Euthanasia, a controversial issue from an ethical point of view, that a pluralistic, non-denominational and democratic society must address
When a word is shocking due to its negative connotations, we tend to change it or associate it with another word that has less ethical or emotional impact. Today we hear the words interchangeably. dignified death y euthanasiaAlthough they are not the same thing, despite having different semantic fields, one evokes the other. We cannot help but think of euthanasia when we hear the expression "a dignified death," and vice versa.
La public opinionThe vast majority are in favor of a dignified death and the application of the euthanasia In cases of intense suffering, without the possibility of effective treatment, and in the face of terminal illness. Quite another thing is the assisted suicide In cases where there is no terminal situation, opinion is much less unanimous, with greater diversity of viewpoints.
More and more countries have decriminalized euthanasia, having developed fairly similar regulatory frameworks: voluntariness, the applicant's mental capacity, and specific life circumstances. All these laws were developed with absolute respect for the patient's autonomy and voluntariness. However, in countries with a long history of decriminalization, such as the Netherlands and Belgium, there have been some cases where the requirements of both autonomy and voluntariness were not met. This is the main concern raised by those who oppose euthanasia and fuels the well-known "slippery slope" argument.
In this article, I wish to reflect on whether the highly probable decriminalization of euthanasia, which Parliament will decide, will lead us in the near future to the decriminalization of euthanasia for minors. Let's see:
Child euthanasia, infanticide, eugenics.
Belgium was the first country in the world to decriminalize euthanasia for minors (law of February 28, 2014, amending the law of May 2002). It states that a physician will not commit a legal offense when performing voluntary euthanasia on a minor possessing "the capacity for discernment." This capacity must be assessed by a child psychiatrist or psychologist, who will be provided with all available clinical documentation. The psychiatrist or psychologist must inform both the parents and the medical staff of the content of their decision in writing and with their signature.
If the decision is favorable, both the parents and the minor must submit a written request for euthanasia. It can only be applied in situations where the minor is "in an irreversible medical condition of constant and unbearable physical suffering that cannot be alleviated," and "that will lead to death in the near future, due to an accidental condition or a serious and incurable illness." The law includes provisions for offering psychological support to the parents during and after the euthanasia procedure.
There are other countries, such as Colombia, Canada, and the Netherlands, that, while they do not yet have regulations governing euthanasia for children (in the Netherlands, for children under 12), are currently experiencing strong support from their respective pediatric associations. It should be noted that, although no specific law has been enacted, euthanasia is being performed in specific cases following legal action by parents.
The case of the Netherlands is somewhat atypical, since, although it does not have child euthanasia regulated by law, it does have a law in force. Groningen Protocol from 2005. What does it consist of?
El Groningen ProtocolThis is the practice of euthanasia in newborns with "serious malformations." In my opinion, it is the 21st-century application of what the classical Greek and Roman world already practiced. It was Christian morality that suspended the practice of killing newborns and children with serious health problems. Ultimately, the revulsion we feel toward killing young children who, due to their malformations or poor health, would be a burden on society, stems from... christian moralityI believe that this protocol, regardless of the regulatory conditions for its application, goes hand in hand with infanticide and eugenicsHowever, I leave it to the reader of this article to form their own opinion.
What requirements does the Groningen Protocol impose?
- That the newborn suffers unbearable pain and that there is no possibility of improvement.
- The diagnosis and prognosis must be accurate and also endorsed by an independent physician.
- Parents must give their informed consent.
- That the euthanasia procedure be carried out according to the criteria accepted by the doctor.
- That all clinical documentation on which the euthanasia decision was based be provided.
- The euthanasia request must include all information regarding the personnel involved, the where, the when, and those involved in the process.
- Comprehensive description of the procedure, including any drugs that may be used.
To whom can the Groningen protocol be applied?
- Newborns with a certain death shortly after birth, even if all available means are applied.
- Newborns who require intensive care to survive and whose future quality of life and recovery are also very low.
- Newborns with a poor prognosis and unbearable suffering, even though intensive care is not necessary for their survival.
There are several criticisms leveled against this protocol. The first is that the concept of quality of life The basis for this argument is quite ambiguous and its evaluation is hardly objective. Secondly, it opens the door to infanticide, since some parents are afraid to take responsibility for a child with such severe anomalies and would sue. Thirdly, with the resources of 21st-century medicine, how can the concept of "unbearable suffering" be objectively measured?
Conclusion
I am convinced that the next step, once euthanasia is decriminalized for adults, will be euthanasia for children; that there are too many cases where parental consent is not a prerequisite (Alfie's case, for example, although there are a considerable number), so legislators should consider how to reconcile parental rights and other interests (such as economic ones) when making decisions. I am also concerned about how the law will regulate the penalties for those who violate it.
In any case, I advocate for palliative care that is equally accessible to all children and provides them with the necessary resources, rather than using euthanasia as a substitute. A dignified death is essential, simply out of human dignity. But it can be achieved without euthanasia. This concerns me particularly in childhood and adolescence because autonomy, voluntariness, and the capacity for discernment are not always clear.
