Netherlands Health Minister Proposes Protocol for euthanasia of children under 12.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

• Sign the Petition: No to child euthanasia (Link).

The DutchNews.nl reported today that Dutch Health Minister Ernst Kuipers announced the intention to extend euthanasia to children, but without changing the law. Kuipers intends to extend the Groningen Protocol, which currently applies to babies, to include children under the age of 12.

An article by Peter McLaren Kennedy for EuroWeekly stated:

The proposed protocol contains seven criteria for euthanasia for those between one and 12. Doctors will have to be convinced the child’s suffering is unbearable and there is no possibility of a cure or a treatment to alleviate the pain.

The diagnosis would have to be fully discussed with the child’s parents as well as the possibility of euthanasia, for which both parents will have to give their permission.

Doctors will also discuss the procedure with the child in a way the child will understand and will only proceed if the child is in no way opposed to it.

In addition, doctors will have to consult at least one independent doctor who will be required to evaluate if all the criteria have been met before euthanasia can take place.

The concept is currently out to consultation with Kuipers to present the final concept in October, when he will also announce when the protocol will come into force.

In October 2020, Netherlands Health Minister Hugo de Jonge announced that the government would amend or permit child euthanasia. According to the DutchNews.nl:

De Jonge added that current laws would not need to be amended. Rather, doctors would be exempted from prosecution for carrying out an approved euthanasia on a child.

At that time, an effective campaign opposing child euthanasia was established by a group of Netherlands citizens and the Euthanasia Prevention Coalition ran a petition with more than 100,000 people opposing child euthanasia. The Netherlands government did not extend euthanasia to children.

This latest announcement sets a dangerous precedent. The Groningen Protocol permits euthanasia of newborns who are experiencing current or possible future suffering. If you use the same definitions for children under 12, there will be many euthanasia deaths of children who may have treatable conditions. Further to that, there are many medical conditions that possibly lead to future suffering.

As much as I oppose euthanasia in general, it would be more honest if the Netherlands parliament debated and passed clear legal guidelines rather than avoid the contentious debate and approve a killing protocol that will enable doctors and parents to make lethal decisions in a back room.

health minister Ernst Kuipers

Read more at DutchNews.nl:

health minister Ernst Kuipers has said in a briefing to MPs.

Read more at DutchNews.nl:

Netherlands group opposes termination of life for children (euthanasia).

Press release - March 12, 2021

The network ‘Bescherm het Kinderleven’ (Protect Children’s Lives) is making a plea against the Proposal by the Dutch government for active termination of life for children age 1 to 12

On the 13th October 2020 the then minister of Health, Wellbeing and Sport, Hugo de Jonge (CDA) announced coming with regulations for active termination of life for seriously ill children ages 1-12. As a reaction on this announcement, a collective of citizens with diverse backgrounds an affiliations have join forces to initiate the network ‘Bescherm het Kinderleven’ (BHK). BHK denounces the plan to allow for regulated termination of life for children. In the coming days the network is launching a social media campaign in which they wil elaborate on the dangers associated with this plan.

Invest in good palliation
The network BHK calls on authorities to invest in better palliative care. Research has shown that inadequacies persist especially in palliation for minors. These express in the realms of communication, organization, decision making, attention for family and child and symptom relief. A deficit amongst physicians in specific knowledge of child palliation has also been indicated. 1 2 

BHK is convicted that the Dutch government makes a mistake in regulating for the termination of lives of children while palliation has yet to be optimized. This way we risk removing the incentive to improve palliation. 

“We should rather work at limiting suffering within the parameters of life” says Henk Reitsema, spokesperson for BHK.

Vulnerable and incapable of informed consent
The network would like to emphasise the vulnerable position that children have. Informed consent without external influence is very unlikely with children given their dependence on adult caregivers and limited ability to weigh medical decision making. While it is heart-breaking when a child suffers, every child deserves the best possible protection from the law irrespective of their condition. Active termination of life does not fit in with this. Terminating the life of a child that is impressionable, cannot defend itself and is incapable to express its will is problematic on all scores. Soon decisions will be being made about their lives but not by them. They should stay optimally protected in this.

Incremental extension
BHK has good reason to argue the dangers of incremental extension. The Dutch experience so far with the regulation and legalisation of euthanasia has shown that there is an ever increasing number of categories that qualify once the step has been taken. The journey from initially legalising for physical pain and then incrementally including dementia, psychological pain, psychiatric conditions, existential pain and the so called piling of complaints related to aging, has shown how rapidly this develops. We now even have the proposal for a law that would allow those 75 and older to opt for euthanasia even when physical and psychiatric suffering are not at issue.

A similar development took place with the Groningen protocol which allows for infanticide. While initially allowing for the termination of life age 0-1 on the basis of unbearable physical suffering, now potential future suffering can be included in this evaluation.

The BHK is concerned that the newly proposed regulation, will once again lead to new grey areas arising. The spokesperson for BHK, Henk Reitsema asks: 

“For who will termination of life be deemed appropriate in 2050?”

Website: beschermkinderleven.nl

1 Brouwer M, van der Heide A, Hein I, Maeckelberghe E, Verhagen E, van de Wetering V. Medische beslissingen rond het levenseinde van kinderen (1-12). Groningen, Rotterdam, Amsterdam: UMCG, Erasmus MC, AMC in opdracht van het ministerie van VWS, afdeling Ethiek, namens de Nederlandse Vereniging voor Kindergeneeskunde; 2019.
2 Rapportage patient journeys kinderpalliatieve zorg. Jb Lorenz, Kenniscentrum kinderpalliatieve zorg, PAL kinderpalliatieve expertise: 2018