In 2002, the Netherlands legalized euthanasia. Euthanasia is still a criminal offence, but the law codified a twenty-year old convention of not prosecuting doctors who have committed euthanasia in specific circumstances.
The Dutch Euthanasia Act
The Dutch Euthanasia Act states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. The criteria for euthanasia need to comply with the following conditions:
- It must be done at the patient's request
- The patient's suffering needs to be unbearable and hopeless
- The patient needs to be provided with information concerning his or her condition
- All alternatives need to be considered
- A second physician needs to be consulted
- The applied method of ending life needs to be reviewed
- Physicians need to report euthanasia to a review committee
- The doctor must report the cause of death to the municipal coroner in accordance with the relevant provisions of the Burial and Cremation Act.
Termination of Life on Request and Assisted Suicide (Review Procedures) Act took effect on April 1, 2002. It legalizes euthanasia and physician assisted suicide in very specific cases, under very specific circumstances. The law was proposed by Els Borst, the Dutch Minister of Health, Welfare and Sport in 2001.
The procedures codified in law had been a convention of the Dutch medical community for over twenty years. The law allows a medical review board to suspend prosecution of doctors who performed euthanasia when each of the above conditions is fulfilled. A regional review committee assesses whether a case of termination of life on request or assisted suicide complies with their established criteria. Depending on its findings, the case will either be closed or, if the conditions are not met, brought to the attention of the Public Prosecutor.
Euthanasia in the Case of an Infant
The first requirement of the Dutch Euthanasia Act – that euthanasia is done at the patient's request – cannot be complied with in the case of an infant. The Groningen Protocol establishes the criteria that need to be adhered to if the doctors together with the parents decide to curtail a child's suffering through euthanasia. The Groningen Protocol applies to children up to 12 years of age.
For a child's life to be ended, the parents needs to give their consent. A baby's life can be ended if the illness is terminal and the suffering is unbearable. The situation needs to be hopeless, in that there can be no expectation of the child being able to ever lead a normal life.
Debating the Ethics of Killing a Child
Since the Protocol has been adopted there have been debates among students of ethics and religious leaders about the morality of this decision. The main question remains: Does anyone (including physicians and parents) have the right to take another person's life without their consent or without provocation?
Even if that person is only an infant and is unable to speak for themselves, who can say that they would prefer death over life? Do doctors and parents have the right to decide whether a baby or child should live or die? A hospital spokesman, who declined to be identified, has estimated that the Protocol would not be used more than ten 10 to 15 times a year.
Hugh Hewitt in his blog entitled Death by Committee for the Weekly Standard suggested that the Groningen Protocol could have been the stuff of a fine presidential debate question, or a series of questions. In his opinion, the Protocol should enter the history books as shorthand for an appalling brutality, so appalling in fact, that The Groningen Protocol could have been an entry on the agenda at the Wannsee Conference (where the Final Solution to the Jewish question was decided).
Other writers and students of ethics have also compared the Groningen Protocol to policies adopted in Nazi Germany. They argue that when one person decides about whether another person should live or die, the whole moral fiber of society is in danger of being eroded. Others defend the Protocol, insisting that sometimes death is the best solution when suffering becomes too extreme to bear.
References:
Chervenak, Frank A., Laurence B. McCullough and Brigit Arabin. Why the Groningen Protocol Should Be Rejected. The Hastings Center Report. Thomson Gale. Michigan: 2006.
Remmelink, Jan. Euthanasia in the Netherlands: Groningen Protocol. Books LLC. 2010.
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