Distress felt by parents of a dying newborn can justify the child’s euthanasia, says Royal Dutch Medical Association (KNMG), which represents doctors in the Netherlands.
In a new policy document, “Medical decisions about the lives of newborns with severe abnormalities” (in Dutch only) the KNMG explains why it is acceptable, and perhaps even necessary, to euthanase children. This is no longer headline news in the Netherlands, as newborn euthanasia is allowed under the so-called Groningen Protocol, drafted by Dr Eduard Verhagen in 2004.
The stunning novelty of this statement is that it says that the parents’ suffering may be a reason to kill the newborn. Amongst other conditions, the policy states that a lethal injection of muscle relaxant is ethically possible when “The period of gasping and dying persists and the inevitable death is prolonged, in spite of good preparation, and it causes severe suffering for the parents.”
Dr Verhagen, one of the authors of the KNMG report, explained to Volkskrant, a leading Dutch newspaper, why parental anguish is relevant. "These children are gray and cold, they get blue lips and suddenly every few minutes they take extremely deep breaths. That's very nasty to see, and it can go on for hours and sometimes days."
The experience is extremely stressful for parents. The sight of a child shuddering in its last moments could scar them for ever. However, even Dr Verhagen admits that the child may not actually be suffering. It may feel pain and discomfort, but suffering is complex social and psychological phenomenon without scientifically validated criteria.
What is more objective is the suffering of the parents who witness the child’s distress. Doctors should spare parents the “abomination” of seeing their child die in distress, argues Dr Verhagen. It is part of good palliative care.
The criteria for euthanasing newborns are as follows (from page 54 of the report): if the child is suffering, if it cannot express its own wishes, if death is inevitable and if the dying process is prolonged, then the child may be euthanased and spare the parents further severe suffering.
Of the 175,000 babies born every year in The Netherlands, the KNMG suggests that about 650 might be cases which would be worthy of euthanasia.
“These babies, despite very intensive treatment, will certainly die in the short term. They have a poor prognosis and a very bleak life perspective. They may not be dependent on intensive care but they face a life of serious and hopeless suffering. Doctors and parents face the exceedingly profound question of whether to start or continue treatment or even whether a good action may actually be a harm, in view of the suffering and disability that may result from the poor health of the child.”