ONE of Britain’s royal medical colleges is calling on the health profession to consider permitting the euthanasia of seriously disabled newborn babies.
The proposal by the Royal College of Obstetricians and Gynaecology is a reaction to the number of such children surviving because of medical advances. The college is arguing that “active euthanasia” should be considered for the overall good of families, to spare parents the emotional burden and financial hardship of bringing up the sickest babies.
“A very disabled child can mean a disabled family,” it says. “If life-shortening and deliberate interventions to kill infants were available, they might have an impact on obstetric decision-making, even preventing some late abortions, as some parents would be more confident about continuing a pregnancy and taking a risk on outcome.”
Geneticists and medical ethicists supported the proposal — as did the mother of a severely disabled child — but a prominent children’s doctor described it as “social engineering”.
The college called for “active euthanasia” of newborns to be considered as part of an inquiry into the ethical issues raised by the policy of prolonging life in newborn babies. The inquiry is being carried out by the Nuffield Council on Bioethics.
The college’s submission to the inquiry states: “We would like the working party to think more radically about non-resuscitation, withdrawal of treatment decisions, the best interests test and active euthanasia as they are ways of widening the management options available to the sickest of newborns.”
Initially, the inquiry did not address euthanasia of newborns as this is illegal in Britain. The college has succeeded in having it considered. Although it says it is not formally calling for active euthanasia to be introduced, it wants the mercy killing of newborn babies to be debated by society.
The report does not spell out which conditions might justify euthanasia, but in the Netherlands mercy killing is permitted for a range of incurable conditions, including severe spina bifida and the painful skin condition called epidermolysis bullosa.
Dr Pieter Sauer, co-author of the Groningen Protocol, the Dutch national guidelines on euthanasia of newborns, claims British paediatricians perform mercy killings, and says the practice should be open.
Sauer, head of the department of paediatrics at the University Medical Centre Groningen, said: “In England they have exactly the same type of patients as we have here. English neonatologists gave me the indication that this is happening.”
Although euthanasia for severely handicapped newborn babies would prove contentious, some British doctors and ethicists are now in favour. Joy Delhanty, professor of human genetics at University College London, said: “I would support these views. I think it is morally wrong to strive to keep alive babies that are then going to suffer many months or years of very ill health.”
Dr Richard Nicholson, editor of the Bulletin of Medical Ethics, who has admitted hastening the death of two severely handicapped newborn babies when he was a junior doctor in the 1970s, said: “I wouldn’t argue against this.” He spoke of the “pain, distress and discomfort” of severely handicapped babies.
The college’s submission was also welcomed by John Harris, a member of the government’s Human Genetics Commission and professor of bioethics at Manchester University. “We can terminate for serious foetal abnormality up to term but cannot kill a newborn. What do people think has happened in the passage down the birth canal to make it okay to kill the foetus at one end of the birth canal but not at the other?” he said.
Edna Kennedy of Newcastle upon Tyne, whose son suffered epidermolysis bullosa, said: “In extremely controlled circumstances, where the baby is really suffering, it should be an option for the mother.”
However, John Wyatt, consultant neonatologist at University College London hospital, said: “Intentional killing is not part of medical care.” He added: “The majority of doctors and health professionals believe that once you introduce the possibility of intentional killing into medical practice you change the fundamental nature of medicine. It immediately becomes a subjective decision as to whose life is worthwhile.”
If a doctor can decide whether a life is worth living, “it changes medicine into a form of social engineering where the aim is to maximise the benefit for society and minimise those who are perceived as worthless”.
Simone Aspis of the British Council of Disabled People said: “If we introduced euthanasia for certain conditions it would tell adults with those conditions that they were worth less than other members of society.”