in 2002, and Luxembourg in 2009. Switzerland has allowed assisted suicide (where the patient administers the lethal drug) since 1942.
While euthanasia numbers in the Netherlands have risen only slightly, in the last few years they have risen remarkably in Belgium. Last year the country logged a record 1800 cases, double that of six years before.
Dr Kenneth Chambaere is a researcher with the End-of-life Care Research Group at University of Brussels. The group runs a big project interviewing doctors after every end-of-life decision, and it is hoped that, once they crunch the data, they might get some answers on why the numbers are rising so quickly.
"The question is, of course, whether it is actually from people getting used to the application of the law and the procedure for euthanasia or whether it's expanding boundaries," Dr Chambaere said. "That's a question I don't have an answer for."
Their research has quelled some fears, showing that legalised euthanasia has dramatically reduced the numbers of "unrequested killing" – the medical shortening of life without proper consent. And it has not resulted in the separation of euthanasia from palliative care: instead, the two work together.
However, Dr Chambaere said, his group often hears complaints that the body set up to control and monitor euthanasia does not have the means or resources to do so properly. The review committee works from reports written by the doctors themselves – and they have no oversight of the estimate 5% of cases not reported to them.
"We do see some outlier cases, such as people who are not actually terminally ill, or people who are really depressed for a large number of years … are receiving euthanasia," he said. "This is a very delicate point in Belgium."
The group has also heard that some people with advanced dementia were receiving euthanasia – even though this should not be possible under the legal tests, which require conscious, mentally competent consent by the patient.
"These are borderline cases which we are seeing now. We saw them in the past also, but not in these numbers."
Criticism is building that the law is becoming more and more loosely interpreted, he said.
"Some terms that are used can be interpreted such as 'suffering unbearably'. What is unbearable? Some physicians will say 'I have to see that for myself' Other physicians will say 'no, this is a subjective thing, I cannot interfere with that. If the patient says he is suffering unbearably then I have to believe him'."
But it's important to keep perspective, Dr Chambaere said. Around 85% of all patients receiving euthanasia are still terminal cancer patients.