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Thursday, December 02, 2004  

Health: Dutch may extend euthanasia to children

Euthanasia is one of those taboo topics I am willing to give a fair hearing. It seems to me that there are much worse things than death, particularly if a mentally competent person has chosen to to die. I live in the only state that has made assisted suicide an option for the terminally ill. They can ask for and get a prescription for the drugs needed to end their lives from a willing physician.

So, it was with some interest that I read about a proposal to carry the practice a step further.

In August, the main Dutch doctors' association KNMG urged the Health Ministry to create an independent board to review euthanasia cases for terminally ill people ``with no free will,'' including children, the severely mentally retarded and people left in an irreversible coma after an accident.

The Health Ministry is preparing its response, which could come as soon as December, a spokesman said.

Three years ago, the Dutch parliament made it legal for doctors to inject a sedative and a lethal dose of muscle relaxant at the request of adult patients suffering great pain with no hope of relief.

The Groningen Protocol, as the hospital's guidelines have come to be known, would create a legal framework for permitting doctors to actively end the life of newborns deemed to be in similar pain from incurable disease or extreme deformities.

The guideline says euthanasia is acceptable when the child's medical team and independent doctors agree the pain cannot be eased and there is no prospect for improvement, and when parents think it's best.

Not yet viable fetuses, children with extreme brain damage and those having conditions that require life long life support would be included. Dutch hospitals report having hastened the deaths of four children who fell under the guidelines last year. Researchers estimate that about ten children would be subject to the practice each year if it is implemented. Predictably, the hospitals are being criticized. The Roman Catholic Church and right-to-life groups in the United States have taken the lead in taking the Dutch task.

However, euthanasia itself is not unusual. It has probably been occurring since humans dwelled in caves. What is different is the movement to bring mercy killing out into the open. I believe many people find it difficult to confront the harsh realities of extreme disability. They can't acknowledge that lives of pain, or not even knowing that one is alive, are so poor in quality that people might be better off not living them.

A writer at a the American Medical Network considers the core objection to extending euthanasia to children.

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," saidHenk 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."

It seems to me that if those who suffer most are subjected to continued suffering because they are unable to express their pain, the benefit is not to them, but to those who refuse them the option of ending their lives. The sufferers are being denied relief so that those making the decision can ride their moral high horse. Assuming that the Groningen Protocol is applied equitably, with procedural safeguards in place to prevent rash decision-making, I can think of no rational reason not to extend it to those unable to reach decisions about continuing their lives for themselves.

10:45 PM