Two-year-old euthanised in Netherlands in first assisted dying case of its kind

[IwantToRetire]

I'm not going to select any part of the article but just post the link for those who want to read
https://www.mirror.co.uk/news/world-news/netherlands-infant-2-euthanised-assisted-37709218

This is becoming laughable. Dear God.

Assisted suicide is where the medical staff provides the drugs and the patient self- administers.

Euthanasia is where the medical staff administer the lethal medicine.

There is voluntary euthanasia and involuntary euthanasia. The former is at the request of the person. The second is where it is forcibly applied.

@Somuchgoo was talking about where a person lacks capacity to judge for themselves. That means that others would be making the decision and administering the death-bringing medications.

So yes, she was talking about euthanasia.

@ReleaseTheDucksOfWar “The only excuse is simple ignorance, but when people who are against euthanasia consistently choose to ignore the actual reality of some people's lives, there is something deeply dishonest and wrong.”

I agree. Euthanasia should be legal in the UK for this reason. If people are severely suffering and can’t kill themselves, it would be humane to have euthanasia as an option.

I know there many people like you describe but that doesn’t apply to this child. Things can obviously change but for now he is mostly pain free, sleeps well and is an easy child apart from the psychical challenges of handling him. The important part also is he goes to school with 1:1 support and they get respite too. My friend is largely happy with her life. Could you predict that when he was 2 and constantly seizing? No.

@kxeil I think so on balance too .... but Im also in the crowd that has profound reservations about the way it would be carried out in the UK.

In the NL there is a functioning, though certainly not flawless, health system. (You struggle here to get an appointment in 3 days' time when it suits you because they want to see you the same day instead, I kid you not. Minor issue, m'leg wasn't hanging off or anything).

This means there is the funding for an independent, technically modern and well run euthanasia service.

I'd be very concerned if that would be the case in some NHS trusts.

Additionally, and this cuts more to the core of the matter, there is a culture that people know their own mind and their stated wishes should be respected. It is seen as absolutely unacceptable to override a competent someone's stated expressed wishes, if they are reasonable (or they made these wishes in the past when they were competent).

Im afraid to say that cultural mindset is not as clear in the UK. I would be afraid of coercion in some cases. I hope the safeguards would be strong enough, but I doubt it because at the point where someone is being coerced, a team would need to remove that person from the coercive situation and ensure good care for them. And there isnt the money for that.

But that does not alter the fact that some people live in excruciating agony, and on balance, I think that euthanasia / assisted dying should be legalised. But on the Dutch model, not the Canadian.

@SiberFox the problem is we don't have a crystal ball and can't know for sure which children will end up as adults with enough quality of life to count as satisfactory and which children won't.

We also don't know how matters will be for the severely disabled person once their parents pass. So much depends on the care situation or care home then. Some are appalling.

I think if euthanasia is brought in, all that can be done in this sort of situation is for the parents to make the best decision they can at the time and then to go on.

No. You've got your definitions muddled up. If you don't believe me look it up.

The Netherlands has euthanasia, not assisted suicide, and had done so for a long time. Consent is an integral part of this. Around 120,000 people have died in the Netherlands via euthanasia, current rates are about 6% of deaths. Are you telling me the doctors are killing that number of people without their consent in the Netherlands?

Assisted suicide requires the person dying to perform the act. Whether that means swallowing pills, or drugs that will kill them, or pressing a button to allow drugs via a cannula to start. With assisted suicide, these drugs are provided by medical professionals and the person taking them is usually under medical supervision until their death.

With euthanasia, it's the medical professional that administers the drugs. It is always voluntary, with a couple of very well defined exceptions. The law we are discussing in this thread, is one g of those exceptions - a change to the law in the Netherlands to allow parents to make that decision on behalf of their suffering child.

In most cases assisted suicide is sufficient to allow those who want to die, to die. For people with locked in syndrome, for those with paralysis, those with most motor neurone disease, and other degenerative conditions, allowing assisted suicide but not euthanasia means they can either not be allowed to die, all would need to exercise their right to die earlier than they would otherwise do so because they would lose the ability to administer the drugs later.

@ReleaseTheDucksOfWar “So much depends on the care situation or care home then. Some are appalling.”

This is why I think the Canadian model is better. In an ‘ideal world’ I would agree with you about having a model like the Dutch, but in the world we actually live in people need options. If people can’t get the care, housing and financial help they need, what do they do? Isn’t it better to at least have the choice to die by assisted dying or euthanasia?

No, it doesn't! I was recently asked about permission for a 'DNR' for my father who has dementia and is in a care home. He also has COPD, asthma and now repeated infections. Furtermore he is also immobile and dependent on assistance with dressing, toileting, and sometimes eating.

That is what 'Lasting Power of Attorney' is about - for when someone no longer has capacity to make decisions for themselves.

Maybe, but not everyone agrees with that assessment...and as we have seen in countries which offer this 'route', the boundaries shift and people end up being 'assisted to die' who wouldn't have met the original criteria. Once you have crossed the Rubicon it is a slippery slope.

We've been on the slippery slope for a very long time.

