The Dutch government will permit doctors to euthanise terminally ill children aged between one and 12 after months of debate within the ruling coalition.
The country’s health minister, Hugo de Jonge, said a change in regulations was necessary to help “a small group of terminally ill children who agonise with no hope, and unbearable suffering”.
The government estimates that the new rules, lifting the threat of prosecution from doctors, will affect between five and 10 children per year who have no hope of improvement in their condition.
Belgium became the first country to allow for voluntary child euthanasia in 2014 when it legislated to allow euthanasia in cases where the young patient was terminally ill and in great pain. Two Belgian children aged nine and 11, became the first to be euthanised in 2016 and 2017.
Intervention to end a life is also already legal in the Netherlands for children older than 12 if consent is given by the patient and their parents. Babies up to a year old may also have their lives ended with parental consent.
The group of children referenced by the planned regulation currently may only be given palliative care or have their nutrition withheld to speed up their death under the current rules with doctors facing prosecution if they take any other action to end a life.
This gap in provisions for children aged between one and 12 has been described as a “grey area” by physicians calling for change.
The issue has been the cause of heated debate within the ruling four-party coalition, with opposition from both the Christian parties, the Christian Democrat Appeal party, led by De Jonge, and the more conservative ChristenUnie.
De Jonge had been open to a debate on the issue but he faced opposition from ChristenUnie. But in a letter to the Dutch parliament announcing the government’s intentions, De Jonge cited a recent report which showed overwhelming support for a change in the law among doctors.
He wrote: “The study shows that there is a need for active termination of life among doctors and parents of incurably ill children, who are suffering hopelessly and unbearably and will die within the foreseeable future”.
Parental consent will be needed and the patient must be enduring “unbearable and endless suffering” for euthanasia to be granted. At least two doctors must agree to the procedure.
Since 2002 doctors have been able to euthanise adults in the Netherlands in cases where it is regarded as a voluntary and well considered request in the context of unbearable suffering from which there is no prospect of improvement, or alternative remedy.
Last year there were 6,361 cases of euthanasia in the country – just over 4% of the country’s total deaths. Of those, 91% were for terminal medical conditions.
The remainder of euthanasia cases involve severe psychiatric illness. Two years ago, the case of Aurelia Brouwers, 29, who was chronically suicidal, triggered a debate when her decision to die was covered in a documentary by the Dutch TV network, RTL Nieuws. Brouwers was filmed for two weeks before her death, including during a visit to the crematorium she had chosen for her funeral.
Brouwers’ own doctors would not help their patient terminate her life but she was granted her wish after applying to the Levenseindekliniek – the End of Life Clinic – in The Hague.
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