Ethics briefings

Assisted dying

A question increasingly arising in jurisdictions that permit assisted dying concerns the possibility of extending the rules for competent adults to allow doctors to help children or adults with impaired capacity to die. In a previous briefing, we drew attention to the Dutch “Groningen protocol”,1 which set out five criteria for the provision of euthanasia to incurably ill babies. Public debate on the protocol in 2005 forced the Dutch government to confront the issue of suffering in babies with incurable conditions. Euthanasia for adults has been legal in Holland since 2001, but providing assisted dying to children under the age of 12 years was prohibited. Despite this, child euthanasia was reportedly taking place, but only a few cases were reported under the rules regulating adult-assisted deaths. It was estimated that each year, at least 15 seriously ill babies were illegally helped to die with their parents’ consent. The Groningen University Medical Centre stated that it had begun reporting cases of euthanasia in babies with spina bifida in 2002.2 As a result, a Dutch committee was established to implement the Groningen protocol and formally regulate euthanasia in young children. It began work in March 2006. This made Holland the first country to permit child euthanasia. Opponents of euthanasia saw the establishment of the committee as proof of a “slippery slope”, whereas supporters saw it as bringing greater openness to a practice that previously occurred in secret.

Belgium legalised euthanasia in May 2002. It can legally be provided only to competent adult patients with untreatable medical conditions that entail unbearable physical suffering or mental agony. Patients must make voluntary, well-considered and repeated requests for their lives to be ended. This rule was challenged in February 2006 by …