Euthanasia of newborns under the microscope

This is an excellent summary of the data from The Netherlands on child euthanasia written by Associate Professor of Pediatrics at Miami University, Prof.  Felipe E. Vizcarrondo MD, MA, FCP. 
Published with permission by MercatorNet:
Euthanasia is defined as the act of intentionally ending the life of a terminally ill and suffering person in a quick and painless manner for reasons of compassion and mercy.
Euthanasia was practiced by the ancients. The term means "good death," and the practice was to allow the patient to die in peace and with dignity. For the physician, it would mean caring for the patient and alleviating pain and suffering. However, the physician of ancient times could also cause the death of the patient. One physician would heal; another would provide the poison draught to cause the death of the patient.
The Oath of Hippocrates (ca. 500 BC) was the first attempt from a group of concerned physicians to establish a set of ethical principles that defined the physician as healer, rejecting the role of executioner. The principle of "primum non nocere," first do no harm, from where the modern concepts of beneficence and non-maleficence are derived, became one of the guidelines in the doctor-patient relationship.(1,2)
The current concept of euthanasia is based on the utilitarian worldview; the main principle is individual autonomy. The value of the individual is defined in terms of quality of life and contribution to society. Voluntary euthanasia is euthanasia provided for a competent person with his informed consent. Involuntary euthanasia is euthanasia performed without the person's consent.
Euthanasia in the Netherlands 
In the Netherlands, voluntary euthanasia and physician assisted suicide have been legal since 2002. However, the courts had failed to exercise judgment on both these practices since 1984. This unofficial permission by the courts led to their widespread use by the medical community and eventually acceptance by the public.
In the Netherlands, euthanasia is defined as the intentional termination of the life of a patient by an individual other than the patient at the patient's request. This definition requires active termination of the life of the patient and voluntary request by the patient.(3) Involuntary euthanasia is also practiced widely. Frequently it is the Dutch physician who decides who lives and who dies. (4)
In the 1990s, end of life issues for neonates and infants became a concern for the Dutch pediatric community. A nationwide survey (5) in 1995 showed that of 1041 deaths of children within the first year after birth, 62 percent of deaths were preceded by an end of life decision; in the neonatal intensive care unit (NICU) the frequency was 87 percent. End of life decisions were: to forego life sustaining treatment in 57 percent; to administer potentially life shortening drugs to treat the pain and suffering in 23 percent; and to give a drug to hasten death in 8 percent.
A drug was given to cause death in 1 percent (15-20 cases) of neonates who were not on life-sustaining treatment. The motives for this act were no chance of survival in 76 percent of cases, and poor prognosis if remained alive in 18 percent. A repeat survey (6) that included the years 1995 to 2001 showed similar results, with 68 percent of deaths preceded by end of life decisions. Most of the decisions were to withdraw or withhold life sustaining treatment.
Deliberate ending of life of babies remained at 1 percent, or 15-20 cases yearly. An average of only 3 cases/year of neonatal euthanasia had been reported to the authorities. Obviously, most were not being reported.
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