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August 12, 2020  
MEDTECH NEWS: Technology & Innovation

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  • The Dutch Debate Euthanasia for Infants

    The Dutch Debate Euthanasia for Infants


    August 18, 2005

    “It’s beautiful in a way,” said Eduard Vehagen, M.D., a pediatrician who acknowledges he has enabled four infants in the last three years to die by a lethal administration of morphine and midazolam (a sleeping medication), “It is after they die that you see them relaxed for the first time.”

    Learn More
    Groningen Protocol for Euthanasia in Newborns


    Requirements that must be fulfilled:

    The diagnosis and prognosis must be certain.

    Hopeless and unbearable suffering must be present.

    The diagnosis, prognosis, and unbearable suffering must be confirmed by at least one independent doctor.

    Both parents must give informed consent.

    The procedure must be performed in accordance with acceptable medical standard.

    Vehagen is one of many, at Groningen University Hospital and other hospitals in the Netherlands that have admitted ending the lives of babies who had no chance of surviving and were suffering unbearably.

    The Dutch legalized euthanasia for patients over 12 in 1994, but the mercy killing of the infants is not being prosecuted because each case met criteria established as the Groningen protocol (see side bar). Nonetheless, although a report was published in the Dutch Journal of Medicine in October 2004, the controversial subject remains a topic of debate as in a recent New York Times Magazine article titled “Euthanasia for babies? Is this humane or barbaric?” indicates.

    Clearly people on both sides of the issue have stepped forward to comment. The Evangelical Times in the U.S. speculated on whether publication of the report “could be that the guilt felt by these doctors [that] cries out to be admitted and confessed, and rather than openness, they are seeking social acceptance to excuse their deeds and ease their consciences.”

    Vehagen, one of the authors of the report takes clear issue. “You are trained to save the life of a child but with these children the suffering can only be stopped by ending their lives. It takes courage to do that.” More, he advocates strongly for making the Groningen protocol law, as the Dutch are currently considering. “The babies are there, but we were never allowed to talk about them. That must change. If we take this awfully difficult decision, it must happen with complete openness,” which means physicians must know they are operating within the bounds of the law and thus, free from prosecution.

    Still, according to the director of Holland’s Lindeboom Institute for the study of medical ethics, Henk Jochemsen, the country needs to bring great gravitas to its reflections on the issue. “Applying euthanasia to children is another step down the slope in this debate,” Jochemsen said. “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.”

    That said, Hazel Biggs, director of medical law in University Kent whose research indicates there are 18,000 assisted deaths in Britain annually, observed, “Assisted dying is fact. We have to regulate it, to ensure that vulnerable people are being protected.”

    Perhaps, but Jochemsen counters. “I do accept that there are very difficult cases, very rare cases where a baby is in such pain that death with be the humane option. 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.”

    The babies that underwent euthanasia had extreme spina bifida, a severe deformity of the spine. But other hopeless medical conditions have also entered the debate.

    Ancephaly occurs when one in every 2,000 babies are born missing most all of its brain. What is the correct course in these situations, people wonder. Also in 1982 there was the case of Baby Doe in Indiana where a child was born with Down’s syndrome and an improperly formed esophagus that prevented food from reaching its stomach. Rather than repair the gastrointestinal tract surgically, the boy’s parents and physician chose pain killers instead, and the child died within days. In the aftermath, even though the Reagan administration drafted the “Baby Doe guidelines,” the mandatory rules for saving life at all cost were supported by neither the American Medical Association nor the Supreme Court.

    Clearly, the Dutch debate is being watched closely by all, especially Belgium that has laws similar to the Netherlands and is also considering permitting euthanasia for infants and children. Great Britain, as well, is monitoring the situation in Holland inasmuch as legalizing the assisted suicide that thousands are purportedly already accessing in England.

    The U.S. has characteristically lagged behind more progressive Europe. If a report from top-rated cable network, Fox News, is any indication, moves toward legalizing euthanasia of any kind will not be forthcoming at the national level any time soon. Indeed, Fox News compared what it termed “baby-killing” in Holland to the Nazi murder of Anne Frank, the young girl who left her diary for the world to read.

    Ultra-conservative and inflammatory remarks aside, a hospital spokesperson at Groningen University noted that euthanasia for babies “is for very sad cases. 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.”


    Last updated: 18-Aug-05

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