Brother Rene Stockman, superior general of the Brothers of Charity, told Catholic News Service that Cardinal Pietro Parolin, Vatican Secretary of State, is personally examining the situation.

Brother Stockman complained directly to Rome after the Brothers of Charity Group, which runs 15 centres for psychiatric patients across Belgium, rejected a formal request from him to reverse the new policy.

In a May 4 email to CNS, Brother Stockman said: "Because it is a matter of the Belgian group, I informed the Belgian bishops' conference in order to ask for their opinion and to ask a clear statement of them.

"At the same time, I am in contact with the Vatican – the Congregation (for Institutes) of Consecrated Life (and Societies of Apostolic Life) and the secretary of state who asked me for more information," said Brother Stockman, a psychiatric care specialist.

"I hope that there will come a clear answer from the Belgian bishops and the Vatican," he continued. "I have trust in it."

He suggested that the new policy could force the brothers from providing psychiatric care in Belgium.

Brother Stockman said: "I wait for the clear answer of the church and that answer will be presented to our organization, in the hope that it will adapt its vision ... I hope we will not have to withdraw our responsibility in the field of mental health care in the place where we started as a congregation with such care more than 200 years ago."

The Brothers of Charity was founded in 1807 in Ghent, Belgium, by Father Peter Joseph Triest, whose cause for beatification was opened in 2001.

Inspired by the spirituality of St. Vincent de Paul and dedicated to working with the elderly and the mentally ill, the order initially was known as the Hospital Brothers of St. Vincent and spread to 30 countries.

In the Flanders region of Belgium, the group is considered to be the most important provider of mental health care services, serving 5,000 patients a year. The order also runs schools, employing about 12,000 staff nationwide.

The Brothers of Charity Group announced it would allow euthanasia on its premises in a nine-page document in March, about a year after a private Catholic rest home in Diest, Belgium, was fined $6,600 for refusing the euthanasia of a 74-year-old woman suffering from lung cancer.

About 12 psychiatric patients in the care of the Brothers of Charity are believed to have asked for euthanasia over the past year, with two of them being transferred elsewhere to receive the injections to end their lives.

The new policy document harmonizes the practices of the centres in the group with Belgian law on euthanasia.

It sought to balance the Catholic belief in the inviolability of innocent human life with duty of care under the law and with the demands of patient autonomy.

Brother Stockman said, however, that for the brothers, "respect of life is absolute and cannot be offered for the autonomy of the patient."

The group's largely lay board of directors, he said, see euthanasia as a medical act, but the brothers "cannot accept it as a medical act."

"Finally, they agree that euthanasia should be done inside the institutes," he said. "We always refused to let euthanasia be done inside the walls of the centre."

He rejected suggestions that many of the Brothers themselves favoured the policy, insisting instead that the order upholds the doctrine of the Catholic and "cannot accept the law on euthanasia."

Brother Stockman said: "The whole mentality in Belgium is changing very fast and there is pressure from the government against any refusal of euthanasia. But until now, the institutes have had the right to refuse."

"I see it as a real crisis and I call it a door that is opened and cannot be closed anymore," he added. "More groups will be touched by it: It started with somatic suffering, now psychiatric suffering, afterward people with a severe handicap, elderly people and so on."

Belgium legalized euthanasia in 2003, a year after the Netherlands became the first country since Nazi Germany to introduce the procedure.

Technically, euthanasia in Belgium remains an offence, with the law protecting doctors from prosecution only if they abide by specific criteria.

In 2014, the law was extended to "emancipated children," and doctors are increasingly giving lethal injections to people who are disabled, demented or mentally ill.