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

Legal euthanasia makes killing the norm, not the exception

By Henk Reitsema

Henk Reitsema

Henk Reitsema wrote an insightful article that was published in the Times UK on February 23, 2021. Reitsema is responding to the campaign to legalize euthanasia in Scotland. Reitsema comments on the expansion of euthanasia and the growth in acceptance of other acts that cause death, but are not defined as euthanasia. He writes:

Campaigners plan a new move to legalise assisted suicide in Scotland this year. The Netherlands, which legalised euthanasia in 2001, should offer a cautionary tale. My country expected a fall in backdoor euthanasia and the stopping of incremental extension by pinning down the definitions in law. But 20 years later it is clear we were profoundly mistaken.

There has been a massive greying of the lines, with a significant increase in life-shortening treatments that are not being called euthanasia. The term “unbearable suffering” has been expanded from physical suffering to include psychological and existential suffering — now even the term “tired of life” is sufficient. We have also seen the restrictions on age and mental competency shift.

The debate started in response to the many life-lengthening medicines that were being developed in the late 1960s. Rather than debate the medical imperative of treating patients one could not heal, professionals started taking matters into their own hands, with the first court case taking place in 1973 when a nurse killed her mother with a morphine overdose. Though the nurse got a one-week suspended sentence, more importantly the courts stipulated which procedures they would have wanted to have seen met in this case. This opened the door to legalisation in 2001.

Initially, it looked like reform had slowed down the euthanasia rate. From 2001 to 2005 numbers dropped from 3,500 to 2,300. Subsequently they started to rise again and are now at roughly 6,500 cases a year. This is more than 4 per cent of all deaths in any given year.

Once active killing by physicians was legalised, their attitudes towards pain treatments that shortened life changed. Palliative sedations, in which a patient is sedated for the final phase of life without hydration or food, rose from 5.6 per cent of all deaths in 2001 to 8.2 per cent in 2005. Now roughly 25 per cent of all deaths take place under these circumstances.

Since legalisation, the incentive to improve palliation has diminished and euthanasia has gone from being an exceptional situation to becoming the norm, with people who feel they are a “burden” to their next of kin requesting to end their lives even when they do not really want it.

When euthanasia is ever more frequently used, the tendency is then to move in the direction of euthanising those who are not able to request it owing to dementia or other incapacity. Paradoxically, that which was supposed to provide autonomy could lead to the ultimate loss of autonomy.

Reitsema started opposing euthanasia after his grand father was killed without request or consent.