Belgium mulls child euthanasia law

How far is too far for the culture of death?

Apparently, there are no boundaries left.

The Associated Press is reporting on the debate going on in Belgium over children being allowed to decide to end their own lives.

This is not assisted suicide. Neither is it "pallitive sedation" where the physician puts you under and then removes all life support, including a feeding tube. You die of starvation. This is the doctor sticking a needle in your arm and ending your life.

And Belgium wants to grant that option to children.

Advocates argue that euthanasia for children, with the consent of their parents, is necessary to give families an option in a desperately painful situation. But opponents have questioned whether children can reasonably decide to end their own lives.

Belgium is already a euthanasia pioneer; it legalized the practice for adults in 2002. In the last decade, the number of reported cases per year has risen from 235 deaths in 2003 to 1,432 in 2012, the last year for which statistics are available. Doctors typically give patients a powerful sedative before injecting another drug to stop their heart.

Only a few countries have legalized euthanasia or anything approaching it.

In the Netherlands, euthanasia is legal under specific circumstances and for children over the age of 12 with parental consent. (There is an understanding that infants, too, can be euthanized, and that doctors will not be prosecuted if they act appropriately.) Elsewhere in Europe, euthanasia is only legal in Luxembourg. Assisted suicide, where doctors help patients to die but do not actively kill them, is allowed in Switzerland.

The Netherlands is the home of the notorious Groningen Protocol - guidelines for doctors and hospitals on how to kill an infant and not break the law.

The fact is, as some ethicists point out, we've been on a slipperly slope for more than a decade and the Belgium proposals are just the latest manifestation of an argument that has been raging about how patients should be allowed to face the end of life:

Charles Fostr, who teaches medical law and ethics at Oxford University, believes children couldn't possibly have the capacity to make an informed decision about euthanasia since even adults struggle with the concept.

"It often happens that when people get into the circumstances they had so feared earlier, they manage to cling on all the more," he said. "Children, like everyone else, may not be able to anticipate how much they will value their lives if they were not killed."

There are others, though, who argue that because Belgium has already approved euthanasia for adults, it is unjust to deny it to children.

"The principle of euthanasia for children sounds shocking at first, but it's motivated by compassion and protection," said John Harris, a professor of bioethics at the University of Manchester. "It's unfair to provide euthanasia differentially to some citizens and not to others (children) if the need is equal."

To be clear, this is not pulling the plug on a breathing machine keeping a brain dead patient alive, or allowing "Do Not Resuscitate" orders from patients or their legal guardian. This is the a far more impersonal and destructive way of death with the additional moral hazard of believing a child can decide for themselves that life isn't worth living anymore.

Less shocking, but perhaps more problematic is that rules would also be written for patients suffering from early dementia:

People now can make a written declaration they wish to be euthanized if their health deteriorates, but the request is only valid for five years and they must be in an irreversible coma. The new proposal would abolish the time limit and the requirement the patient be in a coma, making it possible for someone who is diagnosed with Alzheimer's to be put to death years later in the future.

In the Netherlands, guidelines allow doctors to euthanize dementia patients on this basis if they believe the person is experiencing "unbearable suffering," but few are done in practice.

Dr. Patrick Cras, a neurologist at the University of Antwerp, said people with dementia often change their minds about wanting to die.

"They may turn into different people and may not have the same feelings about wanting to die as when they were fully competent," he said. "I don't see myself killing another person if he or she isn't really aware of exactly what's happening simply on the basis of a previous written request (to have euthanasia). I haven't fully made up my mind but I think this is going too far."

There is so much we don't know about the mind, about consciousness, that it seems incredible that society would allow this practice on its most vulnerable and helpless members. If the state is not there to protect them, then abuses are bound to occur. Last year in Belgium, a patient who suffered from a botched sex change operation was euthanized, despite no outward signs of physical suffering. 

The slope is getting steeper and more slippery.

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