Thursday, December 02, 2004

The Groningen University Hospital Protocol

In a recent article, Hugh Hewitt chides the nation's elite media for failing to report on, and take offense at a Dutch hospital's (Groningen University Hospital) patient care protocol. Unfortunately, in his rush to give us his opinion, Mr. Hewitt omits to give his readers the facts.

The Groningen University Hospital protocol [the hospital protocol] under discussion is an experimental policy allowing child euthanasia in patients diagnosed as terminally ill.

According to Mr. Hewitt, the first report about this hospital protocol appeared in the Grand Forks Herald, in October. From this report we learn several facts:

  • The protocol requires a patient already be diagnosed with a terminal condition.

    Under the Groningen protocol, if doctors at the hospital think a child is suffering unbearably from a terminal condition, they have the authority to end the child's life.

  • According to the protocol each individual case has to be investigated.

    The protocol was written by hospital doctors and officials, with help from Dutch prosecutors.


    Under the protocol, assisted infant deaths are investigated...

  • All cases to date have been investigated and found to be medically appropriate.

    Official investigations have found that the doctors made appropriate and professional decisions...

    ... far all of them [assisted infant deaths] have been determined to have been in the patients' best interests.

  • Details about the protocol and the individual cases are not available, and the parental role in the decision is assumed to be limited.

    A parent's role is limited under the protocol. While experts and critics familiar with the policy said a parent's wishes to let a child live or die naturally most likely would be considered, they note that the decision must be professional, so rests with doctors.

    A second article, in November, gives us a bit more detail about the protocol:

    The Groningen Protocol, as the hospital's guidelines have come to be known, would create a legal framework for permitting doctors to actively end the life of newborns deemed to be in similar pain [great pain with no hope of relief] from incurable disease or extreme deformities.

    It also reveals that the protocol does, in fact, require the parents' full participation:

    The guideline says euthanasia is acceptable when the child's medical team and independent doctors agree the pain cannot be eased and there is no prospect for improvement, and when parents think it's best.

    So, these are the facts, yet Mr. Hewitt writes:

    On Tuesday the AP carried a second story, and Drudge broadcast the news to the cyber world: The protocol was already in effect, and at least four babies had been deemed disposable, and killed.

    Of course, the newborns were not deemed disposable. They were diagnosed as terminally ill.

    Mr. Hewitt continues:

    The establishment of "independent committees" to dispatch non-consenting humans is nothing but a death penalty committee for innocents.

    The hospital protocol does not establish "independent committees", rather it sets forth guidelines for medical care. The care is rendered by the patient's primary and consult physicians, and the decision is made by these physicians and the parents, not some uninvolved strangers.

    Moreover, the physicians and the parents are not dispatching humans. Rather, they are making very difficult and complex medical decisions about terminally ill patients' medical conditions, not their guilt or innocence.

    Finally, he writes:

    But now the Netherlands has gone farther--much, much farther. If the "severely retarded" may be killed upon appropriate motion, second, debate, and majority vote, why not the moderately retarded?

    The Groningen hospital protocol has nothing to do with the severely retarded. It applies to terminally ill patients, suffering great pain with no hope of relief from an incurable disease or extreme deformities. Severe retardation is not a terminal illness. Other conditions, like anencephaly, and certain types of epidermolysis bullosa are.

    Also, the current Dutch law, in existence since 1994, provides for euthanasia by patient request, not kill[ing] upon appropriate motion, second, debate, and majority vote:

    Under the law, any critically ill patient older than 12 can request an assisted death, including adults in the early stages of dementia.

    The law doesn't allow involuntary euthanasia nor does it apply to children younger than 12, who aren't considered aware enough to make a life-or-death choice.

    Bottom line: Just like teenagers can not make an informed decision about abstinence if they are taught false and misleading information, adults can not form an educated opinion about a hospital's euthanasia protocol if they're not familiar with the actual facts.

    A couple of notes. I deliberately did not mention my stand on euthanasia; my point is not that you should be for or against euthanasia, but rather that you should base your opinion on facts.

    I also noticed something interesting. When strangers, and politicians, based on a personal belief that the unborn child [has the capacity] to experience great pain during [an] abortion, try to enact laws that only function to further their dogma, they are praised, and everybody's aglow with moral righteousness.

    However, when a newborn's physicians and parents express concern for, and try to do something about the patient's intractable pain, something that, in their professional and parental judgment, is the best medical care for that newborn, they are mightily condemned by Mr. Hewitt, accused of appalling brutality, and committing a radical leap past Kevorkian land into the regions of Mengele.

    (via Instapundit)


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