April 20, 2024
end of life issues

Dutch ethicists defend infanticide

Michael Cook

Groningen protocol works well in the Netherlands

Infanticide is not a practice that has taken off in most paediatric wards. However, in the Netherlands it is effectively legal for severely impaired newborns under the so-called Groningen protocol, named after the hospital where it was written. Recently the Hastings Center Report, an American publication which is probably the world’s leading bioethics journal, published a robust defence of the Dutch position by two feminist bioethicists, Hilde Lindemann and Marian Verkerk. It is a revealing look at how Dutch have rationalised this controversial practice.

Lindemann and Verkerk calmly point out that, however disturbing the notion of deliberately killing disabled babies might seem to doctors elsewhere, the reality is "even more radical than its critics [have] supposed". They demonstrate that the Dutch system condones both the deliberate killing of babies whose quality of life will be "very grim" and babies who could survive without technological support for "many years, even into adulthood". Such children will face a life of "hopeless and unbearable suffering", in their opinion. But how can doctors justify mounting "lethal preemptive strikes before any actual suffering has occurred"? This is a tough question, the authors acknowledge, and they call for more research to knot it out. In the meantime, however, it seems "a pity" not to give doctors the power to end lives whose future might include constant pain and dependency.

What suits the Netherlands may not suit the United States, but they are happy with the current situation. "When a tragically impaired infant is born into a society that is hospitable to its children, offers universal access to decent health care, and promotes an ethos among its citizens whereby they look after each other as a matter of course, we believe that the doctor’s ending the baby’s life could be the best, most caring response."

Coincidentally, an American doctor published a stinging critique of the Groningen protocols in British journal The Lancet not long afterwards. Eric Kodesh, of the Cleveland Clinic, says that they violate several basic principles of paediatric ethics. Assessing "unbearable suffering" in an infant depends on "a mirage of clinical accuracy that borders on hubris", he comments acidly. And after analysing the five criteria which must be met before infanticide can be legal in the Netherlands, he calls for civil disobedience and non-violent protest against it.  "Despite social and cultural differences, some things are universal," Koresh writes. "Paediatricians around the world should condemn the Groningen protocol." ~ Hastings Center Report, Jan-Feb; Lancet, Mar 15

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