Worse Than First Reported: Killing Infants in Europe

A few months ago we learned that the Netherlands had a policy of killing infant children deemed to have little chance of survival. Chilling in an of itself, the fact that the issue was taken out of the hands of parents was also horrifying. Having read the articles on what was going on, I was disturbed enough to rethink my usual objections to slippery slope arguments. As it turns, out, it is much worse over there than we thought. According to the AP:

Dutch doctors estimate that at least five newborn mercy killings occur for every one reported in that country, which has allowed euthanasia for competent adults since 1985.

In a follow up post I did on this topic, I questioned whether the government and medical authorities who advocated such policies were underestimating The Value of a Short Life. Today, while reading The Corner (a blog for National Review contributors), I found reported this email by a pediatrician and medical geneticist:

As a pediatrician and medical geneticist I've had to deal with the issue of newborns with fatal malformation or syndromes on a few occasions, and this whole euthanasia thing in the Netherlands really makes my skin crawl. About 1 in every 7 or 8,000 newborns has trisomy 13 or 18, for example (think Down syndrome, only a lot worse). These conditions are almost always lethal in the first few months of life and are characterized by a variety of birth defects, everything from cleft lip and palate to complex congenital heart disease, to structural brain malformations and severe retardation. Very few live more than a few years. These are terrible conditions, but they're not painful, except, of course to the family. Counseling in these situations usually involves spelling out the facts (obviously in much more detail) and, in my experience, most families accept the situation, understand their baby is going to have a short life, and enjoy the time with their baby as much as possible. I've never heard anyone suggest euthanasia. However, medical intervention is often tailored to the situation, for example, in an otherwise healthy newborn with complex congenital heart disease, corrective surgery would be arranged. However, if the infant has trisomy 13, it's difficult to justify the expense, resources and pain required to fix the heart, if the ultimate outcome won't be altered. So if no amount of medical intervention is going to lengthen their life, why put them thru it? It's always seemed to me that the humane thing to do in these hopeless cases is to just let nature take its course, and I don't mean exposure on a hillside, but rather provide food, comfort, love and attention, and understand that medical technology can only do so much. I don't see how any active measures to "speed things along" could ever be justified on the basis of sparing the infant unnecessary suffering, because I really don't think they are suffering. While I'm sure there is a financial incentive driving this, as every day in the NICU costs thousands of dollars, I think it's clear that one reason infants are being euthanized in the Netherlands to spare their parents (and the "caregivers") needless suffering. Once we start justifying infanticide to make ourselves feel better, what's next?

Update: Another doctor emailed to the Corner with the following comments about treating the suffering felt by infants:

Let me also point out that I have yet to see a patient -- ever -- with truly untreatable pain. There are other symptoms that can be very refractory to treatment, particularly nausea or depression, but pain is *easy*. The difficulty comes when the dose of medication required to treat pain produces enough depression of respiration to endanger the patient's breathing. That's where the "doctrine of double effect" comes in -- the idea that a dose of (for example) morphine that hastens a patient's death is not euthanasia and hence ethically acceptable if it truly is the lowest dose required to make the patient comfortable. It's the intent of the prescriber that matters, not the effect on the patient. While this can be difficult in the sense of trying to evaluate someone's conduct afterward, I've never had any difficulty in knowing the difference between increasing the dose of a pain medication because the patient still hurts (even though I know I'm taking greater risks with his breathing, risks that are acceptable to him because of limited prognosis) on the one hand, and prescribing something with the intent of ending someone's life (which I've never done). The idea of killing an infant because I in all my wisdom think that his life is not worth living is repugnant.


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