September 29, 2005
Dutch Set to Expand Euthanasia Guidelines
By THE ASSOCIATED PRESS
Filed at 10:54 a.m. ET
AMSTERDAM, Netherlands (AP) -- The Dutch government intends to expand its current euthanasia policy, setting guidelines for when doctors may end the lives of terminally ill newborns with the parents' consent, The Associated Press has learned.
A letter outlining the new directives was expected to be submitted to parliament for discussion by mid-October, but the new policy will not require a change of law, Dutch Health Ministry spokeswoman Annette Dijkstra said Thursday.
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The new guidelines are likely to spark an outcry from the Vatican, right-to-life proponents and some advocacy groups for the handicapped who abhor the current policy that allows adult euthanasia if the patients request it and if certain conditions are met.
Proponents and opponents agree the change is doubly important because it will provide the model for how the Dutch will treat other cases in which patients are unable to say whether they want to live or die, such as the mentally retarded or elderly people who have become demented.
The governing conservative Christian Democrat party -- a majority of which fought legalization of euthanasia in 2001 when it was in the opposition -- will embrace the guidelines drawn up last year by doctors at the Groningen University Medical Center.
The guidelines, known as the Groningen Protocol, prompted reactions of shock and outrage from the Vatican and from social conservatives and religious groups worldwide -- but have received minimal coverage in the Dutch media.
Under the protocol, euthanasia would be permissible when a child is terminally ill with no prospect of recovery, when it is suffering great pain, when two sets of doctors agree the situation is hopeless, and when parents give their consent.
The Dutch Health Ministry has postponed this decision several times, and wishes to control the release of information around the policy change, which is still being finalized.
But Dijkstra confirmed the broad lines of the guidelines after details began leaking to the Dutch press and to some members of the medical industry who have been involved in the long-running debate over the issue in the Netherlands.
Johannes Verheijden, a spokesman for the group BOSK, which represents parents of children with motor handicaps, said the changes were morally wrong and unnecessary.
''There is no need for a doctor to play an active role in death, the focus should be on easing pain,'' he said. ''There always has to be some doubt in these cases, and the benefit of doubt should be on the side of life.''
The government will establish a vetting commission -- modeled on commissions currently in place for adult euthanasia -- to test whether conditions have been met in each case, and to refer the case to public prosecutors if they don't. But unlike with adult euthanasia, prosecutors won't be bound to follow the commission's judgment that conditions have been satisfied.
''The public prosecutor's office will always make an independent decision (whether to prosecute),'' Dijkstra said.
The Netherlands set up adult euthanasia vetting commissions in 1998, well before the practice was formally legalized under a 2001 law, which took effect the following year.
The commissions report around 2,000 people are euthanized in this country of 16 million each year, using a mix of sedatives and a lethal dose of muscle relaxant. But independent studies suggest the number of unreported cases is higher.
Cases of euthanasia for ''people with no free will'' -- such as infants and severely demented or mentally retarded people -- were left in a legal gray area by the law because they were so controversial.
They remain classified as murder, and doctors who carried out such killings were required to report themselves to the authorities for potential prosecution.
Government-sponsored studies in the 1990s and repeated in 2001 estimated there are around 15-20 such infant killings in any year. Just 22 cases were reported to the Justice Ministry between 1997 and 2004 -- most involving infants with severe damage to the brain and spine from Spina Bifida -- and the ministry decided against prosecuting any of them.
The decision was based on precedents set when doctors were taken to court for euthanizing elderly patients and were either acquitted or found to have acted in good conscience. Judges ruled the level of guilt was so small it didn't merit punishment.
The main author of the protocol, Dr. Eduard Verhagen, said it was intended to remove the confusion surrounding what is permissible.
''We think the decision is of such incredible importance that the social responsibility of the doctor should be openly discussed and assessed,'' he told the AP.