Euthanasia / Assisted Suicide - Archive

Dutch Commission Would Set Euthanasia ‘Rules’ of Newborn Babies (2005)

The Commission may allow doctors to euthanize more “seriously suffering” newborn babies they believe will not live even with medical care and attention.

Euthanasia of newborns is still technically illegal but the commission, which would consist of 3 doctors, an attorney and a bioethicist, will likely recommend that physicians who kill newborns but follow certain guidelines will not be charged with manslaughter or murder. Justice Minister Piet Hein Donner and Junior Health Minister Clemence Ross-van Dorp said the commission would begin its work in mid-2006 [Reuters]. They hoped it would add “transparency” to what’s taking place there.

Bert Dorenbos [Dutch pro-life group Scream for Life] said the commission would just provide cover for doctors to engage in more euthanasia. “It means that doctors will have a freer hand as to whether to end the life of a child or not. It is a slippery slope.” [30Nov05,]



Dutch euthanasia studies, recently published in American medical journals, present new data on end-of-life decision-making as it pertains to the induced deaths of adults and children in the Netherlands.

A Dutch, government-sponsored, euthanasia study, published in the Archives of Internal Medicine, examined patients’ requests for euthanasia and physician-assisted suicide (PAS), and the responses of Dutch doctors to those requests.

Researchers from Amsterdam?s VU University Medical Center sent written questionnaires to general practitioners (GPs) in 18 of the country’s 23 GP districts. A total of 3,614 GPs (60%) filled out the questionnaire and returned it. They were asked about all euthanasia and PAS requests they had received in the previous 12 and 18 months and their subsequent responses. [Jansen-van der Weide et al., “Granted, Undecided, Withdrawn, and Refused Requests for Euthanasia and Physician-Assisted Suicide,” Arch Intern Med 165 (Aug. 8/22, 2005): 1698-1704]

Of the explicit death requests, 44% were granted by GPs. In the other cases, 13% of the patients died before doctors could end their lives; another 13% died before doctors made the final decision to grant or deny their requests; 12% of the requests were refused by the GPs; and 13% of the patients changed their minds and no longer wanted to die.

According to the researchers, “pointless suffering,” “loss of dignity,” and “weakness” were the three most frequent and compelling reasons patients gave for wanting to die. Among those denied euthanasia or PAS by the GPs, “not wanting to be a burden,” “tired of living,” and “depression” were reasons most often given by patients to justify their death requests. [p. 1699]

The Dutch researchers concluded, “Physicians report compliance with the official requirements for accepted [euthanasia/PAS] practice.” [p.1704]

In an accompanying editorial, however, Susan M. Wolf, J.D., from the University of Minnesota Law School, questioned the validity of the researchers? conclusion: “Sadly, there are substantial reasons to doubt this reassurance,” she wrote. The surveyed doctors were picked in part because they had “no negative attitude toward euthanasia.”

[A]ll physicians being surveyed were either recently trained in the [euthanasia law] rules as consultants or the target of a project to encourage them to use these consultants and follow the rules. There was no control group, and retrospective self-report was the only data collection method. This is hardly an adequate basis for assessing whether physician practice actually complies with the rules. [Wolf, “Assessing Physician Compliance with the Rules for Euthanasia & Assisted Suicide,” Arch Intern Med 165 (Aug. 8/22, 2005):1677-1679]

Wolf also pointed out that the study?s data were compiled between 2000 and 2002?precisely when the Dutch government was preparing to pass and enact the new euthanasia statute, created, in large part, to solve the huge problem of physician noncompliance. This study, she wrote, “suggests that there was no significant problem to be solved by this statute. This is difficult to believe.” [p. 1678]

Euthanasia for Children

A two-part Dutch study, published in the Archives of Pediatrics & Adolescent Medicine, examined medical end-of-life decisions (ELDs) as they related to children between the ages of 1 and 17. The government-sponsored study defined ELDs as “decisions that, whether intentionally or otherwise, hasten death.” ELDs range from forgoing life-sustaining treatments and alleviating pain using drugs that can cause death, to opting for euthanasia, assisted suicide, or terminal sedation (where all food and fluids are withheld from the patient). [Vrakking et al., “Medical End-of-Life Decisions for Children in the Netherlands,” Arch Pediatr Adolesc Med 159 (Sept. 2005): 802-809]

The Dutch researchers conducted two separate studies; the data from both were included in the published article. The first study obtained data from a written questionnaire sent to 129 Dutch doctors who signed the death certificates of all children age 1 to 17 who died between August and December 2001. The second study involved face-to-face interviews with 63 doctors from pediatric hospital departments. [p.803]

The death certificate study found that 36% of children’s deaths were preceded by an ELD. Of all the deaths, 12% resulted from non-treatment decisions, 21% from the use of potentially death-hastening drugs to control pain and other symptoms; 2.7% involved “physician-assisted dying” (in 0.7% of these cases, death was requested by the child; in 2%, death was requested by others). [p. 804]

The interview study found 20 cases where doctors used drugs to intentionally end children’s lives. In two of those cases, the death request came from the child. Parents requested that their child be killed in 16 cases, while in two other cases the child’s life was terminated without an explicit death request from either the child or the parents. [pp. 804-805]

Researchers acknowledged that “active life ending occurs as frequently in children as in adults, but a patient request is rare in children.” [pp. 806-807]

While the studies’ authors paint a rosy picture of mutual ELDs among doctors, parents, and children, the fact remains that killing a child under 12 is illegal under the Dutch euthanasia law.

[Editor’s note: It’s become obvious that seriously ill and disabled infants and children are at risk in the Netherlands. The illegal status of infanticide and child euthanasia is just a minor technicality that can be undermined by conducting government-sponsored studies of the practices and publishing the results in reputable professional journals. The more this is done, the more the illegal act seems desirable and, above all, necessary.]

Earlier this year, the ITF Update reported on the “Groningen Protocol,” a series of proposed guidelines which doctors can follow when they terminate the lives of severely disabled newborns. The protocol elicited worldwide outrage, particularly after the New England Journal of Medicine published an article on the issue by the Dutch doctors who helped formulate the guidelines. [See, Update, 2005, no. 1]

Apparently unfazed by all the international criticism, the Dutch Pediatric Society has voted unanimously to adopt the Groningen Protocol as official national guidelines. The vote was called a “confirmation of the acceptability” of a still illegal act.
[British Medical Journal, 7/16/05; International Task Force on Euthanasia and Assisted Suicide Update, 2005, Volume 19, Number 3, 1Oct05]