Euthanasia debate in Europe focuses on children up to 12 years old

Knight Ridder ^ | October 11, 2004 | Matthew Schofield

[NYer]

AMSTERDAM, Netherlands - Four times in recent months, Dutch doctors have pumped lethal doses of drugs into newborns they believe are terminally ill, setting off a new phase in a growing European debate over when, if ever, it's acceptable to hasten death for the critically ill.

Few details of the four newborns' deaths have been made public. Official investigations have found that the doctors made appropriate and professional decisions under an experimental policy allowing child euthanasia that's known as the Groningen University Hospital protocol.

But the children's deaths, and the possibility that the protocol will become standard practice throughout the Netherlands, have sparked heated discussion about whether the idea of assisting adults who seek to die should ever be applied to children and others who are incapable of making, or understanding, such a request.

"Applying euthanasia to children is another step down the slope in this debate," said Henk Jochemsen, the director of Holland's Lindeboom Institute, which studies medical ethics. "Not everybody agrees, obviously, but when we broaden the application from those who actively and repeatedly seek to end their lives to those for whom someone else determines death is a better option, we are treading in dangerous territory."

The Dutch debate is being closely watched throughout the continent. Belgium has laws similar to those in the Netherlands, and a bill permitting child euthanasia is before its Parliament. No date has been set for debate.

Great Britain is considering legalizing assisted suicide for the terminally ill, amid reports that doctors already may be helping thousands of patients to die each year.

"Assisted dying is a fact," said Hazel Biggs, the director of medical law at the University of Kent, who's about to publish a report estimating the number of assisted deaths in Britain at 18,000 annually. "We have to regulate it, to ensure that vulnerable people are being protected."

Under the Groningen protocol, if doctors at the hospital think a child is suffering unbearably from a terminal condition, they have the authority to end the child's life. The protocol is likely to be used primarily for newborns, but it covers any child up to age 12.

The hospital, beyond confirming the protocol in general terms, refused to discuss its details.

"It is for very sad cases," said a hospital spokesman, who declined to be identified. "After years of discussions, we made our own protocol to cover the small number of infants born with such severe disabilities that doctors can see they have extreme pain and no hope for life. Our estimate is that it will not be used but 10 to 15 times a year."

A parent's role is limited under the protocol. While experts and critics familiar with the policy said a parent's wishes to let a child live or die naturally most likely would be considered, they note that the decision must be professional, so rests with doctors.

The protocol was written by hospital doctors and officials, with help from Dutch prosecutors. It's being studied by lawmakers as potential law.

Under the protocol, assisted infant deaths are investigated, but so far all of them have been determined to have been in the patients' best interests.

Euthanasia has been legal in the Netherlands since 1994. Under the law, any critically ill patient older than 12 can request an assisted death, including adults in the early stages of dementia.

The law doesn't allow involuntary euthanasia nor does it apply to children younger than 12, who aren't considered aware enough to make a life-or-death choice.

Dutch doctors have some intentional role in 3.4 percent of all deaths, according to statistics published in the medical journal The Lancet. About 0.6 percent are patients who didn't ask to be euthanized, the journal said.

Dutch courts often treat those cases leniently if an investigation determines that the doctor acted out of concern for the patient's well-being.

Opponents of expanding euthanasia to the young cite a recent Dutch court ruling against punishment for a doctor who injected fatal drugs into an elderly woman after she told him she didn't want to die.

The court determined that he'd made "an error of judgment," but had acted "honorably and according to conscience."

News reports say that since that decision some elderly hospital patients are carrying written appeals not to be euthanized. A German company has proposed a nursing home just across the border from the Netherlands that would be promoted to aging Dutch residents as a safe haven in a country where euthanasia is illegal and likely to remain so.

What happens to vulnerable people is a particularly sharp issue in a continent where birthrates have declined, populations have aged and five nations have more old than young. Euthanasia opponents fear that as costs increase for long-term intensive care and health-care budgets become more strained, financial reasons could creep into euthanasia debates.

"The danger, of course, is ensuring a debate on the right to die does not become one on a duty to die," said Urban Wiesing, the chair for ethics in medicine at Germany's prestigious Eberhard Karls Tuebingen University.

The issue is a particularly delicate one in Germany, where euthanasia was used by the Nazis as cover for wide-scale murders of the disabled, among others. Germany is one of the few countries where there's no serious push to legalize assisted suicide.

