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December 1992, Vol 146, No. 12 >
Article | December 1992

Pediatric Euthanasia FREE

James P. Orlowski, MD; Martin L. Smith, STD; Jan Van Zwienen, MD
[+] Author Affiliations

Accepted for publication June 26, 1992.

Reprint requests to Pediatric Intensive Care Unit, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Ave, Cleveland, OH 44195-5086 (Dr Orlowski).


Am J Dis Child. 1992;146(12):1440-1446. doi:10.1001/archpedi.1992.02160240050019.
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References
Comments

• Pediatric euthanasia is currently practiced in the Netherlands on newborns, infants, children, and adolescents, although exact numbers are not known. Euthanasia in the Netherlands is generally assumed to be active and voluntary, but some cases of pediatric euthanasia would have to be characterized as nonvoluntary. Much of the motivation behind the euthanasia movement and the performance of pediatric euthanasia in the Netherlands is a genuine, compassionate desire to alleviate pain and suffering. In this study, we review the Dutch experience, with particular attention to the current practice of euthanasia on newborns, infants, children, and adolescents. We discuss pediatric euthanasia from an ethical point of view. We assert that more effective pain control, better symptom management, and psychosocial support of the dying and their families would alleviate the perception of suffering, and reduce the perceived need to resort to euthanasia.

(AJDC. 1992;146:1440-1446)

