The Living Force
Source: Health Min. wants to expand euthanasia access to terminally ill children under 12

Tuesday, 28 June 2022 - 08:10

Health Min. wants to expand euthanasia access to terminally ill children under 12

Minister Ernst Kuipers of Public Health wants to make euthanasia possible for terminally ill children aged 1 to 12 who suffer unbearably and without hope. He is working on a regulation to allow this, with a series of due care criteria like is the case for euthanasia in adults and infants younger than 1, he said in a letter to parliament, the Volkskrant reports (in Dutch).

The Netherlands currently has nothing formally in place to relieve critically- and terminally ill children aged 1 to 12 from unbearable suffering. While a study in 2019 showed a great need for an option to end the life of kids in this age group who suffer "without hope and unbearably." In the study, parents described how they could do nothing while their children screamed in pain for hours on end or had almost continuous seizures. One mother told how a brain tumor had her child screaming for three days, banging his head, and shouting for help.

Kuipers stressed that this concerns “a small group of terminally ill children who suffer hopelessly and unbearably and for whom all options of palliative care are insufficient to alleviate their suffering.” He opts for regulation instead of a legislative amendment at the request of pediatricians. They worry that a change in the law will spark another polarizing debate while they are looking for a practical solution for a very small group of children who need urgent help.

The Euthanasia Act already allows adults and children over 12 to end their lives if they are suffering unbearably and without hope. The law considers them capable of understanding their situation and the gravity of their decision. Euthanasia presupposes self-determination and competence, considered lacking by children under age 12 by the law.

For infants under the age of 1, the 2005 Groningen protocol applies. It contains guidelines for the termination of the life of infants who suffer unbearably and without hope. Bot parents must give informed permission, and the decision is checked afterward. Kuipers plans to build on this protocol for kids aged 1 to 12.

The Minister set seven due care criteria that euthanasia must meet. The doctor must be convinced based on “prevailing medical insight that the child is suffering hopelessly and unbearably,” also getting a second opinion from an independent expert. The doctor must also believe that there is no other option to alleviate the child’s suffering.

The doctor must “completely” share the diagnosis and prognosis with both parents and discuss it with the child in a “manner appropriate to the child’s comprehension.” This discussion must include that “the termination of life is the only reasonable possibility to remove the suffering.” And the doctor can have no suspicion that euthanasia was happening against the child’s will. Both parents must consent. Finally, euthanasia must be carried out with “medical care.”

Kuipers hopes to give parliament more information on the draft regulation in October, including when he plans to implement it.

Similar: Health minister proposes euthanasia protocol for children under 12 -

Coverage in Dutch:
Kuipers: euthanasie ook mogelijk voor kinderen onder 12 jaar
Minister Kuipers: euthanasie voor kinderen onder de 12 jaar mogelijk
Kuipers wil euthanasie voor doodzieke kinderen mogelijk maken


FOTCM Member
Canada seems to be very much on the near carte blanche euthanasia bandwagon, and BC in particular with a mental health aim to allow death on a mental whim, or it could be soon. Here is an article and talk coming from the place of Palliative care societies, wherein the model is fast being force-changed (as Ireland says in rebuttal, we do not kill our patients). The government of BC has other ideas, though, and they have become "ruthless" in this, as they did with covid terrorization - end of life care is moving to usurp hospice societies and others, and turn them into kill centers (sorry to be blunt).

People have spent their lives seriously considering the human and ethical aspect of end of life care, and it seems to be moving to an appointment center model with a 8 hour wait time or less. All kinds of flowery words are, and will be used to help some social conditions of euthanasia make sense without individual and societal proper care of thought. In a mental health setting, medical and psychiatric associations that have members who are government funded may well be called upon - pressured, to make it much more easy to thumbs-up someone to die, or a simple policy alone will be all that is needed. Thus, these are the slippery slopes that humanity is slowly becoming locked into, and how long will it take to change the words from individual choice/consent (even when not menially capable to understand consent) to something more flagrant and, acceptable on the bases of differences of attitudes, opinions and beliefs - could it go that far?

Forty years ago, while reading through university archives of 1930's medical type written reports, reports of how to treat the infirm, they spoke of non-ethical accepted horror. This can never be forgotten, and yet in some societies it now seems to be a very close parallel - look at the many covid care homes as example (whitewashed now), and look where this may all be going?

Two things come to mind. One: much of this now takes place out of sight out and out of mind (it is not even in the press unless put into a certain frames of reference). Two: with where things seem to be going (lack of food, income, loss of work, housing et cetera), an explosion of mental health conditions would surly be on the horizon. I can't know what will happen, however the same people who brought about these conditions are still in charge.

