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The Netherlands to Allow Doctors to Assist the Lives of Terminally Ill Children




The Dutch government announced plans this week to allow doctors to end the lives of terminally ill children under the age of 13, a decision that is expected to sparks the debate over physically assisted death.

The Netherlands already allows doctors to facilitate the deaths of people who are over 12 years old or less than a year old as long as their parents have given their consent.

In a letter to parliament on Tuesday, Dutch Health Minister Hugo de Jonge proposed expanding the law to include children between the ages of 1 and 12 who die and suffer.

In a small number of cases, palliative care is not enough, wrote Mr. De Jonge. Because of this, some children suffer unnecessarily without any hope of recovery.

He estimated that the measure will affect about five to 10 children each year.

Doctors in the Netherlands have expressed concern that they could be held criminally liable if they would help end the lives of terminally ill children between 1 and 12, as the law had no provision for children of that age expected to die soon.

Under current law, a doctor can end the life of a child younger than 1 year, with the consent of the child’s parents, if the child is experiencing intolerable and hopeless suffering, wrote Mr. De Jonge.

He said the new regulation will provide more transparency for doctors.

Three other European countries Luxembourg, Belgium and Switzerland allow physician-assisted death, although laws vary from country to country. Belgium allows children to die with the help of a doctor, but in Luxembourg, the law is limited in adults with incurable medical condition.

Canada, parts of Australia and Colombia have also legalized physically assisted adult death in certain cases.

In the Netherlands, parliament does not need to vote on the new regulation because it will be included in the already existing law, said Mr. De Jonge on paper.

However, a parliamentary majority is expected to agree to the change, which will take several months to complete, a spokesman for Mr de Jonge said.

It is a very complicated and sad issue, Mr. De Jonge told the Dutch broadcaster NOS Tuesday.

According to Dr. Ira Byock, a palliative care physician and director of Providence Institute for Human Care, development in the Netherlands is a disturbing example of growing support for medically assisted death to address distressed health cases, rather than to find compassionate ways to help people cope with pain and suffering.

We can always manage someone’s physical suffering, he said. We can always provide medicines that approach general anesthesia and allow someone to die gently while sleeping until the end of their life.

Dr. Byock said he was concerned about that growing calls in the United States use euthanasia to help adults with degenerative conditions end their lives.

When suffering patients are seen as problems to fix, rather than entire persons to care for, we have set ourselves up for a situation that is detrimental to the profession and to our society as a whole, he said.

Dr. Byock added: We were all on this slippery slope.

Eight states and Washington, DC, have laws that allow mentally fit adults with a terminal illness and live six months or less to get prescription drugs that will speed up their deaths, according to Death With Dignity, an Oregon-based nonprofit that supports such laws.

The new language in Dutch law could put pressure on the United States to try and expand our conservative policy to include people who are unable to consent but are terminally ill and adults, he said. Arthur Caplan, a professor of medical ethics at NYU Langone Medical Center.

But he expressed doubts that the United States would start following the example of the Netherlands, where people with mental illness have been allowed to end their lives with the help of doctors.

Americans have less confidence in their medical system than the Dutch, who are more likely to trust doctors when they say a medical condition is hopeless, said Professor Caplan.

The Netherlands is a small country, he said. Doctors and patients know each other very well and have quite good access to health care.

Professor Caplan added: In the United States, we have large segments of people who do not have access to good health care and that means more mistrust.

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