Child euthanasia

Child euthanasia is a controversial form of euthanasia that is applied to children who are gravely ill or suffer from significant birth defects.

Ethical considerations

Generally, when a newborn's life is contested, the parents are the ones who determine their child’s future. The parents and the doctor both take part in making the decision. When there is persistent disagreement, the case may be taken to court where the decision is made. Considerations include the cost of treatment and the newborn's quality of life. The cost of the treatment includes medical resources and their availability.^[1] The newborn’s quality of life will depend on whether the treatment is applied, continued or ceased (which can result in passive euthanasia). This can also be classified as a crime under certain laws without the approval of parents. There are ongoing debates about parents' roles in choosing euthanasia for their children, and whether this can be considered voluntary euthanasia. Specifically, if considered voluntary euthanasia it is because the parents authorized it and they have a say in the life of their children.^[2]

The concept of child euthanasia has sparked heavy debate. For example, Eric Kodish and Daniel A Beals^[3] have compared child euthanasia to infanticide. Kodish says "the very notion that there is an “accepted medical standard” for infanticide calls for resistance in the form of civil disobedience".^[4] Others, such as Joseph Fletcher, founder of situational ethics and a euthanasia proponent, proposed that infanticide be permitted in cases of severe birth defects. Fletcher says that unlike the sort of infanticide perpetrated by very disturbed people, in such cases child euthanasia could be considered humane; a logical and acceptable extension of abortion.^[5] American bioethicist Jacob M. Appel goes one step further, arguing that pediatric euthanasia may be ethical even in the absence of parental consent.^[6] Bioethicists Alberto Giubilini and Francesca Minerva argue that killing a newborn "should be permissible in all the cases where abortion is, including cases where the newborn is not disabled".^[7]

Child euthanasia by country

Belgium

On February 13, 2014, Belgium became the first country to allow voluntary child euthanasia without any age limit.^[8]

Netherlands

In the Netherlands, euthanasia remains technically illegal for patients under the age of 12. However, Eduard Verhagen has documented several cases of infant euthanasia. Together with colleagues and prosecutors, he has developed a protocol to be followed in those cases. Prosecutors will refrain from pressing charges if this "Groningen Protocol" is followed.^[9][10]

This Protocol prompted a very critical response from Elio Sgreccia, the head of the Pontifical Academy for Life.^[11]

United Kingdom

The Nuffield Council on Bioethics launched an enquiry in 2006 into critical care in fetal and neonatal medicine, looking at the ethical, social and legal issues which may arise when making decisions surrounding treating extremely premature babies.

The Royal College of Obstetricians and Gynaecologists, in its submission, recommended that a public debate be started around the options of "non-resuscitation, withdrawal of treatment decisions, the best interests test and active euthanasia" for "the sickest of newborns".^[12] The College stated that there should be discussion over whether "deliberate intervention" to cause death in severely disabled newborn babies should be legalised; it stated that while it was not necessarily in favour of the move, it felt the issues should be debated. The College stated in this submission that having these options would save some families from years of emotional and financial suffering; it might also reduce the number of late abortions, "as some parents would be more confident about continuing a pregnancy and taking a risk on outcome".^[12] In response to this proposal, Pieter Sauer, a senior paediatrician in the Netherlands, argued that British neonatologists already perform "mercy killings" and should be allowed to do so openly.^[12]

The Church of England submission to the enquiry supported the view that doctors should be given the right to withhold treatment from seriously disabled newborn babies in exceptional circumstances, and the Christian Medical Fellowship stated that when treatment would be "a burden" this was not euthanasia.^[12][13][14]

Notable examples

Harry Haiselden and Baby Bollinger

Baby Bollinger, born to Allen and Anna Bollinger, was born with various physical abnormalities in 1915.^[15] The surgeon Harry J. Haiselden advised the Bollinger parents to forgo the surgery that could have saved the baby’s life. Haiselden then brought this case to the public through a press conference and argued that a “mercy killing” was more humane.^[16] Haiselden drew supporters and critics alike through his support for euthanasia in the United States. Unlike Jack Kevorkian, Haiselden did not assist patients who wished to be euthanized. Instead, Haiselden chose to euthanize babies who were born with deformities.^[17]

