Unspeakable ...

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Dutch to OK euthanasia for children

Terminally ill babies can be killed under law now for adults-only

AMSTERDAM - The Dutch government intends to expand its current euthanasia policy, setting guidelines for when doctors may end the lives of terminally ill newborns with the parents' consent.

A letter outlining the new directives will be submitted to parliament for discussion by mid-October, but the new policy will not require a vote or change of law, Dutch Health Ministry spokeswoman Annette Dijkstra told The Associated Press yesterday.

The Netherlands became the first country to legalize euthanasia for adults under some conditions in 2001, and the latest move is likely to spark an outcry from the Vatican, anti-abortion groups and advocacy groups for the handicapped.

Euthanasia is banned in most countries, although Belgium legalized it under strict conditions in 2002. Switzerland allows passive assistance to terminally ill people who have expressed a wish to die.

In the United States, Oregon is alone in allowing physician- assisted suicide, but its law is under constant challenge and the U.S. Supreme Court is to hear arguments against it on Wednesday.

In Canada, euthanasia is against the law. But debate has seldom rested since 1994, when Sue Rodriguez, a woman with Lou Gehrig's disease, took her own life, after the Supreme Court of Canada rejected her bid to be legally assisted. A Senate study in 1995 came up deeply divided, but recommended against changing Canada's law.

The change in Dutch policy is especially significant because it will provide the model for how the country treats other cases in which patients are unable to say whether they want to live or die, such as those involving the mentally retarded and elderly people who have become demented.

The governing conservative Christian Democrat party, which fought legalization when it was in the opposition, will embrace the guidelines, known as the Groningen Protocol, drawn up last year by doctors at the Groningen University Medical Centre.

Under the protocol, euthanasia would be permissible when a child is terminally ill with no prospect of recovery and suffering great pain, when two sets of doctors agree the situation is hopeless, and when parents give their consent.

The Dutch Health Ministry has postponed this decision several times, and wishes to control the release of information around the policy change, which is still being finalized.

But Ms. Dijkstra confirmed the broad lines of the guidelines after details began leaking to the Dutch media and to some members of the medical community who have been involved in the long-running debate over the issue.

The government will establish a vetting commission, modelled on those currently in place for adult euthanasia, to determine whether conditions have been met in each case, and to refer the case to public prosecutors if they do not.

But unlike with adult euthanasia, prosecutors will not be bound to follow the commission's judgment that conditions have been satisfied.

"The public prosecutor's office will always make an independent decision," Ms. Dijkstra said. "The ending of a life must occur with the utmost of caution."

American ethicist and pediatrician Dr. Chris Feudtner of the Children's Hospital of Philadelphia said he hoped the Dutch government would rethink its position.

"I admire the Dutch desire for openness in addressing what is an incredibly difficult issue, but I categorically do not endorse ending people's lives with the argument that it's alleviating their suffering," he told in an interview.

"I think, too often, the impulse is to resort to extreme measures, because we're not being effective enough in the management of pain."

He said removing life support is a possibility in cases parallel to that of coma patient Terri Schiavo, for instance if a child is born with just the stem of a brain.

But active euthanasia is "prone to abuse," he said. "If you allow it to occur, it will occur in cases where it is not ethical, period," he said.