In the UK a little boy like this would probably also be allowed to die, but rather than drifting off into a drug-induced coma and then dying, nutrition would be withdrawn and he'd starve, or next time he has an infection he wouldn't be given antibiotics. The end is the same, but they'd be more suffering.

I think I would like to allow full euthanasia, whilst allowing nutrition to be withdrawn, and potentially assisted suicide, is more about our own squeamishness about death rather than best interest of the patient.

We are fine with causing death, but we make artificial distinctions so that we don't feel like we are to blame. Withdrawing nutrition is fine because we aren't actively killing them. Removal of life support is fine, because although we hit the off switch, we tell ourselves we're not killing them we just aren't artificially keeping them alive any more. Then we've got the 'double effect' of morphine at the end where it's given for pain relief, but knowing it also might suppress breathing and hasten death.

A concern is though that this encourages the convenient route taken by governments/people/families to not make care and palliative care a priority. It is much easier if people just die.

What will happen if people can’t find carers, don’t have anyone willing to care for them and are financially unable to pay for care?

If I was in that position I would want some options. Obviously suicide is always one if you’re able to do it by yourself.

I mentioned this earlier, we already have a massive shortage of carers and people are increasingly living longer with more health problems. What is the alternative right now if you need care but can’t get it?

I do see what you're saying and think it's a valid argument, but I run into a quagmire here and can't find a way forward.

In a world with an increasing right wing creep, I'd be afraid that this option would be seen as desirable by some flavours of government and used to cut services further. And shelter and medical centres for long term homeless people where every time you go, you're asked if you'd like for this situation to come to an end via a specialised service - just no. I don't have faith that a government like that won't be elected.

And in practise with the Canadian model people have been pressured into assisted dying.

Honestly, personally in the UK's case I'm closer to the fence than I give the impression, because of the nature of the healthcare system. But the cruelty of forcing a loving partner to being a longed- for release to their spouse, or the cruelty of not allowing a safe death for someone who genuinely wants to die, tips the balance. Although I'll fight to the bitter end the utterly controlling and selfish "I can live with my pain so no one else should have the option for eithanasia" or "I'm afraid someone will tell me I should go for euthanasia so I'm going to vote that no one can.

The flip side of objecting to euthanasia because a tiny minority of people might be pushed into it, is that you are truly just as controlling because you are removing a competent adult's ability to make their own free choices (assuming there is a medical team willing to assist).

Either way, if you force a mentally competent unwilling person into euthanasia or if you refuse them euthanasia, you are not listening to their stated and reasoned desires. This is the core of the matter.

A competent adult who is clear and consistent in their desire should be respected, if there are people willing to help them carry their wish out.

I don't believe anyone should have the right to override a competent adult's sincere desire just because they are afraid that sometime, someone in the future might apply it to them, maybe. Or someone like them. In the presence of extreme intractible suffering it's psychological self indulgence of the highest order.

I have more of an issue with people's squeamishness towards suffering than I do with death itself, to be honest.

How is suffering measured? How is it defined? Who decides? And when a person no longer has mental capacity, or in the case of a child that doesn't yet have capacity, or never will, how is intolerable suffering to be judged. Is there a measurable or universal standard?

Many people would say that ethics is not so much about individual desires and wants as about the moral boundaries of the entire community. None of us exists in a vacuum. If you want to commit suicide that is your decision, but involving others and the State is a different matter.

I agree with you. NO ONE should be coerced into dying. If people find there is no help for them when they need it most what happens? Suicide has always been an option but some people won’t be able to do it. I would want there to be an alternative if I couldn’t kill myself. I realise this probably won’t happen in my lifetime. This is another sign of society beginning to collapse.

@Shortshriftandlethal in that particular case the doctors have more of an idea than us what constitutes unbearable suffering than us. The Professor was (according to the article) clear that withdrawing nutrition and water can work differently in children than adults though and the implication was, lead to unnecessary suffering.

As to competent people's definition of unbearable suffering, shouldn't that come down to their own decision? (Long term)

..and what of those that don't have the maturity or cognitive capacity to engage with what consitutes 'unbearable' and the wider ethical implications?

Withdrawing food and water goes beyond the remit of DNR - as that would represent more of an active intention to kill.

@fuschiaproudparrot is this called the Liverpool Pathway?

I feel muddled because when I have expressed my horror at people dying from dehydration, more medical people than I have said that if you give liquids that is horrific because they are not eliminated by the (dying) kidneys and so the lungs get full of water and it is like slow drowning. So I am confused about which of these horrors is worse.

Euthanasia by definition is a community/society matter I suppose, yes.

Equally, so is the tolerance of unbearable suffering.

Suicide is a messy and often unsuccessful business and attempts have a nasty trail of severely disabled people after them. Which also becomes a society matter.

I guess it comes down to the nature and how well run the society in question is, and where you (the generic you) stand when those three (or four, taking into account the state of the welfare system) are balanced.

The State chose to legalise assisted dying / euthanasia. Doctors freely choose if they want to participate.

Yes, some States have, but that doesn't necessarily mean that there are no longer any ethical issues to be debated or considered, nor any breaching of safeguards and boundaries in those territories.. Inevitably there will be.