I would think a sense of identity would allow the person to declare for themselves if their life has been satisfying. Of course, that would leave us with the difficulty of determining whether to trust that person’s account. What if someone surprised everyone by living to age 20, but then said his life was a misery and a torment and then he killed himself? Would we say that he obviously didn’t have a satisfying life, based on his own report, or would we say that he might have had, though he didn’t, and that’s good enough?
I think I’d set the bar lower. Reaching a age of maturity necessary to have a sense of identity puts one in the category of people who might not have had a satisfying life but who might have had one if some circumstances, possibly not related to the physical problem, had been different.
In other words, if the person has the chance to survive to whatever age we have determined where self-identity comes in, that person should get that chance. Since we’re talking newborns, that would mean that the condition is not considered immediately terminal–which is part of the original law as enacted anyway.
Could we get a working definition of exactly what we mean by ‘this protocol’? - I’ll be happy to look for a cite, but I fear that doing so on the basis of articles from Fox News and CNN would be to fail to address the actual issue.
I honestly don’t know whether you are honestly advocating euthanasia without having even a basic understanding of the facts or if you are trying to derail the debate by pretending to be obtuse. Either is horrifying.
There is no “symbolic” slippery slope. The Groningen Protocol is exactly and precisely the same thing as the infants who were euthanized. Those children were killed under the Groningen Protocol. You say there’s a distinction – the people who actually killed the children say there is not. They, and again, they’re the guys actually doing this as opposed to arguing about it on a message board, think that killing an infant born with (they claim) a severe, painful and terminal illness is exactly the same as an 11 year old in a similar circumstance.
Bullshit. Look at you! You don’t have the faintest foggiest idea the actual condition of the children killed and here you are defending it! All you have is the word of the hospital, which is already demonstrably unreliable by virtue of having euthanized the children in a way contrary to Dutch law, that all four were cases of severe spinal bifida. That doesn’t sound a little weird to you? That a disease with a U.S. incidence of 7 per 10,000 live births saw four cases at a single hospital in the Netherlands in 2003 so severe that euthanasia was carried out? Maybe the incidence is higer there – maybe not. You just don’t know. Do you know the percentage of cases that result in infant death in other places? The range of prognoses of people born with “severe” spina bifida? The actual causes of death in spina bifida cases?
To summarize: 100% of all state-sanctioned youth euthanasia programs ever put into practice have turned into horror shows. 100% of the youth euthanasia programs known to exist today contemplate killing children as old as 12 years old. 100% of all the youth euthanasia programs known to exist today are being carried out by a small group of doctors contrary to the laws of their country. Proponents of this have a very, very, very high threshold, both theoretical and historical, to overcome and a quick dismissal of actual, real-life concerns about how the practice is being carried out in actual, real-life situations is reprehensible. And you wonder why people use Nazi imagery when talking about this? It’s because of people like you.
These babies can live anywhere from stillborn, to minutes to days, to in very very rare case a week or so, depending on whether the stem is enough to keep basic life functions going. There is no hope of “recovery” because the higher brain structures are basically not formed: there is little to recover. The skull is sometimes also incompletely formed, leaving the brain cavity exposed to massive infection. In the US it is increasingly rare because of selective abortion, but it’s worldwide incidence can be as high as 1 in 1000. Here is a picture of the general problem: http://www.anencephalie-info.org/images/med_sketch.gif
As to whether such babies can “feel” pain, there is some dispute. They clearly have most of the necessary structures for pain experience in a very crude sense, but they lack the higher brain structures that might be necessary to “experience” pain, and really there is just no way to know what they can or cannot feel. Development of the brain tissue can vary, and clearly some of these infants can develop enough function to cry, respond to vibration, swallow, and do other things. It’s not clear whether these reactions are simply responses not unlike what some coma patients can have, or intended actions. We just don’t know enough about the brain to know what life without some of the major structures would be like. But given that these babies usually die of starvation, massive organ failure, or massive infection, it’s not a pretty life, morphine or no.
People often forget how commonly pregnancies fail or result in very serious birth defects. Selective abortion as well as reparative surgery in utero (which can now correct a lot of the spinal bifidia cases that might have been terminal so that the fetus can develop properly) has radically lessened the commonality of carrying such births to term (or to early and complicated stillbirths), but I assume if pro-life people have their way, we’ll be back to bringing lots of severly deformed, stillborn, and already-dying babies into the world, and our infant mortality rates will shoot back up.
Lots of people speak of cloning research, which doesn’t even generally try to bring anything to term, as creating monstrosities doomed to early death, forgetting that gross malformations and terminal birth defects occur naturally (and, ironically, cloning research in part holds out the promise that we can prevent such abnormalities from happening by giving us great insight into early cell development so that we can prevent or fix various developmental problems).
For purposes of action, yes. For purposes of illuminating the discussion, no. I’m not defending this euthanasia practice; I’m just trying to figure out what’s going on with it, and one useful way for me to figure it out would be to see counterexamples, cases of people that defied the odds that these doctors are talking about. This ain’t a court case; this is me trying to understand.
