I am a doctor. I am Dutch. I am very much in favor of the right to euthanasia or assisted suicide when at the end of someone’s life illness and suffering makes him wish for death.
Furthermore, I am convinced that the only real choice you have is between legal, controlled, public euthanasia and euthanasia that is carried out in the dark, possibly without the patient’s knowledge or even against his own wish. Prohibiting euthanasia will not make it go away, and tainting it with references to Nazi-Germany will not make those who wish for it suffer any less.
Euthanasia (or physician assisted suicide) is per definition carried out only if the patient has repeatedly requested it. This means the patient must be both
compos mentis and able to express himself. This precludes euthanasia in, for instance, coma patients or patients with severe dementia. All sorts of moral and legal dilemmas then ensue, such as in the case of
Terry Schiavo. (In my opinion, there is no real moral difference between removing a life-saving feeding tube and active euthanasia, except for the amount of hypocrisy involved.)
Mercy killing of patients that are
non compos mentis always leaves you with three options: it’s either what the patient “would have wanted”, it’s not, or the patient has never considered his predicament. However, wherever there is unmitigable suffering, there will be mercy killings wether it is legal or not and wether these cases will be subject to public vetting or not.
Over the last several years, Dutch pediatricians, especially those at the University Hospital of Groningen, have been trying to work out a vetting procedure in cooperation with government prosecutors. It concerns infants in constant pain from incurable disease or extreme deformities, although for legal reasons the procedure would apply to all children up to age twelve. The thing they came up with is called the Groningen Protocol. Wether mercy killing of infants will become legal in the Netherlands remains to be seen, but a lot of conservative, mostly American websites are already on the case.
To give you an idea, an
Google search of “Groningen Protocol” will currently (as of this writing) get you about 8,100 hits, but if you restrict the language to
Dutch you’ll only get four. To give you a further idea, Hugh Hewitt has already compared Groningen to both Wannsee and Auschwitz. He just can’t seem to stop writing about it. And he just can’t seem to get his facts straight.
Let me just translate a paragraph from the
October 29 press release of the University of Groningen Hospital concerning the protocol (and I apologize beforehand for my horrific treatment of the original text):
In het protocol, dat tot stand is gekomen na overleg met kinderartsen in heel Nederland en dat is afgestemd met het Openbaar Ministerie, staat precies beschreven in welke gevallen het behandelteam het kind verder lijden kan besparen. Zo moet er sprake zijn van ernstig lijden dat niet via andere wegen, zoals geneesmiddelen, verlicht kan worden. Ook mag er geen enkele kans op verbetering bestaan (uitzichtloosheid). Het gehele behandelteam (een ernstig ziek kind wordt veelal omringd door een multidisciplinair team van behandelend artsen en verpleegkundigen) moet ervan overtuigd zijn dat er geen enkele andere mogelijkheid is om het kind te helpen, en ook de geraadpleegde artsen van buiten het behandelteam moeten het daarmee eens zijn. Ook de instemming van ouders is verplicht. Tenslotte moet de levensbeeindiging zelf aan alle zorgvuldigheidscriteria voldoen.
In the protocol, that was realized after consultation with pediatricians in the entire Netherlands and that was attuned with the Public Prosecution Service, is exactly described in which cases the medical team can prevent further suffering in a child. There has to be grave suffering that cannot be eleviated by other means, such as drugs. Also, there may not be any chance of improvement (no hope of relief). The entire medical team (a gravely sick child is usually treated by a multidisciplinary team of doctors and nurses) must be convinced that there is no other possibility to help the child, and the consulted physicians from outside the medical team treating the child must agree. Also, permission by the parents is mandatory. Finally, in the termination of the child’s life all the due care criteria [presumable those that already exist for euthanasia, j.e.] must be observed.
Now, I’ve got a couple of questions for Hugh Hewitt:
Why do you insist that parents do not have a say in the matter, when in fact, the parents have the final say? It’s up to the medical team to ascertain that the medical situation indeed constitutes grave and hopeless suffering, but the decision to go ahead lies with the parents and no one else.
Why haven’t you contacted the hospital and asked for an explanation? Let me help you: just follow the link above to the Dutch press release.
Contactpersoon means contact person in Dutch, and
telefoon means telephone. The international dialing code for Holland is 031.
Why don’t you acknowledge that the choice that parents and doctors face is between a mercy killing and a life of suffering for the child? Why do you talk of “
deeming babies disposable” when their own parents see it as an act of mercy?
Why do you use the repugnant hyperbole of comparing euthanasia to the Holocaust? Pediatricians estimate that if the protocol were to apply to the entire Netherlands the annual number of children involved would be 10 to 15. At present levels of population (16 million) and medical care, it would take the Dutch pediatricians something like 10,000 years to get as gruesome as the Germans were during five years of occupation. My grandfather survived the Holocaust, in his last years he was terrified of being hospitalized in some Catholic hospital where they would not respect his own wishes. You think linking the Groningen Protocol and the Nazis is “
appropriate”. I think it is vile. Maybe you can explain yourself?
Why do you deny the good intentions of those pediatricians? On what grounds? Do you really think they are “
executioners” , that “
had [Annah’s] orphanage been attached to the Groningen Academic Hospital, [they] wouldn't be very far down the pick list”? On what grounds, sir?
The first time you mention the Groningen Protocol on
your website, you link to
this news article posted on MyWay.com. A couple of days later, in your
Daily Standard piece, you link to
another article appearing in the Grand Forks Herald. However, the only quote you give contains an error, claiming "
a parent's role is limited under the protocol. While experts and critics familiar with the policy said a parent's wishes to let a child live or die naturally most likely would be considered, they note that the decision must be professional, so rests with doctors." This is most certainly not how the Groningen hospital itself describes the decision making process. However, the two articles are most informative. This is from MyWay.com:
However, experts acknowledge that doctors euthanize routinely in the United States and elsewhere, but that the practice is hidden.
"Measures that might marginally extend a child's life by minutes or hours or days or weeks are stopped. This happens routinely, namely, every day," said Lance Stell, professor of medical ethics at Davidson College in Davidson, N.C., and staff ethicist at Carolinas Medical Center in Charlotte, N.C.
"Everybody knows that it happens, but there's a lot of hypocrisy. Instead, people talk about things they're not going to do."
More than half of all deaths occur under medical supervision, so it's really about management and method of death, Stell said.
And this is from the Grand Forks Herald:
There's little evidence that permitting euthanasia has had much impact on the number of assisted deaths, argued Rotterdam epidemiologist Agnes van der Heide, who's measured euthanasia in Europe for 10 years.
She said her research indicated that the number of assisted deaths in the Netherlands had increased only slightly in 10 years of legalization. She said the inclusion under the law of such groups as those in the beginning stages of dementia and terminally ill 12- to 16-year-olds accounted for only a few cases nationwide each year, similar to predictions on child euthanasia.
"And the fact remains, euthanasia typically shortens life by one month against life expectancy," she said. "There are no trends showing an increase in that number, or in the estimation that quality of life in these cases is so poor that life should not continue. I know the debate focuses on worst-case scenarios, and abuse. There's no evidence of those things taking place."
Following up on that: why don’t you mention illegal mercy killings and their moral implications? Don't you think that the equation alters when you know that a prohibition is rather futile? Do you really think that all parents, nurses and doctors everywhere will follow the law even when they think this merely prolongs the suffering of the child in their care?
In the Daily Standard you write:
The Groningen Protocol is the proposal of doctors in the Netherlands for the establishment of an "independent committee" charged with selecting babies and other severely handicapped or disabled people for euthanasia.
This description of the protocol seems rather different from the one given by the hospital’s own website or the two news articles you link to. Do you really think this is what the doctors propose? Do you really think they propose to set up a commission just to kill babies and cripples because its fun or convenient? What else do you think they do? Drink the blood of Christian babies?
And on your website you write:
Understand that under the protocol, Greg's and Diana's views on Graciana's right to be born and live would not have been dispositive --only advisory.
What are you talking about? Could you please explain? I have seen an anencephalic child be born at full term in the Netherlands because the mother had refused an abortion. And I've seen the child die half an hour later. You see, in a liberal society, a woman's right to choose works both ways.
The reverse of mercy killing is not life, but a life of suffering. You attack others but say nothing to defend your own position. Killing is wrong, but so is torture. An adult patient who is
compos mentis who requests euthanasia considers life (such as he can live it) to be a fate worse than death. You would condemn him to that fate if you could. I would condemn him to whichever fate he chooses. You denounce my position but fail to make a case for yours. This makes your vituperations all the more hollow.
I will say this in defense of the Groningen Protocol:
There are always a few very unlucky innocent children who suffer from the most terrible afflictions. They usually die at an early age, after a few years of intense suffering. As with all children, their parents are entitled to withhold any treatment from their children, even life-saving treatment. After all, the parents are the child’s legal guardians, and children's lives are routinely put in jeopardy by religious parents who refuse them vaccinations or blood transfusions. However, in these cases, even though withholding treatment would lead to a quicker death, it would also increase the suffering of the child. Actively ending the child’s life would be painless. The temptation for mercy killing is there and has always been there. It is a fact of life. Like with euthanasia, mercy killing of suffering infants will not go away when you prohibit it. You can even ask yourself if there will be more mercy killings when you legalize it. Considering the raririty of these illnesses, the strictness of the protocol, and the commonness and strength of parental love, I really doubt that.
Better to have it out in the open where people like yourself can scrutinize the process, then to have parents, doctors and nurses risk years in prison for committing something they and many others see as a selfless act of mercy.
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