Child euthanasia

With infant euthanasia refers to ‘ euthanasia of children, especially infants . The age limit set at 12 years by the law of the Netherlands, it has been all but eliminated beginning in Belgium.

This practice is currently illegal in any country of the world, lawfully or correspond to the proceeds of crime infanticide , although the State of the Netherlands said that pursuing the doctor who had carried out such an act is the discretion of the magistrate [1] .
Recently, however, a debate arose in the Netherlands, the first country in the world where it has been fully legalized euthanasia, around the question whether it is legitimate to determine the death of infants who are under certain conditions.

Differences between euthanasia and infant euthanasia 

The only practice that is looming as a possible infant euthanasia would be that of ‘ “active euthanasia”, ie putting forward the subject through the active intervention and responsible doctor. Alternative forms of “passive euthanasia” and ” assisted suicide ” are excluded, due to the particular conditions in which the child euthanasia would be implemented. Assisted suicide is impossible once the entities would not be able to perform it practically, that of passive euthanasia because it is logically excluded from the definition of the concept.

The main difference between the two ethical practices, which makes opposing this right even to some who support euthanasia on adults, is that infant euthanasia would cover persons who, because of their age, would not consenting (meaning that such persons, despite being sentient, have not reached a level of maturity that they can make a full consensus).
It is therefore impossible to state with certainty that the subject would have the will to be subjected to the processing, as opposed to what happens in ‘ euthanasia on adults.

Parliamentary documents of the Netherlands

Clémence Ross-van Dorp, Secretary of State for Health, Welfare and Sport, and Piet Hein Donner , Minister of Justice, presented on 11 November 2005 that to date appears to be the only written proposal and formally presented officially representatives from a government to a parliament. This proposal distinguishes and analyzes, from a legal perspective, two possible areas of intervention: the first on infants and the second fetuses at an advanced stage of development. In this document it is stated that although some cases may constitute a crime under the law of the Netherlands, a possible lawsuit is at the discretion of the magistrate. Another significant element concerns the differentiation between modes and motivations regarding infant euthanasia, that is, the document stipulates that it is the physician’s discretion to decide which cases should apply euthanasia, as a criterion indicating that suffering should be or could prefigure “unbearable” . Instead the document clearly outlines the legal categories and the related decision-making procedures relating to the various cases and the criteria on which the magistrate must judge whether in a specific case already occurred the (apart from a previous judgment of the magistrate) mode of commissioning practical intervention are followed.

The paper bases its proposals on various recommendations, decisions, requests received by the State of the Netherlands, among which the best known is the Groningen Protocol , already approved by the Association of Pediatricians of the Netherlands, in June 2005, as an indicator of national guidelines (the document recalls that the protocol has no legal value, and that the magistrate may, at its discretion, ignore it).

Termination of life of newborns 

The document states that infant euthanasia may concern: “Children can be born with very few prospects of survival or reasonable health later in life.” Specifically, there are two cases:

  • in the first, “it must be clear that the child will die within a few days or months after birth”, and these should be considered “part of the normal medical procedures do not start or stop treatment,” the child is so pronounced dead of natural causes.
  • in the second, “” Another possibility is that, thanks to the care, the child may have a limited chance of survival, but that his health during the next life may be extremely poor. “

The doctor’s decision is well taken: “compiles an overall prognosis of the current and future health, taking into account the relationship between factors such as the expected degree of suffering, life expectancy, degree of degradation [of conditions of life] linked to the treatment, the expected ability to communicate and to be self-sufficient, and dependence on the medical care sector. ”
Again if the situation is serious, “it is normal medical procedure not to start treatment or to end it,” and the death is considered natural death.

The proposal states that the case is legally registered as euthanasia only in cases where death is intentionally shortened because of the “serious nature of his suffering.” Beyond the decision-making procedures specified the document states that “only the current degree of suffering can serve as a basis for the decision to end his life.”

Interruption of pregnancies in advanced

Another possible field of application of euthanasia regards pregnancies in an advanced state, that is, after 24 weeks, in particular those for which “a serious fetal disorder has been diagnosed and which would result in the death of the fetus .” Also for this possibility they are distinguished two categories.

