Recommend, 2019

Editor'S Choice

Euthanasia to babies with spina bifida, an acceptable practice?

Eva Paris @paris_eva

Holland became in 2002 the first country in the world to legalize euthanasia, and although this practice has not been free from controversy since always, it is now, ten years later, when it has jumped back to the media to get in touch with babies . In the Netherlands, euthanasia is performed on babies with spina bifida .

Now a study questions this practice, criticizing it, and pointing out that the newborns with this congenital malformation studied in their center "hardly had any pain". If the newborns had pain, they could be relieved with acetaminophen, or morphine, whatever the severity of their condition, according to the authors.

In his opinion, the parents (who are the ones who give the final consent) are wrongly informed about the situation of their children when weighing this procedure.

The Dutch law of euthanasia is only intended for patients who can request it by their own will, so it does not include newborns. To practice it in these cases and avoid problems with justice, doctors apply the so-called "Groningen protocol", prepared in 2003 by the University Hospital of that city, which regulates the euthanasia of newborns with incurable diseases .

According to this protocol, added to the current euthanasia law without modifying it, doctors are obliged to make sure that the situation of the newborn has no cure or possibilities of improvement and there is great suffering.

Then they have to consult with another colleague, the parents are informed and it is up to them to give their consent for the help to die. The application of the chosen medicines is also regulated. The procedure is not only for spina bifida, but includes other deadly ailments that can affect the neonate .

Between 1997 and 2004, 22 newborns were helped with this congenital malformation of the neural tube, which does not close the spine and leaves the spinal cord in the air. Legally it is considered that he had done well in desperate situations of "unbearable suffering".

The study on euthanasia in babies

The study, published in the journal "Pediatrics" has the title Discomfort and Pain in Newborns with Myelomeningocele: A Prospective Evaluation (" Discomfort and pain in newborns with myelomeningocele : a prospective evaluation"). Myelomeningocele is the most common type of spina bifida.

The article has been signed, among others, by the pediatric neurosurgeon Rob de Jong, of the Erasmus hospital, in Rotterdam. The author, along with his team of researchers, have followed for five years the evolution of 28 children with spina bifida in different degree of complication.

In eight of the cases, the injury was severe. However, only 3.3% of the measurements made noted discomfort due to pain, which could always be fought well.

It seems to the authors that the term "unbearable suffering", included in the Groningen protocol, is not adequate. Then, for them, one should think better about the practice of euthanasia, since the reasons should be incontestable.

Eduard Verhagen, the pediatrician who promoted the protocol of Groningen, has underlined the intention of the deontological code: "The unbearable suffering goes beyond pain. We talked about the future expectations of these little ones. "

The truth is that I would never want to see myself in such a dilemma, because I never know how I would react in such an extreme and painful situation in which the uncertain future of the baby is linked to serious physical and mental problems. However, now I remember that there are associations that care about the quality of life of children with spina bifida and their families.

But above all I remember that it is easy to minimize the risks of the baby having this neuronal tube defect: taking folic acid before and during pregnancy. However, despite this there will always be cases in which children born with this disease that is the second cause of physical disability in childhood (after cerebral palsy).

For now, euthanasia can be performed in babies with spina bifida if certain conditions are met, although it is logical that this practice raises controversy. What is your opinion about it?

Via | The Country More information | ErasmusMC, Pediatrics Photo | Spec-ta-cles on Flickr-CC In Babies and more | Video: the importance of folic acid during pregnancy, Folic Acid: indispensable help during pregnancy, Prevention campaign for spina bifida in pregnancy