Pediatric Euthanasia in Belgium

As the Associated Press and Washington Post have reported, and as Wesley Smith has been blogging against for a bit, Belgium’s legislature has approved euthanasia for kids (under 18).  Smith says that this is just cover for a practice that is already established there.

“We report, you decide…”

The AP/Post report says there are important “added restrictions” to prevent abuse.  Folks, the whole thing is an abuse at the core.  Witness the “steps”:

  1. Specific provisions in law to create a 16-doctor panel (bureaucracy) to review all requests, with no specific timeline—so supposedly they could prevent these killings with lots of red tape.  But the fact that it would even be considered seriously demonstrates that the conflation of the healer and the killer, that Margaret Mead warned about, is accomplished in Belgium.
  2. Incurable illness:  death must be expected in a “short time.”  Never mind the utility of good palliative care to relieve symptoms and provide care.  The child must be experiencing “constant and unbearable physical suffering.”  Again, that is not able to be palliated?  That warrants physicians recommending death, in essence?  That might be due to, oh, depression?  “Diagnosis and prognosis must be agreed upon by the treating (sic) physician and” an outside second opinion.  But that is a highly malleable criterion.
  3. The child  “understands what they (sic) are doing”:   I submit an adult can scarcely understand what submitting to death would mean—can anyone really promulgate this criterion with a straight face?  Folks, in human subject research, we extend protections to kids as specifically vulnerable subjects, and the notion of kids giving informed consent is a challenging one.  In fact, the parents usually consent for the child, with the researchers obtaining the child’s “assent.”  There is inestimable risk of coercion here by adults—and I do mean coercion.  Now, we do recognize that sometimes an aware minor can clearly choose to forego medical treatment, but foregoing medical intervention is one thing, and an invitation affirmatively to choose death is quite another.  To pose the question is to embrace a bias toward death, not live—a “culture of death,” to use another phrase.
  4. Gets the agreement of parents:  I guess I worry that it would often be the other way around.  Also, do autonomy advocates squirm about this point?
  5. Request in writing:  “We wrote it up for you on this form, just sign here.”  Why?  “It’s to cover us if we get sued.”
  6. Emotional support for all:  Foundational to any critical or end-of-life care.  Included in this list to make the euthanizers feel better about themselves.
  7. The final step—euthanasia:  From the AP/Post report—“There are two methods, according to Dr. Marc Van Hoey of Antwerp who says he performs between three and 10 euthanasia procedures a year. A terminally ill person can drink a barbiturate-laden syrup themselves or a doctor can administer the drug into an intravenous tube. Death comes within minutes either way.”


I wonder what the pediatric oncologists think of this?  If I get a read from any I know, I’ll post in a follow-up.

Margaret Mead, where are ye now?

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Mark McQuain
Mark McQuain

I agree with you (and Margaret Mead). Given Dr. Mark Van Hoey’s comment in #7, it is frankly incoherent that a physician be involved in “the final step”. Every bit of our routine medical education and training is devoted to delaying death. With that training bias, it would seem that physicians would be the last group from which society would select for its euthanists. Dr. Van Hoey’s own satisfaction with an administered death “that comes within minutes either way” seems to support such a delay.