Euthanasia should be an option for ill children between the ages of one and 12 who are in unbearable pain and for whom there is no hope of a cure, health minister Ernst Kuipers has said in a briefing to MPs.

Assisted dying is bound by a number of strict criteria in the Netherlands and is currently only practiced in cases involving adults and infants younger than 12 months.

Euthanasia for terminally ill and suffering babies is not part of the euthanasia law but a ‘protocol’ drawn up by paediatricians and the health and justice ministries dating from 2005.

Kuipers, acting on the advice of paediatricians, is proposing a similar protocol for children under twelve for whom no formal criteria have been created so far. A change in the law might polarise the debate, paediatricians fear, when what is needed are practical solutions for the distress faced by the children.

Kuipers’ concept protocol contains seven criteria for euthansia for the under 12:

Doctors have to be convinced the child’s suffering is unbearable and there is no possibility of a cure or a treatment to alleviate the pain.

Any diagnosis has to be fully discussed with the child’s parents as well as the possibility of euthanasia, for which both parents will have to give their permission.

Doctors will also discuss the procedure with the child in a way the child will understand and will only proceed if the child is in no way opposed to it.

Doctors will have to consult at least one independent doctor who will evaluate if all the criteria have been met before euthanasia can take place.

The concept is currently out to consultation. Kuipers will present the final concept in October, when he will also announce when the protocol will come into force.

Research

A 2019 report by experts at the medical teaching hospitals of Groningen, Rotterdam and Amsterdam found that a small group of children may be suffering because doctors are afraid of the consequences of actions that could hasten their deaths.

The survey of 72 doctors found the vast majority thought it was acceptable to actively end the lives of children under 12 who were in acute suffering, at their parents’ request, and that a new law should allow this.

There were, however, no signs that euthanasia was being carried out with children under 12 in the study of 296 deaths in 2015, the survey said.