The first category concerns cases in which it could not reasonably be considered that the child could not have been born to survive outside the mother’s body. The disorder is untreatable and is almost certain to die during childbirth or immediately after birth. For these cases, the judge is not required to decide whether or not to act, although it should be informed of the fact.
The procedures for implementing euthanasia are specified, for these cases, since November 2003 by the Association of Obstetricians and Gynecologists of the Netherlands.

The second category includes abnormalities that lead to “serious and incurable functional disorders”, but there are chances of survival. It is also specified that medical treatment would still in suffering for all life or may be harmful, and its absence would lead to death.
Please remember that although these interventions constitute “a crime under the law” “invoke the need (inevitability) as the basis for immunity may in some cases result in success,” as long as “the prevailing medical opinion […] He believes that medical intervention after birth would have been meaningless. ”

Legal assessment procedures 

From the legal point of view it is established that only the cases belonging to the latter categories remain crimes , although the decision to prosecute a doctor is in the discretion of the judiciary, which benefits the non-binding opinion of a board of doctors in the specific field of specialization; also it specifies that “not all the failures in meeting the criteria associated with due care will lead to legal action.”

Criteria of due care 

The criteria vary depending on whether it is in advanced pregnancies or babies. It should be noted that the criteria serve primarily to the magistrate to judge whether the death which concerns the second category of cases has been registered , not to the doctor to decide which cases to practice euthanasia. In other words they are criteria that indicate the “how” not the “why” should be implemented such conduct.

Babies 

  • according to the prevailing medical opinion, the child’s suffering was unbearable and without prospect of improvement, which means that the decision to stop treatment was justified. There was therefore no doubt about the diagnosis and prognosis, in the light of the prevailing medical opinion.
  • the child’s parents have given their consent.
  • the doctor has fully informed the child’s parents of the diagnosis and prognosis . This means that together with the parents the physician came to the firm conclusion that there was no reasonable alternative in the light of the child’s situation.
  • the physician consulted at least one connecting independent who visited the baby and gave a written opinion in accordance with these criteria. Alternatively, your doctor may have asked the opinions of the medical team who looked after the child.
  • death was given with due medical care and attention.

Pregnancies in advanced

  • the fetus had a disorder that fell in the second category, this means that it was of such a nature whereby after the baby was born the medical treatment was interrupted on the basis of the considerations that would have been no sense from a medical point of view according to the ‘prevailing medical opinion. In other words, there was no doubt about the diagnosis and prognosis according to prevailing medical opinion. In addition, in the same medical opinion, continuing the pregnancy would bring no significant contribution to a more accurate diagnosis.
  • the child was suffering or you could believe that he would suffer, with no prospect of improvement.
  • the mother had expressly requested that the pregnancy was terminated because of physical or mental suffering caused by the situation.
  • the doctor has fully informed the child’s parents of the diagnosis and prognosis. This means that together with the parents the physician came to the firm conclusion that there was no reasonable alternative in the light of the child’s situation.
  • the physician consulted at least one connecting independent who visited the baby and gave a written opinion in accordance with these criteria. Alternatively, your doctor may have asked the opinions of the medical team who looked after the child.
  • the pregnancy was terminated with due medical care and attention.

Belgian law 

The law passed by parliament and signed by the king March 2, 2014, provides that a child of any age, in the grip of intense suffering (not including psychological), impossible to relieve and suffering from incurable disease, can ask for an end to his sufferings, making him die by lethal injection. In any case it must possess the ability to understand and want, and then will have to be judged in a position to make that choice, in front of a psychologist and a psychiatrist, and must have the written consent of both parents or legal guardian . A pediatrician expressed in these terms the question that the patient, though child, should ask: “Do not let me die in a terrible way. Let me go when I’m still a human being with dignity.”

To try to reduce the controversy, supporters of the law have made it clear that no doctor will be required to apply the law, which will be guaranteed palliative care, and that the request for euthanasia by a minor will be examined by the medical team that has treating the patient.