REFERENCES

1 +
The Netherlands State Commission on Euthanasia.  Final report of the Netherlands State Commission on Euthanasia: an English summary . Bioethics . 1987;;1:163-174.
2 +
Dessaur CI, Rutenfrans CJC.  The present-day practice of euthanasia . Issues Law Med . 1988;;3:399-405.
3 +
Driesse MHN, van der Kolk H, van Nunen-Forger WA, van Swinderen EdeM.  Euthanasia and the law in the Netherlands . Issues Law Med . 1988;;31: 385-397.
4 +
Royal Netherlands Society for the Promotion of Medicine and Recovery, Interest Society for Nurses and Nurses Aids; Lagerwey W, trans.  Guidelines for euthanasia . Issues Law Med . 1988;;3:429-437.
5 +
Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst (The Royal Netherlands Association for the Promotion of Medicine).  Standpunt inzake Euthanasie . Med Contact . 1984;;39:990-996.
6 +
de Wachter MAM.  Active euthanasia in the Netherlands . JAMA . 1989;; 262:3316-3319.
7 +
American Medical Association, Council on Ethical and Judicial Affairs.  Decisions near the end of life . JAMA . 1992;;267:2229-2233.
8 +
Pellegrino E.  Ethics . JAMA . 1991;;265:3118-3119.
9 +
Lundberg GD.  'Its over, Debbie' and the euthanasia debate . JAMA . 1988;;259:2142-2143.
10 +
Aartsen JGM, Admiraal PV, de Beaufort ID, et al.  Mercy, murder, and morality . Hastings Cent Rep . 1989;;19:47-48.
11 +
Brahams D.  Euthanasia in the Netherlands . Lancet . 1990;;335:591-592.
12 +
ten Have HAMJ.  Euthanasia in the Netherlands: the legal context and the cases . HEC Forum . 1989;;1:41-45.
13 +
Rigter H.  Euthanasia in the Netherlands: distinguishing facts from fiction . Hastings Cent Rep . 1989;;19( (suppl) ):31-32.
14 +
Fenigsen R.  A case against Dutch euthanasia . Hastings Cent Rep . 1989;;19( (suppl) ):22-30.
15 +
Battin MP.  Seven caveats concerning the discussion of euthanasia in Holland . Perspect Biol Med . 1990;;34:73-77.
16 +
de Wechter MAM.  Euthanasia in the Netherlands . Hastings Cent Rep . 1992;;22:23-30.
17 +
van der Maas PJ, van Delden JJM, Pijnenborg L. Medische beslissingen rond het levenseinde: Her Onderzock voor de Commissie Onderzoek Medische Praktijk Inzake Euthanasie . The Hague, the Netherlands: Instituut Maatschappelijke Gezondheidszorg Erasmus Universiteit Rotterdam; 1991;.
18 +
Nederlandse Vereninging voor Kindergeneeskunde. Doen of Laten? Het al of niet beginnen met en staken van levensverlengende maatregelen in de neonatologie . The Hague, the Netherlands: Nederlandse Vereniging voor Kindergeneeskunde; 1989;:1-51.
19 +
Fenigsen R.  Euthanasia in the Netherlands . Issues Law Med . 1990;;6: 229-245.
20 +
Gomez C.  The practice of euthanasia: questions, methods, and case studies . In: Regulating Death: Euthanasia and the Case of the Netherlands . New York, NY: The Free Press; 1991;:57-93.
21 +
Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst.  Reactie op Vragen Staatscommissie Euthanasie . Med Contact . 1984;;39:999-1002.
22 +
Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst Officieel.  Levensbeeindigend handelen biij wils-onbekwame patienten . Med Contact . 1988;;43:697-704.
23 +
Spreeuwenberg C.  Levensbeeindigend handelen bij zwaar-defecte pasgeborenen . Med Contact . 1988;;43:675.
24 +
Kastelein WR.  Juridische aspecten van levensbeeindiging bij pasgeborenen . Med Contact . 1988;;43:679-682.
25 +
Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst.  Een euthanasie protocol . Med Contact . 1987;;42:667-668.
26 +
King NMP, Cross AW.  Children as decision makers: guidelines for pediatricians . J Pediatr . 1989;;115:10-16.
27 +
Gaylin W.  The competence of children: no longer all or none . Hastings Cent Rep. 1982;;12:33-38.
28 +
Leiken SL.  Minor's assent or dissent to medical treatment . J Pediatr . 1983;;102:169-176.
29 +
Erickson S, Hopkins MA.  Gray areas: informed consent in pediatric and comatose adult patients . Heart Lung . 1987;;16:323-325.
30 +
Weithorn L, Campbell S.  The competency of children and adolescents to make informed treatment decisions . Child Dev . 1982;;53:1589-1598.
31 +
Johnson DE, Thompson TR, Aroskar M, Crawford RE.  'Baby Doe' rules: there are alternatives . AJDC . 1984;;138:523-529.
32 +
Infant Bioethics Task Force and Consultants.  Guidelines for infant bioethics committees . Pediatrics . 1984;;74:306-310.
33 +
Shapiro DL, Rosenberg P.  The effect of federal regulations regarding handicapped newborns . JAMA . 1984;;252:2031-2033.
34 +
Schecter NL.  The undertreatment of pain in children: an overview . Pediatr Clin North Am . 1989;;36:781-794.
35 +
Schecter NL, Altman A, Weisman S.  Report of the consensus conference on the management of pain in childhood cancer . Pediatrics . 1990;;86 ( (suppl) ):813-834.
36 +
Zylicz Z.  Euthanasia . Lancet . 1991;;338:1150.
37 +
Pence GE.  Do not go slowly into that dark night: mercy killing in Holland . Am J Med . 1988;;84:139-141.
38 +
Schauer F.  Slippery slopes . Harvard Law Rev . 1985;;99:361-383.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