Canadian Gov:
After March 17, 2023, people with a mental illness as their sole underlying medical condition will have access to MAID if they meet all of the eligibility requirements and the practitioners fulfill the safeguards that are put in place for this group of people.

What will be the safeguards is yet to be fully determined, and may change.

And this and this.

And from Weindling, P. (2014, April 29). Nazi euthanasia. Retrieved June 29, 2022
Henry Friedlander, The Origins of Nazi Genocide. From Euthanasia to the Final Solution, Chapel Hill: University of North Carolina Press, 1995

Isabelle von Bueltzingsloewen, L’Hécatombe des fous. La famine dans les hôpitaux psychiatriques français sous l’Occupation (Paris: Flammarion, 2007)

Michael Burleigh, Death and Deliverance. ‘Euthanasia’ in Germany 1900-1945 (Cambridge: Cambridge University Press, 1995)

Paul Weindling, Health, Race and German Politics between National Unification and Nazism, 1870-1945 Cambridge Monographs in the History of Medicine, (Cambridge: Cambridge University Press, 1989

Paul Weindling. Nazi Medicine and the Nuremberg Trials (Basingstoke: Palgrave, 2004)

Udo Benzenhöfer, ‘Der Fall “Kind Knauer” ‘, Deutsches Ärzteblatt, vol. 95 (1998) B-954-5.