The Baby Bollinger case brought Haiselden into the public light as he began advocating for euthanasia aggressively. Haiselden chose to advocate for euthanasia under the idea of “mercy killings”. After the Bollinger case Haiselden began withholding life-saving treatment to other babies as well and advocating to euthanize individuals who cannot take care of themselves.^[16]

See also

• Non-voluntary euthanasia
• Child euthanasia in Nazi Germany
• Joseph Maraachli case
• Robert Latimer
• The Giver

References

1. Slansky, Mark (2007). "Neonatal euthanasia: moral considerations and criminal liability". Journal of Medical Ethics. 27 (1): 5–11. doi:10.1136/jme.27.1.5.
2. Cohen-Almagor, Raphael (2002). "Non-voluntary and involuntary euthanasia in The Netherlands: Dutch perspectives". Croatian Journal of Philosophy. 5: 162–163.
3. Daniel A. Beals (2005). "The Groningen Protocol: Making Infanticide Legal Does Not Make It Moral" (2 ed.). The Center for Bioethics & Human Dignity. Trinity International University.
4. Kodish, Erick (2008). "Paediatric ethics: a repudiation of the Groningen protocol". The Lancet. 371 (9616): 892–893. doi:10.1016/S0140-6736(08)60402-X.
5. Fletcher, Joseph (1978). "Infanticide and the ethics of loving concern". In Kohl, Marvin. Infanticide and the Value of Life. NY: Prometheus Books. pp. 13–22. ISBN 978-0-87975-100-5.
6. Appel JM (May 2009). "Neonatal Euthanasia: Why Require Parental Consent?". Journal of Bioethical Inquiry. 6 (4): 477–482. doi:10.1007/s11673-009-9156-3.
7. Giubilini, A.; Minerva, F. (2012). "After-birth abortion: Why should the baby live?". Journal of Medical Ethics. 39 (5): 261–263. doi:10.1136/medethics-2011-100411. PMID 22361296.
8. "Belgium's parliament votes through child euthanasia". BBC News. 2014-02-13. Retrieved 2014-03-05.
9. Verhagen, Eduard; Sauer, Pieter J.J. (2005). "The Groningen Protocol — Euthanasia in Severely Ill Newborns". The New England Journal of Medicine. 352 (10). pp. 959–962. doi:10.1056/NEJMp058026. PMID 15758003.
10. "Outrage from Churches over Euthanasia on Newborns". December 1, 2004. Retrieved 2007-05-22.
11. Statement by Mgr Elio Sgreccia Archived October 20, 2012, at the Wayback Machine.
12. Templeton, Sarah-Kate."Doctors: let us kill disabled babies", Sunday Times, 2006-11-05 (retrieved 11-2011).
13. "Church supports baby euthanasia - Times Online". The Times. London. November 12, 2006. Retrieved 2007-10-19.
14. "Church enters euthanasia debate". BBC News. 12 November 2006. Retrieved 2007-10-19.
15. "Dr. Haiselden of Chicago Refuses to Operate to Save a Day-Old Infant. Physician, Who Acted Similarly in the Bollinger Case, Suspects Pre-Natal Influence.". New York Times. July 25, 1917. Retrieved 2008-12-28.
16. Gerdtz, John. "Disability and Euthanasia: The Case of Helen Keller and the Bollinger Baby" (PDF). Life and Learning. 16: 491–500.
17. Cheyfitz, Kirk (1999–2000). "Who Decides? The Connecting Thread of Euthanasia, Eugenics, and Doctor-Assisted Suicide". Omega. 40 (1): 5–16. doi:10.2190/djfu-aawp-m3l4-4alp.