AMSTERDAM — A hospital in the Netherlands — the first nation to permit euthanasia — has proposed guidelines for mercy killings of terminally ill newborns and then made a startling revelation: It already has begun carrying out such procedures, which include administering a lethal dose of sedatives.
The announcement by the Groningen Academic Hospital came amid a growing discussion in the Netherlands on whether to legalize euthanasia on people who are incapable of deciding for themselves.
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 irreversible comas after accidents.
The Health Ministry is preparing its response, which could come this month, 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 that the pain cannot be eased and that there is no prospect for improvement and when parents think it’s best.
Examples include extremely premature births, where children suffer brain damage from bleeding and convulsions and diseases where a child could survive only on life support for the rest of its life, such as severe cases of spina bifida, a neural tube defect; and epidermosis bullosa, a rare blistering illness.
The hospital revealed last month that it had carried out four such mercy killings in 2003 and had reported the cases to government prosecutors. There have been no legal proceedings against the hospital or the doctors.
Roman Catholic organizations and the Vatican have reacted with outrage to the announcement, and U.S. euthanasia opponents contend that the proposal shows the Dutch have lost their moral compass.
“The slippery slope in the Netherlands has descended already into a vertical cliff,” said Wesley J. Smith, a prominent California-based critic.
Child euthanasia remains illegal everywhere. Analysts say doctors outside the Netherlands do not report cases for fear of prosecution.
“As things are, people are doing this secretly, and that’s wrong,” said Eduard Verhagen, head of Groningen’s children’s clinic. “In the Netherlands, we want to expose everything, to let everything be subjected to vetting.”
According to the Justice Ministry, four cases of child euthanasia were reported to prosecutors in 2003. Two were reported in 2002, seven in 2001 and five in 2000. All the cases in 2003 were reported by Groningen, but some of the cases in other years were from other hospitals.
Groningen estimated that the protocol would be applicable in about 10 cases per year in the Netherlands, a country of 16 million people.
Since the introduction of the Dutch law, Belgium also has legalized euthanasia, and legislation to allow doctor-assisted suicide is under debate in France. In the United States, the state of Oregon is alone in allowing physician-assisted suicide, but that law is under constant legal challenge.