Milestones to Adulthood in the Netherlands and Slippery Slopes

Compulsory education exists from 5-16.  From the age of 16 to their 18^th birthday children are obliged to pursue at least part-time education.

The age of consent to sexual relations is 16.

Children cannot purchase tobacco products until the age of 16.

The minimum age to buy wine and beer is 16 and 18 to buy spirits and hard liquor.  If a person is under 20 an identity card has to be shown before purchasing.

Children can enlist in the army at 17

Children cannot drive a vehicle until the age of 18.

Children cannot vote until the age of 18.

Children cannot marry until the age of 18, although they can with parental consent at age 16 and with permission from the queen if under 16.

The age of criminal responsibility is 12.

Termination of Life on Request and Assisted Suicide (Review Procedures) Act.

A patient of at least 12 years of age can request a termination of life (patients12-16 require the consent of their parents).

Slippery Slopes

Deliberate termination of life of newborns (involuntary euthanasia) with meningomyelocele (MMC) is practiced openly only in the Netherlands using the Groningen Protocol.

The Groningen Protocol is very controversial and as elicited papers such as ‘Deliberate termination of life of newborns with spina bifida, a critical reappraisal,” T.H. Rob de Jong (2007)

Isabel’s comment (Jan 19) to the previous post would suggest that the slippery slope exists here and that newborns – who fall outside the Groningen Protocol are terminated -  and I have no doubt that it is does.  I am certain that deliberate termination of life of newborns now covers more than those born with MMC and is unreported.

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It would be foolish of me to infer that the rest of the world is squeaky clean in regard to the termination of children deemed to be handicapped and not worthy of life – for abortion allows this.  However is there a difference in terminating a life before or after birth?  What do you think?

Do you think a child of twelve and above has the maturity to decide that their life should be terminated especially as the Termination of Life on Request and Assisted Suicide (Review Procedures) Act has been given more scope including ““mental and psychosocial ailments” such as “loss of function, loneliness and loss of autonomy” as acceptable criteria for euthanasia. The guidelines also allow doctors to connect a patient’s lack of “social skills, financial resources and a social network” to “unbearable and lasting suffering,” opening the door to legal assisted death based on “psychosocial” factors, not terminal illness. The June 2011 position paper, titled “The Role of the Physician in the Voluntary Termination of Life” concludes that the “concept of suffering” is “broader” than its “interpretation and application by many physicians today.”

Included in a broader interpretation of suffering would be “disorders affecting vision, hearing and mobility, falls, confinement to bed, fatigue, exhaustion and loss of fitness,” according to the authors.

“The patient perceives the suffering as interminable, his existence as meaningless and—though not directly in danger of dying from these complaints—neither wishes to experience them nor, insofar as his history and own values permit, to derive meaning from them,” explains the KNMG position paper.

“In the KNMG’s view, such cases are sufficiently linked to the medical domain to permit a physician to act within the confines of the Euthanasia Law.”

“It doesn’t always have to be a physical ailment, it could be the onset of dementia or chronic psychological problems, it’s still unbearable and lasting suffering. It doesn’t always have to be a terminal disease,” said Dr. Nieuwenhuijzen Kruseman, Chairman of KNMG to Radio Netherlands Worldwide.”

Anna :o]

PS Can't 'understand' the sudden white background - blogs or me?

Assisted Suicides and Slippery Slopes

Termination of Life on Request and Assisted Suicide (Review Procedures) Act” (2002

Euthanasia and physician assisted suicide in the Netherlands is regulated by the above act.  Patients must meet specific criteria in that the patient has a terminal illness and requests (and this must be persistent and over time) a termination of life, has not been influenced by others, the patients suffering is unbearable and hopeless, the patient has been informed of and refused all possible alternatives (including treatment), has received the consultation of two physicians and has been made aware of the applied method of ending life.

However The Royal Dutch Medical Association has now released new guidelines widening the interpretation of the Act to include: ““mental and psychosocial ailments” such as “loss of function, loneliness and loss of autonomy” as acceptable criteria for euthanasia. The guidelines also allow doctors to connect a patient’s lack of “social skills, financial resources and a social network” to “unbearable and lasting suffering,” opening the door to legal assisted death based on “psychosocial” factors, not terminal illness.

” The June 2011 position paper, titled “The Role of the Physician in the Voluntary Termination of Life” concludes that the “concept of suffering” is “broader” than its “interpretation and application by many physicians today.”