European advocates of expanding euthanasia laws say they're acting in the best humanitarian tradition to halt intolerable suffering. Belgian Sens. Jeannine Leduc and Paul Wille noted that motive in their proposed law: "Their suffering is as great, the situation they face is as intolerable and inhumane."

But others worry that after children, who will be next?

"I do accept that there are very difficult cases, very rare cases where a baby is in such pain that death would be the humane option," Dutch ethicist Jochemsen said. "But hard cases make bad laws. As soon as a law is passed, it will expand the number of those who are considered extreme cases."

There's little evidence that permitting euthanasia has had much impact on the number of assisted deaths, argued Rotterdam epidemiologist Agnes van der Heide, who's measured euthanasia in Europe for 10 years.

She said her research indicated that the number of assisted deaths in the Netherlands had increased only slightly in 10 years of legalization. She said the inclusion under the law of such groups as those in the beginning stages of dementia and terminally ill 12- to 16-year-olds accounted for only a few cases nationwide each year, similar to predictions on child euthanasia.

"And the fact remains, euthanasia typically shortens life by one month against life expectancy," she said. "There are no trends showing an increase in that number, or in the estimation that quality of life in these cases is so poor that life should not continue. I know the debate focuses on worst-case scenarios, and abuse. There's no evidence of those things taking place."

[NYer]

"But others worry that after children, who will be next?"

[BenLurkin]

I guess this is why it takes a village.

[Mr. Mojo]

Elements of the Third Reich live on in Europe.

[dead]

"Applying euthanasia to children is another step down the slope in this debate,"

Dude, it’s a leap off the cliff edge.

[Conspiracy Guy]

What's all this talk about the Youth in Asia? We have enough problems with the youth here at home.

Emily that's Euthanasia not Youth in Asia.

Never mind.

[dead]

Socialized medicine is murder.

There's no two ways about it.

[trebb]

"But others worry that after children, who will be next?"

That just goes to show how venal and sick the societies of the world are getting - instead of worrying about the killing of innocent children as a problem, they don't see a problem until it has the potential to affect them personally.

[NYer]

"The danger, of course, is ensuring a debate on the right to die does not become one on a duty to die," said Urban Wiesing, the chair for ethics in medicine at Germany's prestigious Eberhard Karls Tuebingen University.

“Though it is true that sometimes it is lawful to tolerate a lesser moral evil in order to avoid a greater evil or in order to promote a greater good," it is never lawful, even for the gravest reasons, to do evil that good may come of it (18)—in other words, to intend directly something which of its very nature contradicts the moral order, and which must therefore be judged unworthy of man, even though the intention is to protect or promote the welfare of an individual, of a family or of society in general.”
HUMANAE VITAE

Catholic Ping - let me know if you want on/off this list

[Psalm 73]

"Even so, Lord Jesus - come quickly"

[Fury]

I guess this is why it takes a village.

Note to self - don't bring young son/daughters on trips to Europe...

[NYer]

Opponents of expanding euthanasia to the young cite a recent Dutch court ruling against punishment for a doctor who injected fatal drugs into an elderly woman after she told him she didn't want to die.

"The court determined that he'd made "an error of judgment," but had acted "honorably and according to conscience."

This was an unconscienable act!!

[Lil'freeper]

a parent's wishes to let a child live or die naturally most likely would be considered, they note that the decision must be professional, so rests with doctors.

Words fail me.

[Alberta's Child]

The Germans may have lost World War II, but the Nazis won.

[dead]

Under the Groningen protocol, if doctors at the hospital think a child is suffering unbearably from a terminal condition, they have the authority to end the child's life. The protocol is likely to be used primarily for newborns, but it covers any child up to age 12.

Twelve. About the age where a kid might actually grab the needle and jam it into the doctor.

[EggsAckley]

Very depressing.

[Reagan Man]

Four times in recent months, Dutch doctors have pumped lethal doses of drugs into newborns ...

Sounds like a return to Nazi Germany, circa 1940.

[Mad Dawgg]

"But others worry that after children, who will be next?"

I vote we retro-abort these Doctors!

[Angry Enough]

This is truly horrifying.

[conservativewasp]

These freaks are no better than terrorists/nazi's. So much for Europe.

[dha]

And the worship of death continues...