Absolutely–no question.
Here I don’t agree. If we have a circumstance in which the child is as likely to develop wings and fly out the room as to spend a single day not in agony, or to live to the age of two, then I see it as a positive duty on the physician’s part to ease the child’s suffering in whatever means possible. If that suffering can only be eased by ending the child’s life, then that’s what it means to do no harm. Prolonging the agony would be harming the child.
If easing the suffering is in this case illegal, the ethical duty to the child–to end his or her agony–trumps the legal duty.
Good question: in looking around a bit, I was unable to find one. The whole thing is too fuzzy right now for me to be able to evaluate it.
jsgoddess, I’m afraid I don’t quite understand your post; I’m sorry.
Manhattan, I’m afraid I don’t think you’re discussing this in good faith. Surely you can recognize the statistical fallacies and outright untruths in your own post.
JohnC:Step 2: Very small minority of doctors distort the facts and conditions of certain cases in order to euthanize people that they believe will be a ‘burden on society’ […]
One thing that I think is being overlooked in this kind of slippery-slope scenario is the fact that the trend in Western society is towards greater acceptance of “burdensome” or otherwise “abnormal” people, not less.
Remember that the early twentieth-century eugenics movement was rife with chest-thumping social Darwinism and ethnic chauvinism. Breeding from the best, weeding out and/or sterilizing the unfit, etc. The so-called “inferior” ethnic groups were regarded with great hostility, as were homosexuals and transgendered and similar “deviants”, physically and mentally handicapped and other “subnormals”, etc.
But the social trend nowadays is in precisely the opposite direction. Prevalent attitudes of the sort that are often mocked as “political correctness” have pushed for greater tolerance and acceptance of different ethnicities, sexual orientations and gender identities, and all sorts of “challengedness”. Gay rights, Special Olympics, ADA, multiculturalism, “mainstreaming” handicapped or learning-disabled children—in short, practically every sort of “PC coddling” that so many people like to complain about—all these things are acting against social-Darwinist “remove the unfit” mentalities.
That is, as a society we’ve become more accepting of euthanasia for the terminally ill and suffering at the same time that we’ve become stronger defenders of the rights and worth of people formerly considered “unfit”. I think that argues against the likelihood of our being on a slippery slope that will carry us from euthanasia for the dying to eugenic executions of the “unfit”.
Don’t be sorry. I’m being particularly illiterate today.
You said that a satisfying life must include consciousness, or freedom from pain at some point, or a sense of identity.
My suggestion is that a sense of identity is a matter of time. We don’t assume a newborn has it. No newborns have it. So if we’re talking about euthanasia of a newborn, a sense of identity isn’t relevant. If someone might survive long enough to get a sense of identity, they aren’t a terminal case and wouldn’t be the subject of this Dutch law in the first place.
You don’t think I’m discussing in good faith? You’re the one who wants to proceed with euthanasia unless the other side can prove a negative. You’re the one who doesn’t wonder that in a country which saw less than 200,000 live births in 2003 there were four, in a single hospital, with spina bifida so severe that euthanasia was called for even though the vast majority of spina bifida children carried to term have rewarding lives. You’re the one arguing that despite the 0-for-forever history this time the doctors will do it just right.
So tell me, Doctor, about my statistical fallacies and outright untruths. I’m curious to know what they are, particularly from a guy with no apparent knowledge of or care for the facts underlying your pollyannish belief. Tell me what they are.
You think the doctors are lying??? Why?? I can’t imagine they just enjoy killing babies, and they did get an outside opinion for each case, as well as reported each case to the gov’t, despite the risk that this would get them in legal trouble. The articles I’ve seen have said that the paritculars of the cases of the four infants killed last year haven’t been released and the spina biafla is one disease they might have had, not that all four died of spina b. Given that no one has given any evidence to the contrary, or even any possible motive for lying, I see no reason not to belive the opinion of the doctors.
What the Nazis called euthanasia wasn’t what we mean by euthanasia, it was murder of “undesirables” to reduce their burden on society. It didn’t turn into a horror show, it started that way. In fact the german word for doctor assisted suicide is not euthanasia, because of the eugenic conotoations that word has in that language.
Ah, I see. With one quibble–consciousness is necessary, according to my definition, and at least one of the other conditions must be met. A person who does not experience pain but also does not experience anything else cannot, I think, be said to lead a satisfying life.
That quibble aside, I agree that someone who attains a sense of identity would not be covered by this protocol (as I understand the protocol, that is). I was trying to define “satisfying life” separately from the protocol, so that we could figure out how the protocol applies to it.
I don’t know, to be honest. What I do know is that the available facts just don’t add up right now to anything that a good-faith proponent of euthanasia might want to use to bolster his case.
Here’s what we’ve got, in my eyes:
The doctors already violated Dutch law.