Included in a broader interpretation of suffering would be “disorders affecting vision, hearing and mobility, falls, confinement to bed, fatigue, exhaustion and loss of fitness,” according to the authors.”

“Alex Schadenberg, Executive Director and International Chair of the Euthanasia Prevention Coalition committee responded to the new guidelines, saying that in his view “the expansion of euthanasia and assisted suicide has been constant and deliberate.”

Schadenberg warned that what has happened in the Netherlands can—and will—occur in other jurisdictions, if euthanasia and/or assisted suicide is legalized.

When the Netherlands sanctioned euthanasia for emotionally ill patients in 1994, Karl Gunning, head of the Dutch Doctors’ Union warned the country of the “slippery slope” it was sliding down.

“We have always predicted that once you start looking at killing as a means to solve problems, then you’ll find more and more problems where killing can be the solution,” he said.”

Charles Falconer’s ‘Commission on Assisted Dying’ (5.1.2012)

has concluded that there is a strong case for legalisation of ‘Assisted Dying’ and those that have twelve months or less to live should be allowed to end their own life/commit suicide.

The document is  here - it is a lengthy document – some 415 pages – and I have not read it all.  To summarise, the document suggests that to be eligible patients must be over eighteen years of age with a diagnosed terminal illness and less that twelve months to live, has made a voluntary choice and not been influenced by others, has mental capacity to make an informed choice and their decision making ability is not impaired by mental health problems such as depression, the patient is fully assessed to determine eligibility by at least two independent doctors, made aware of all options for treatment, care and support and still wishes to proceed and must be capable of administering the lethal medication themselves.

Author Sir Terry Pratchett (who jointly funded the so-called independent report) has stated that the report does not go far enough.

It is of a course a recommendation and there is no likelihood of ‘Assisted Dying’ becoming enshrined in law – yet.  Are we following the history of the Netherlands where certain assisted suicides became permissible in the 1980s, as in the need to clarify assisted suicide in 2009  in the UK?

The seeds for acceptance of legalised suicide are being sown, slowly but surely.  Lord Joffe has made four attempts during 2003-6 to introduce bills to legalise suicide and all were rejected by parliament.  Margo MacDonald’s “End of Life Assistance Bill” was rejected by the Scottish Parliament in 2010.

The drip, drip, drip is leading to a softening of opinion, indeed a “YouGov" poll commissioned by Sky News found 69% believe the law should be changed, compared to 17% who want it to stay the same and 14% who do not know.”

It is a fact that I understand that some of those suffering a terminal illness experience unimaginable pain and welcome death to alleviate this suffering – indeed when my own father was dying in such circumstances – initially I prayed (selfishly) to his God that he might live and upon realisation of his suffering prayed that he would die – quickly.  In hindsight – I wish to God that the Liverpool Care Pathway (LCP) existed then.

However – as those that have read previous posts will know – I have great reservations regarding the LCP.  Its admirable origins are firmly placed in alleviating the suffering of cancer patients diagnosed to be in the process of dying and yet its tendrils have spread to encompass all diagnosed (or thought to be) near death.  It is my opinion that the slippery slope exists here already and I know of occasions where it was initiated inappropriately.  To me the declaration that “The LCP is only as good as the people who are using it” is an acceptance that mistakes are made – for indeed the LCP is assisted dying.

During research I found myself confused as to what my true opinions/beliefs were, for as said I witnessed the awful slow painful death of my father and witnessed the same in residents in my home – this prior to the LCP – and then I have seen those diagnosed as near death living for years after.

I guess my epiphany was found at the Christian Medical Comment for I found much solace, much wisdom here – and I would stress that there is no conflict of interest as I am an atheist – and I thank Dr Peter Saunders for his communication – please read his wise posts on  euthanasia.    

I am concerned that assisted suicide will in the future be legalised in the UK – I am certain that it will (in time) – for just as the slippery slope exists in the Netherlands – it surely will happen here.

Before I sign off – please view this Dutch doctor’s experience as  the agent of death and consider that she states that she has no problems with assisted suicide and yet it emotionally affects her.

What say you on assisted suicide?

Anna :o]

Links:  http://witchdoctor.wordpress.com/2012/01/05/the-atheist-humanist-predicament-or-not/

          http://www.mercatornet.com/articles/view/the_new_year_should_begin_by_saving_lives_not_killing_them

PS  Had great difficulty creating links here - the post developed a mind of its own -  also messiness in its format and structure - can't correct it!