The Netherlands State Commission on Euthanasia.  Final report of the Netherlands State Commission on Euthanasia: an English summary . Bioethics . 1987;;1:163-174.
2 +
Dessaur CI, Rutenfrans CJC.  The present-day practice of euthanasia . Issues Law Med . 1988;;3:399-405.
3 +
Driesse MHN, van der Kolk H, van Nunen-Forger WA, van Swinderen EdeM.  Euthanasia and the law in the Netherlands . Issues Law Med . 1988;;31: 385-397.
4 +
Royal Netherlands Society for the Promotion of Medicine and Recovery, Interest Society for Nurses and Nurses Aids; Lagerwey W, trans.  Guidelines for euthanasia . Issues Law Med . 1988;;3:429-437.
5 +
Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst (The Royal Netherlands Association for the Promotion of Medicine).  Standpunt inzake Euthanasie . Med Contact . 1984;;39:990-996.
6 +
de Wachter MAM.  Active euthanasia in the Netherlands . JAMA . 1989;; 262:3316-3319.
7 +
American Medical Association, Council on Ethical and Judicial Affairs.  Decisions near the end of life . JAMA . 1992;;267:2229-2233.
8 +
Pellegrino E.  Ethics . JAMA . 1991;;265:3118-3119.
9 +
Lundberg GD.  'Its over, Debbie' and the euthanasia debate . JAMA . 1988;;259:2142-2143.
10 +
Aartsen JGM, Admiraal PV, de Beaufort ID, et al.  Mercy, murder, and morality . Hastings Cent Rep . 1989;;19:47-48.
11 +
Brahams D.  Euthanasia in the Netherlands . Lancet . 1990;;335:591-592.
12 +
ten Have HAMJ.  Euthanasia in the Netherlands: the legal context and the cases . HEC Forum . 1989;;1:41-45.
13 +
Rigter H.  Euthanasia in the Netherlands: distinguishing facts from fiction . Hastings Cent Rep . 1989;;19( (suppl) ):31-32.
14 +
Fenigsen R.  A case against Dutch euthanasia . Hastings Cent Rep . 1989;;19( (suppl) ):22-30.
15 +
Battin MP.  Seven caveats concerning the discussion of euthanasia in Holland . Perspect Biol Med . 1990;;34:73-77.
16 +
de Wechter MAM.  Euthanasia in the Netherlands . Hastings Cent Rep . 1992;;22:23-30.
17 +
van der Maas PJ, van Delden JJM, Pijnenborg L. Medische beslissingen rond het levenseinde: Her Onderzock voor de Commissie Onderzoek Medische Praktijk Inzake Euthanasie . The Hague, the Netherlands: Instituut Maatschappelijke Gezondheidszorg Erasmus Universiteit Rotterdam; 1991;.
18 +
Nederlandse Vereninging voor Kindergeneeskunde. Doen of Laten? Het al of niet beginnen met en staken van levensverlengende maatregelen in de neonatologie . The Hague, the Netherlands: Nederlandse Vereniging voor Kindergeneeskunde; 1989;:1-51.
19 +
Fenigsen R.  Euthanasia in the Netherlands . Issues Law Med . 1990;;6: 229-245.
20 +
Gomez C.  The practice of euthanasia: questions, methods, and case studies . In: Regulating Death: Euthanasia and the Case of the Netherlands . New York, NY: The Free Press; 1991;:57-93.
21 +
Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst.  Reactie op Vragen Staatscommissie Euthanasie . Med Contact . 1984;;39:999-1002.
22 +
Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst Officieel.  Levensbeeindigend handelen biij wils-onbekwame patienten . Med Contact . 1988;;43:697-704.
23 +
Spreeuwenberg C.  Levensbeeindigend handelen bij zwaar-defecte pasgeborenen . Med Contact . 1988;;43:675.
24 +
Kastelein WR.  Juridische aspecten van levensbeeindiging bij pasgeborenen . Med Contact . 1988;;43:679-682.
25 +
Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst.  Een euthanasie protocol . Med Contact . 1987;;42:667-668.
26 +
King NMP, Cross AW.  Children as decision makers: guidelines for pediatricians . J Pediatr . 1989;;115:10-16.
27 +
Gaylin W.  The competence of children: no longer all or none . Hastings Cent Rep. 1982;;12:33-38.
28 +
Leiken SL.  Minor's assent or dissent to medical treatment . J Pediatr . 1983;;102:169-176.
29 +
Erickson S, Hopkins MA.  Gray areas: informed consent in pediatric and comatose adult patients . Heart Lung . 1987;;16:323-325.
30 +
Weithorn L, Campbell S.  The competency of children and adolescents to make informed treatment decisions . Child Dev . 1982;;53:1589-1598.
31 +
Johnson DE, Thompson TR, Aroskar M, Crawford RE.  'Baby Doe' rules: there are alternatives . AJDC . 1984;;138:523-529.
32 +
Infant Bioethics Task Force and Consultants.  Guidelines for infant bioethics committees . Pediatrics . 1984;;74:306-310.
33 +
Shapiro DL, Rosenberg P.  The effect of federal regulations regarding handicapped newborns . JAMA . 1984;;252:2031-2033.
34 +
Schecter NL.  The undertreatment of pain in children: an overview . Pediatr Clin North Am . 1989;;36:781-794.
35 +
Schecter NL, Altman A, Weisman S.  Report of the consensus conference on the management of pain in childhood cancer . Pediatrics . 1990;;86 ( (suppl) ):813-834.
36 +
Zylicz Z.  Euthanasia . Lancet . 1991;;338:1150.
37 +
Pence GE.  Do not go slowly into that dark night: mercy killing in Holland . Am J Med . 1988;;84:139-141.
38 +
Schauer F.  Slippery slopes . Harvard Law Rev . 1985;;99:361-383.

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