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Dutch minister announces ruling about ‘active termination of life’ for younger children

On Oktober 13, Dutch Health minister Hugo de Jonge announced that he plans to make it possible to help terminally sick children aged between one and 12 to die, in limited circumstances. 

Letter to members of parliament

In a briefing to MPs, De Jonge said that he wants to ensure that there are ‘more legal guarantees for doctors’ who take the decision to end the life of a child, as well as transparency for healthcare staff and parents, and protection for the rights of children. The measure, he said, is aimed at the very small group of terminally ill children who are suffering unbearably and for whom palliative care is inadequate. The measure would only apply to children who would die in the short term, he said. De Jonge said he plans to work on the issue in the coming period together with professionals and legal experts.

Legal situation now
In the Netherlands, babies of under one who are severely ill can be helped to die under the so called newborn regulation. From 12 on, they can ask for euthanasia under the Dutch euthanasia law. In the period inbetween, no legal possibilities exist for help to die. 

The recommendation for this new possibility was done in a report by experts last year. The report was made by experts at the medical teaching hospitals of Groningen, Rotterdam and Amsterdam. They found that a small group of children may be suffering because doctors are afraid of the consequences of actions that could hasten their deaths. In a survey amongst 72 doctors, they found the vast majority thought it was acceptable to actively end the lives of children under 12 in acute suffering, at their parents’ request, and that a new law or regulation should allow this.

In Belgium euthanasia laws were in 2014 extended to include all children. However, the Belgium law still requires the child to be mentally capable to foresee the consequences of this act. Very young children, think of 5 years old, do not fullfill this requirement so also in Belgium, termination of life for this group of children is not possible.  

Political background of this announcement
A spokesman for the Dutch health ministry told that a debate, expected earlier this year, had been postponed due to the corona pandemic. The issue of whether and what new laws are needed is now expected to be raised during a medical ethics debate next Thursday. ‘About a year ago, a piece of research on children’s doctors was published which suggested that they thought these children needed a new ruling. This isn’t something that the current cabinet can easily take a view on, because it contains both Christian and liberal parties. This will be part of the next debate but the current cabinet has not taken a view.’ Reports in some Dutch papers have suggested that the issue is likely to split the coalition. A spokesman for the ChristenUnie party, widely considered the most opposed, told that it does not oppose palliative sedation – strong painkilling sedatives which Dutch guidelines say can be given to adults if death is expected within 12 weeks. ‘There is a whole spectrum,’ he said. ‘We are against euthanasia for children, who are not considered mentally competent, but we have nothing against palliative sedation. Between them, there are a lot of different possibilities and the question is what the formal proposal will be. Actively ending a life is a very difficult and nuanced question and what are the boundaries?’ The general debate next week may also consider a proposal from D66 MP Pia Dijkstra to extend current euthanasia laws to allow healthy over-75s to request state help to die because they no longer want to live. (Source: