Dutch paediatricians have unanimously approved a set of guidelines for euthanasing incurably ill newborn children. The Dutch Paediatric Society now accepts that “in exceptional circumstances and under strict conditions… deliberate ending of life” of such newborns can be an acceptable option”. The so-called Groningen protocols have been approved by the public prosecution service, but the government has not yet issued its opinion.

The requirements for non-voluntary euthanasia of children would include: a clear diagnosis and prognosis, hopeless and unbearable suffering, the informed consent of the parents, confirmation by a second doctor and a report to the local coroner.

A system of reporting must be set up urgently, says the society, so that there will be accountability and social and legal control. At the moment, it believes that about 15 newborn children are euthanased each year in the Netherlands, but only 3 are reported. Most of these are believed to be babies born with severe spina bifida and babies who suffer severe hypoxia at birth. How scrupulously this will be observed is a matter of conjecture. It is believed that half of the euthanasia cases in the Netherlands are never reported.

The announcement that Dutch doctors were drafting these protocols created an outcry late last year. The spokesman who defended them in the media, Dr Eduard Verhagen, is the clinical director of paediatrics at Groningen University Hospital. He is also the chairman of the society’s ethics and law committee. “The ball is now with the politicians,” he says.

The news that the protocols have been released has not been widely reported, but several letters to the British Medical Journal were scathing. Italian neonatologist Carlo Bellieni noted that newborns were incapable of psychological suffering and that their pain was manageable. “Neonatal euthanasia does not cure newborns’ suffering,” he wrote. “It is more appropriate to say that it ‘helps’ adults (parents, caregivers)… but we cannot accept the idea that somebody may be killed to cope with the needs of someone else.”

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