For those wanting to Google, the correct spelling is Rachischisis. It may be inadvisable to search Google images for that while eating.
Infants born with massive terminal birth defects vs. and kids up that live up to 12 but then develop a terminal illness. Legally the issue IS currently pretty much the same: neither can give informed consent about what their wishes would be. But obviously, there’s more to it than that as killing deformed infants is radically different than killing a child with proven and longstanding viability, and infants cannot give ANY consent, which is pretty darn different from informed consent: something the law doesn’t recognize and perhaps should.
But I still don’t see the value in prolonging the life of a child with no brain just to avoid killing a grown child with a terminal illness because people believe one leads to the other.
That’s true. Good thing, then, that I haven’t been defending the specific acts or doctors in the Netherlands, but instead responding to Abbie’s assertions and pointing out that not all cases of euthanasia are the same. Too bad I’m currently debating someone dishonest enough to pretend otherwise just to be characteristically abusive and disruptive.
Note: not all posters are exclusively attacking or defending the particular doctors actions: some are responding to the more general implications raised by other posters in the course of discussing the OP.
I don’t believe I mentioned spinal bifida of any serverity: I brought up to Abbie the related but much more severe case of anencephaly. I think I read about it in fictional a fairy tale book somewhere.
It seems very high, especially since spinal bifida can often be cured in utero, as I mentioned. And the Netherlands actually has one of the lowest incidences of neural tube defects in the world: considerably lower than even the U.S. I believe (if only they’d adopt a more U.S.-like healthcare system, their infant mortality could maybe reach new heights! Same outcome as the Nazis, only you don’t have to feel bad about it!).
Okay.
Yes.
Sounds like a real mess.
Yep, I agree. But not all cases should be treated as if they were the same. And I simply don’t agree that the behaviors or practices of doctors in the Netherlands should somehow rule out even the most obvious candidates for infant euthanasia. There are lots of scary gray lines. But there are also lots of cases that are very clearly way over the line.
The reason people use that imagery is because people like you use it, even if they try to slip it in indirectly: no other reason. They use it because it’s an effective way to avoid thought.
I think you’re looking more for people to yell at than to seriously consider all sides of this issue or even understand what position anyone is taking before launching into them.
A cluster of severe spina bifida cases in one place doesn’t surprise me at all. If their healthcare is arranged anything like ours, routine pregnancy surveillance would have identified a problem which resulted in a referral to a second tier of care, which probably then sent the mother to a specialty Doctor who likely works at a specialty hospital…etc. That is the routine here and seems like a sensible model to follow.
Also, developmental disorders do cluster in different countries and in different groups. I seem to recall that Ireland had the highest rates of cleft palate in all the world. I wish I could remember the stats- they were shockingly high, but I don’t recall them now. That was information I got a some seminar somewhere, so no cites. I’ve always been interested in Saudi birth defects- I’ve heard through the rumor mill that they suffer some particularly high rates of unusual birth defects, but that the information is kept secret.
That’s OK, I think you said “This is not a slippery slope” and I demonstrated that not only is it a slippery slope but it already slipped.
I am quite familiar with the condition. Personally and deeply familiar. I am also aware of the extreme possibilities it presents. Again personally and deeply familiar.
How many years ago was it that a child with Cerebral Palsy had a “grow wings and fly around the room” prognosis? Sickle-cell anemia? Tay-sachs?