This CNN article has the doctors claiming that “In these cases, the diagnosis was extreme spina bifada.” Perhaps that’s a translation error or otherwise – I’m certainly willing to accept contrary data here. But absent that data, let’s proceed.
Some hospitals have specialities, and spina bifida is a) subject to clustering and b) much more prevalant among whites, so it’s not unreasonable to suspect that a single hospital in the Netherlands (a white-guy country) might have more than one case. Even four doesn’t seem way out of line.
But. But most cases of spina bifida are nowhere nearly severe enough that euthanasia is even a brief consideration. So to expect four of that severity at a single hospital in a single year is a heck of a stretch.
Why would they lie? I dunno. I agree that it’s probably not because they have a baby-killing fetish. One wholly unsupported speculation: meningitis, a disease to which spina bifida babies are particularly vulnerable, is rampant at their hospital and they’re covering it up. Or maybe they’re not lying at all. I just don’t know.
Here’s what I do know – given the available facts here, it’s the people who are arguing that only babies with only their pain centers intact or have similarly severe afflictions are being euthanized are the ones who are setting up improper strawmen to knock down, not the ones who are arguing that the policy might be much more expansive than the pro-euthanasia forces claim.
And I understood your consciousness thing, I just miswrote it.
Okay, back to a sense of identity!
Does the person have to have a current sense of identity, or does the sense merely have to have existed at some point? Can we use the newborn example and say if there is a chance of future sense of identity (that the person will survive long enough to have a sense of identity, either for the first time or restored) that the condition of “sense of identity” has been met?
I know, and I’m reserving judgement as well. Like I said, I’m not one of the decision makers and I don’t have primary source material on hand. Spina Bifida, even with a poor prognosis, is survivable and it is not in the same realm as “growing wings and flying out of the room”. By the way, can we stop with the over-the-top comparisons? I know it is difficult to discuss these fringe issues, but the reality is there aren’t really bright lines. It is all grey. It doesn’t help us to postulate situations which would never occur and use them to support or attack this policy. I have listed, admittedly anecdotal, real-life evidence. I have not postulated miraculous cures anything near the order of growing wings and flying around.
I think we’re talking about different things. I’m talking about looking at the totality of a person’s life and whether it was “satisfying.” Unless there’s an afterlife, potential identity doesn’t enter into it: over the course of their life, either they had an identity at some point or they did not.
Obviously we can’t know this for certain when making decisions of whether to end an infant’s life. But in rare circumstances we can get so close that our guess is indistinguishable from certainty.
If a child is born with no brain, for example, then the odds of the child ever having a sense of identity are pretty astronomically low, wouldn’t you agree?
When I talk about circumstances under which a patient went on to live a satisfying life, I’m not saying the patient potentially lived one. I’m interested in cases in which this actually happened.
Spina Bifida comes in various forms. Although I’m no physician, I have trouble understanding how a patient could survive being born with severe Raschichisis, an extreme form of Spina Bifida. If you google it, you’ll end up looking at some nightmarish pictures–essentially children born with a bloody lump of flesh where their head should be. I won’t link to them.
When I talk about their prognosis being as likely as their growing wings and flying out of the room, that’s the form I was talking about; in trying to discover more about this protocol, I’d done a little basic digging into “extreme spina bifida” and came across information on this disease. I don’t see that I was exaggerating.
It has to be a poorly written article. Look at it again, it’s not clear that “these cases” are the four from last year. The juxtaposition with the previous paragraph suggests that, but it really isn’t clear. What’s more, earlier in the article they say cite him as saying the babies had “incurable conditions [plural] that were so serious…” suggesting it was for more then one disease. Also I googled for more articles and couldn’t find any others that would say what the specific diseases were, and the one I cited above claimed the details hadn’t been released.
The idea of a cover up doesn’t make any sense for two reasons, one they consulted with outside physicians, so if there was a cover up they went out of thier way to involve extra people outside of the direct influence of the hospital. Finally, if they were going to cover up baby deaths why report to the Dutch gov’t that you killed them in an extremely contraversial manner and risk scrutiny and a legal investigation.
We’re saying that the doctors are doing what they say they are doing. If you have evidence to the contrary, I’d be interested but I really don’t see any reason to question there honesty in this matter. They reported what they were doing, if they’d wanted to obfusicate it, they could have easily not come into the open, as they apparently have done in previous years.
And what I’m finding seems to say that there are 22 hospitals in the Netherlands.
My arithmetic then says that there would be about 100 children born in 2003 with spina bifida for an average of 4.5 per hospital. (Not of course that this eliminates anything.)
That’s my perception, too. On the NPR interview (yesterday, I think), the physician interviewed also mentioned a blistering disease as one of the reasons an infant might be euthanized. I definitely didn’t get the impression that all four cases were spina bifida. But I think the hospital hasn’t released the specifics of the cases, which makes my earlier question difficult to answer absent someone digging up the text of the protocol.