A doubt that needs clarification

In the year 2007 no case of neonatal euthanasia was reported by the authorities, a circumstance questioned by the central Commission of Experts on Belated Abortion and Newborn Life Suppression established by the Dutch government in 2006. Joep Hubben, Professor of Healthcare Law at the University of Groeningen is among the many people who believe that such practices might still be carried out. In the past it was suspected that each year doctors performed approximately 15 cases of euthanasia on seriously ill children or with strong handicaps. The referent for ethical problems of the Dutch Bishops Conference and current archbishop of Utrecht Msgr. Willem Jacobus Eijk expressed his view on this issue on the magazine Medicina e Morale of the Cattolica University in Rome.The protocol of Groeningen. In The Netherlands it is legal for doctors to actively help a person to die provided there exist specific conditions. These include: the disease ought to be incurable, the suffering unbearable, the patient must have given his consent and an external practitioner, not involved in the process, ought to be present. In 2004 Groeningen’s hospital issued, in agreement with the local public prosecutor’s office, a protocol regulating life-suppression in young children suffering unendurable pain caused by incurable diseases. This protocol, known as the Groeningen Protocol, was approved by the Dutch pediatricians association in 2005. Accordingly, a medical life-terminating decision can be taken on three groups of newborn: those who have no chances of survival or who are bound to die immediately after birth; those with negative diagnosis and who depend on intensive care with difficult future prospects; children with hopeless diagnosis who suffer unbearable pain. Present and future suffering. “What’s worse – wrote Msgr. Eijk – is that the medical decision on the first two categories is considered normal”. In reality, the Protocol of Groeningen regulates the third category, overcoming a previous limit established by Dutch pediatricians in 1992 with the report “To act or to omit?” “provided that strict rules be followed like the certainty of the diagnosis, suffering with no perspectives of healing, confirmation by an external doctor, parents’ consent, and the compliance with current medical practices”. “Also the request for clarity and legal protection of doctors from the charge of homicide has thus been overcome, since, in the case of newborn the consent requisite is inapplicable”, Msgr. Eijk pointed out. Indeed, in a note to the Chamber filed on 11.29.205 the Minister of Justice reaffirmed that deliberate life-termination is subject to Penal Code sanctions, however he indicated a procedure to be followed in the framework of a situation of emergency and, something new, he said it may be notified not to the public prosecutor but to a National Commission of Experts (a jurist, a ethics scholar and three pediatricians) “responsible for the accuracy of the procedure and for its penal liability”. The ministers, remarked Msgr. Eijk, “distinguish between two situations where this practice is acceptable: nearing death and unbearable pain with no chance of an independent life of the patient. “The present state of suffering is the discriminating element”, the bishop pointed out. Different is the position of the Centre for Ethics and Health, which envisages the possibility of preventing future suffering. Obligation conflict. In the debates on euthanasia we should ask ourselves if “the doctor who puts an end to life is faced with a clash of duties – the defense of life and the decrease or elimination of suffering – enabling the appeal to a situation of emergency”. A research on euthanasia conducted in the year 2005 showed that palliative treatments rule out resort to euthanasia, assisted suicide, and deliberate, non-requested, life termination. Compared to 2001, data for the year 2005 showed a dramatic decrease in the cases of euthanasia (3.500 compared to 2.325) and a surge of palliative sedation (8.500 in 2001 compared to 9.700 in 2005). “Isn’t the current debate on situations whereby life-termination of the newborn is viewed as a solution, a symptom of the denial and attack against the intrinsic value of human life?”, the bishop claimed. We are witnessing the emergence of a stand which “justifies, in given situations, not only the resort to life-termination on demand, but also the life-termination of the patient without his explicit request”.