US bioethicists take Belgian child euthanasia to task

Michael Cook
27 April 2014
Reproduced with Permission

Three American bioethicists have criticised Belgium's new law permitting children with a terminal illness to choose euthanasia. Writing in the Journal of the American Medical Association , Art Caplan and two colleagues argue that children do not have adults' capacity for informed consent. "Children and adolescents lack the experiential knowledge and sense of self that adults often invoke - rightly or wrongly - at the end of their lives," they argue. Furthermore, a developed nation like Belgium ought to have good enough palliative care so that no child will experience "constant and unbearable suffering".

The Belgian law specifies that euthanasia would be permissible only for "terminally ill children who are close to death, experiencing constant and unbearable suffering." That suffering of such magnitude exists in modern pediatrics is an inexcusable tragedy. But the solution need not and should not be euthanasia.

All patients, including children, must have access to adequate palliative care. Although access to adequate comprehensive palliative care is limited in many settings, it ought not be in developed nations such as Belgium…

The goal of reducing suffering in children at the end of life is a laudable one. However, the ethical way to achieve this goal should be expanded education and clinical guidance around the provision of aggressive palliative care.