The Dutch government announced plans this week to allow doctors to end the lives of children with chronic illness under the age of 13, a decision that should intensify the debate on physician-assisted deaths.
The Netherlands already allows doctors to handle the deaths of people over 12 or less than a year old as long as the parents have given their consent.
In a letter to parliament on Tuesday, Dutch health minister Hugo de Jonge proposed expanding the law to include children between the ages of 1 and 12 who are dying and suffering.
“In a small number of cases, commodity protection is inadequate,” Mr. de Jonge wrote. “As a result, some children suffer unnecessarily without hope of improvement.”
He estimates the measure will affect nearly five to 10 children per year.
Doctors in the Netherlands have expressed concern that they could be held accountable for the crime if they help end the lives of “sick” children between 1 and 12, as the law does not provide for children at the age expected to die soon.
Under current law, a doctor may terminate the life of a child younger than 1, with the consent of the child’s parents, if the child experiences “unbearable and hopeless suffering,” write. Mr. de Jonge.
He said the new regulation would provide more transparency for doctors.
Three other European countries – Luxembourg, Belgium and Switzerland – allow physician-assisted death, although the laws vary from country to country. Belgium allows children to die with the help of a doctor, but in Luxembourg, the law restricts adults with incurable medical conditions.
Canada, parts of Australia and Colombia have also legalized death assisted physician for adults in some cases.
In the Netherlands, parliament does not have to vote on the new regulation because it will be replicated in existing law, Mr. de Jonge said in the letter.
However, a majority parliament is expected to agree to the change, which will take several months to complete, a spokesman for Mr. de Jonge said.
“This is a complex and sad issue,” Mr. de Jonge told the Dutch NOS reporter on Tuesday.
According to Dr. Ira Byock, a palliative care physician and director of the Providence Institute for Human Caring, development in the Netherlands is a worrying example of the growing hope of death assisted medically to address exhausting health cases, instead of looking for compassionate ways to help people cope with pain and suffering.
“We can always manage a person’s physical suffering,” he said. “We can always provide medication that approaches general anesthesia and allows a person to die mildly – sleep at the end of their life.”
Dr. Byock said he was concerned about the growing call in the United States to use euthanasia to help adults with degenerative conditions end their lives.
“When suffering patients are seen as problems that need to be addressed, rather than the whole person having to be taken care of, we set ourselves up for a situation that is detrimental to the profession and to our society as a whole,” he said.
Dr. added. Byock: “We’re all on this slippery slope.”
Eight states and Washington, DC, have laws that allow mentally ill adults with terminal illness and six months or less to live to get a prescription drug that will speed up their deaths, according to Death With Dignity, an Oregon-based nonprofit that supports such laws.
The new language in Dutch law could create “pressure on the United States to try and expand our conservative policy to include people who do not consent but are seriously ill and adults,” said Arthur Caplan, a professor of medical ethics at NYU Langone Hospital.
But he expressed doubts that the United States would begin to follow the example of the Netherlands, where people with mental illness were allowed to end their lives with the help of doctors.
Americans have less faith in their medical system than the Dutch, who are more likely to believe in doctors when they say a medical condition is hopeless, Professor Caplan said.
The Netherlands is “a small country,” he said. “Doctors and patients know each other very well and have great access to health care.”
Professor Caplan added: “In the United States, we have many segments of people who do not have access to good health care and that means more distrust.”