Euthanasia originally meant assisting a terminally ill individual with a painless death. In 1920 the jurist Karl Binding and psychiatrist Alfred Hoche called for the killing of “lives without value”. Nazism further transformed the meaning of euthanasia. Hitler called for euthanasia at a Nuremberg rally in a notable speech at Nuremberg. In 1935, Hitler told Gerhard Wagner, the Reich Physicians’ Führer, that he would implement euthanasia at the start of the war.
Preparations for the killing of patients began in the mid-1930s in Germany with surveys of patients held in psychiatric hospitals, and there is evidence of a debate in the medical circles around Hitler. Hitler’s escort surgeon, Karl Brandt cited the petition of parents of a severely disabled child to the Führer, requesting that their severely handicapped newborn baby be killed. This made the point that the Nazi leaders were responding to a popular wish, and Brandt dated the incident to 1938. Despite the efforts of the medical historian Udo Benzenhöfer to establish the identity of the child, this has not proved possible. Hitler sent Brandt to visit the child in July 1939, who was in the “care” of the Leipzig professor of paediatrics, Werner Catel, and the baby subsequently died. After the outbreak of war on 1 September 1939, the Führer wrote that he entrusted Karl Brandt and the administrator Phillip Bouhler with the implementation of “euthanasia” or “mercy killings” (Gnadentod), and backdated the decree to the start of the war. Brandt supported use of carbon monoxide gas chambers (causing a slow and painful death), but otherwise was not actively involved in reaching decisions on individual patients. The numbers killed in the initial phase, code-named “T4” (after the administrative office at Tiergartenstrasse 4), amount to (according to one set of records) 70,273 persons. The killings were ordered on the basis of medical records sent to the clandestine panel of adjudicating psychiatrists at the central office in Berlin. So-called schizophrenics made up 58% of the victims, and there was a slightly higher proportion of women killed. There were 6 gassing facilities in Germany and former Austria (Brandenburg – replaced by Bernburg, Grafeneck, Hartheim, Pirna-Sonnenstein, and Hadamar).
In 1941, a condemnation came from the Roman Catholic bishop of Münster, Clemens Galen, and some public opposition, particularly from distressed relatives. This resulted in an ostensible stop of T-4, but covert decentralised killings continued. Euthanasia personnel, including physicians and technicians, were transferred to the Aktion Reinhardt, which built and ran extermination camps of Belzec, Sobibor, and Treblinka. Doctors (such as the psychiatrist Irmfried Eberl), now expert in medical killing, were transferred from this so-called ‘euthanasia’ programme to apply their skills in death camps where Jews, Gypsies and others were exterminated (Eberl became the first commandant of Treblinka extermination camp). The use of carbon monoxide gas was a direct link between Nazi euthanasia killings and the Holocaust. Euthanasia continued unabated in concentration camps where prisoners were selected for killing, in the 30 so-called “special children’s wards”, and in other clinical locations. Physicians assisted by nurses killed by starvation, injection, and administering deadly drugs. The groups killed included newborn babies, children, the mentally disturbed, and the infirm. Sometimes victims were killed for merely challenging the staff in institutions, although they were in good health, and others were not the so-called incurables of the Nazi theory. Some physicians killed because of the scientific interest of the “cases”. Identifying those killed shows that networks of referral meant there was widespread complicity of physicians and nurses in euthanasia. At the same time other physicians made efforts to keep potential victims out of the euthanasia apparatus. T-4 continued as an organisation, as it established research departments at Brandenburg-Goerden hospital and at Heidelberg for research on so-called “idiot” children under Professor of Psychiatry, Carl Schneider, and involving Ernst Rüdin, the leading advocate of sterilization.
Hitler and his Chancellery used propaganda to attempt to make the German population accept the killings. The doctor and author, Hellmuth Unger, prepared a film script to elicit public sympathy for euthanasia. Unger was a press officer for the Nazi Doctors League, and author of a novel promoting euthanasia – Sendung und Gewissen. His writings glorified the medical researcher as empowered to take liberties with life.
In the German occupied East, large numbers of patients were killed in Poland and the occupied Soviet Union. The deaths encompassed children’s euthanasia between October 1939 - April 1945 with an estimated minimum number of 5000 child deaths, although numbers are likely to be twice this. The T-4 programme of special killing centres between early 1940 and August 1941 was responsible for 70273 adult and juvenile deaths and the decentralised programme code-named 14-f-13 from April 1941 to 1944 was responsible for the killing of ca. 50000 concentration camp prisoners. The killings of prisoners of war and the forced workers from the East were identified as a distinct phase of euthanasia. The Aktion Brandt initiative to clear hospital beds from August 1943 to the end of 1944 coincided with renewed intensification of euthanasia killings, which continued throughout the war. Overall, it is estimated that about 220,000 victims were killed. Of these brains and other body parts were retained for research. Many specimens were buried only in 1990, and the most recent burial of retained specimens was in May 2013 in Vienna.
Euthanasia was widely carried out in the German-occupied East in Poland and the Soviet Union. A high excess mortality has been identified in France, and patient deaths arose from hunger, and wartime shortages. One estimate is of ca. 40,000 French victims of deprivation as opposed to deliberate killing.
After the war, a series of trials were conducted against the perpetrators of euthanasia in Austria, Germany, and Poland. There were numerous acquittals and shielding of those responsible. The German Psychiatric Association claimed falsely in the 1950s that its members opposed euthanasia. The case against Heinrich Gross, a neuroanatomist in Austria who dissected the brains of many child victims of euthanasia in Vienna during and after the war when he ran a histo-pathological research institute sited at the hospital Am Spiegelgrund in Vienna where many victims were killed, was prevented until his death in 2005 by his plea of mental incapacity. In 1987, an association for those damaged by Nazi euthanasia was founded and limited compensation was paid to relatives. There has been only limited compensation to the relatives of those killed, and only rarely memorials naming individuals who were killed, as was notably the case for the Spiegelgrund victims at the Otto Wagner Hospital in Vienna. There is no death book commemorating victims of Nazi euthanasia as the German authorities consider it illegal to publicly release the names of murdered victims. A counter-argument is that non-disclosure perpetuates the stigma of mental illness.
Post-war “voluntary euthanasia” advocates in North America and Europe (notably the Netherlands) argue that their procedures have nothing to do with the Nazi measures, in that they seek the consent of the person or when this is not possible of relatives. On the one hand, there are terminally ill persons who themselves insist that the pain and level of disability makes them wish to end their lives. Yet the concepts of a life without value, expert medical advocacy in favour of euthanasia, and relatives finding the severely ill person a burden are difficult to exclude from the decision-making procedures. For these reasons euthanasia remains a contested topic and the Nazi abuses a salutary warning in favour of caution in complex and difficult end of life decisions.
-Paul Weindling


The Living Force
Thanks a lot @Voyageur for reporting these rather covert and stealthily developments. :cool2:

I'm both amazed and concerned (as you are) about the lack of broad debate and penetrating analysis within public spaces. Surely the media should report much more, and much more conscientiously about this ongoing process.

In the Netherlands, there have been fierce debates from all sides of pro and con for years before the Euthanasia law was ultimately formulated and debated in parliament. And because of the mandatory annual reports on processed euthanasia cases, especially when the public prosecution gets involved, there still is regular wide spread reporting and debate about the ongoing implementation and the snags that are encountered. What I (and others) report here about that in this thread is just the top of the iceberg of what is going on in this regard. Therefore, I cannot understand the deafening silence on this subject in Canada.

As for the slippery slope in these matters, I agree with your concerns about that but I'm rather confident that the Netherlands stands a much better chance of countering or prohibiting the expansion of a grey zone than Canada currently. Maybe others think differently about it but I'm rather optimistic.
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