A monstrous protocol

“Euthanasia conducted on the newborn is not a humane practice, and can only lead to a progressive erosion of the fundamental principle according to which each life is worthy of protection”, declares Bishop J.W. EIJK of Groningen, delegate of the Dutch Bishops’ Conference for questions of medical ethics. The law voted by the Dutch Parliament on 1st April 2002 authorised assistance in dying for adult patients who had made “explicit and well-founded” request for it, for youth aged between 16 and 18 who had requested it in writing, and for adolescents aged between 12 and 16 capable of giving their consent, on condition that their parents or legal guardians be also in agreement. In the summer of 2004 a protocol agreement was drafted between the university clinic of Groningen and the Dutch judicial authorities, regarding the possible extension of euthanasia also to children below the age of 12, right down to the age of birth. The document was welcomed with satisfaction by the Dutch association of paediatricians (NVK), which in recent weeks expressed the hope that the Secretary of State Ross-Van Dort would adopt the protocol. “We hope that the Secretary of State will not do so”, comments Bishop Eijk. “On the contrary, we hope he will put a halt to the uncontrolled expansion of euthanasia in Holland”. A BOTTOMLESS PIT. According to the bishop, “there are those in the Netherlands who don’t believe there’s any danger of going down a slippery slope; in actual fact the practice of euthanasia in our country risks slipping into a bottomless pit”. Dutch paediatricians hope the so-called “Groningen Protocol”, which authorises euthanasia for children suffering from incurable diseases and intolerable pain, “is the first step of legislation” to this end. “In Holland – that’s the bitter observation of Bishop Eijk – we regulate with care and transparency what elsewhere is practised in secret”, ignoring the fact that “an ethically reprehensible fact can be prepared and conducted in an irreproachable way, but that’s not enough to make it ethically acceptable”. THE LAST BARRIER. The debate on euthanasia has hitherto been based on two principles, points out the bishop: “the right of each person to self-determination, also on matters of life and death, and the deterioration of the quality of life caused by sufferings considered insupportable”. If initially people spoke of “incurable diseases”, today “they also discuss the possibility of assisted suicide for the mentally ill”; a further step, though one that is still subject to the voluntary nature of the decision to die. But now with the Groningen Protocol, the last barrier has also fallen, because, remarks Monsignor Eijk, it provides for the possibility “of actively putting an end to the life of patients who have not requested to die or are incapable of expressing their own consent”. So this is not “an extension of the right of people to decide on their own life and death, but a criterion to decide on the life or death of someone else”. WHO DECIDES if the life of others is worth being lived? “According to recent data – explains the bishop – 22 newborn infants suffering from spina bifida, with or without complications, were allowed to die in Holland between 1997 and 2004”. This is a pathology, he continues, that not all Dutch physicians consider should justify euthanasia, while “adults affected by this disease have protested against the notion that their own life should be considered ‘unliveable'”. Moreover, the conviction that “only active euthanasia can put an end to sufferings is less objective than the Groningen Protocol would have us believe – says Bishop Eijk -: many doctors in the world have different views on the matter, in particular thanks to the existence of various therapies for effectively controlling pain”. PALLIATIVE TREATMENT. On the question of palliative treatment, the bishop explains that “putting an end to a human life does not eliminate suffering; it eliminates the suffering person”. Is it licit to do so, he asks, given that “human life is a fundamental and inalienable good from conception to death, and that its value cannot be circumscribed by the application of scientific, medical or utilitarian criteria?”. Infants have always been born with chronic diseases, “and this is probably the saddest and most complex event that a parent has to face”. Nonetheless the task of physicians is to help them to live, only stopping at the threshold of over-treatment. “In the case in which a reasonable balance between the benefits and disadvantages of any medical treatment is lacking – explains Monsignor Eijk – it should be abandoned, even if that means the patient would die”. In every other case, the recourse to palliative treatment “will make the suffering, even of infant children, more supportable and humane”. What is not humane, he concluded, “is the practice of euthanasia on the newborn; a practice that can only lead to a progressive erosion of the value of the fundamental principle according to which each human life is worthy of protection”.