Enjoy,
Steven
Saudi Arabia has about the highest rate of consanguineous marriage on the planet. However:
http://www.cousincouples.com/info/saudi.shtml
J Community Health 1998 Feb;23(1):75-83
Consanguineous marriage in an urban area of Saudi Arabia: rates and adverse health effects on the offspring. al-Abdulkareem AA, Ballal SG Department of Family and Community Medicine, College of Medicine and Medical Sciences, King Faisal University, Dammam, Saudi Arabia. The objective of this cross-sectional study was to determine the pattern and time trend of consanguineous marriage and its adverse health effects on the offspring in Dammam city, Eastern Province, in the Kingdom of Saudi Arabia. This city is known to attract Saudis from different parts of the country because it is in the heart of this industrial region. Five primary health care centers were randomly selected from different sectors of the city in addition to the city’s only Maternity and Children’s Hospital. For inclusion in the study a wife must have at least one pregnancy that terminated in either full term liveborn baby, still birth, or abortion. A total of 1307 ever-married Saudis completed a pre-structured questionnaire during an interview. The rate of consanguineous marriage was 52.0% with an average inbreeding coefficient of 0.0312. First-cousin marriages were the commonest (39.3%) of all matings. The consanguineous groups had a significantly higher number of pregnancies. The mean birth weight of the offspring of consanguineous couples was not statistically significant being less than that of the non-consanguineous. However, within the consanguineous groups the more closely related couples had smaller babies on average. No significant differences were noted for the rates of inherited diseases and reproductive wastage. The rate of consanguineous marriage in this city was high and so was the inbreeding coefficient. These figures place this nation among the countries with a high rate of consanguineous marriages. A nationwide study to determine accurately the relationship between consanguinity and inherited diseases has much to commend it. PMID: 9526727, UI: 98187475
If Saudi Arabia has a high rate of birth defects, then I guess they must be covering it up.Good stats, thanks. The number of hospitals seems very low – that’s almost 750,000 Dutch per hospital, as opposed to around 60,000 per hospital in the U.S. But that’s OK – let’s throw that out and make a simplifying assumption.
We’ve got ~100 cases of live-birth spina bifida in the Netherlands per year. Myeloschisis has an incidence of about 2 per 1,000 live spina bifida births. That’s one every five years, nationwide. The Netherlands is small – I’ll agree that it’s not wholly unreasonable to assume that nearly 100% of women who give birth to spina bifida babies do so at Groningen (that’s the simplifying assumption). But that still means they euthanized 20 times the expected incidence of myeloschisis in 2003. And even that assumes that each instance of myeloschisis birth resulted in a life long enough to conduct the alleged review process. Malodorous, I’m still willing to believe that the article is wrong, but it is not unclear to me. It’s very clear (but again, possibly incorrect) that the medical director was talking specifically about the euthanized babies.
Someone tell me something doesn’t smell to high heaven about all this.
Yes, I was very unsure about that stat as well. I didn’t have a cite that I felt confident about, though I did find that particular stat repeated quite a few times. That doesn’t mean that they aren’t all wrong.
Not that it matters to anything but thy and my thirst for knowledge, but here’s something claiming 118 hospitals there. That brings the ratio to a much more managable 138,000 people per hospital. Given that U.S. hospitals tend to run at ~50% occupancy that’s almost the same as here if their hospitals run fuller.
Alternatively, we could recruit a speaker of Dutch. Here’s the homepage of the Association of Hospitals in the Netherlands. 
Much better!
On further review, I think the sites I was seeing were talking about various research programs that seem to have been held at 22 hospitals. Perhaps those hospitals are research hospitals or somehow distinguished in some way.
I am related to quite a few Dutch speakers, but none are online!
We have several cites now that say all of the deaths were not from spina b., while on the other side we have one out of context quote from one doctor who may or may not have been talking about the babys in question. Also note there really is no reason for the doctors to be lying about this, and if they did then they subsequently brought the maximum amount of attention to their doing so by reporting the deaths to the Dutch gov’t and independent doctors. Finally note that despite the amount of attention and opposition to the deaths of these babies, no one but yourself has suggested that the babys were not in fact suffering from the diseases that the doctors said they were. Surely someone actually involved in the case would have noticed if the doctors account of the babies medical condition wasn’t belivable.
I really don’t think you have any reasonable case here. Euthanasia of infants may or may not be justified and is certainly worth discussing, but saying that seriously ill infants don’t exist in the reported numbers and are instead a construction of some sinister plot by doctors at a particular hospital (and note that in previous years other hospitals reported doing the same thing in similar numbers, so they might be in on it to) is really not a productive line of discussion.
(My goodness there is some nastiness on this thread! To the extent I added to it, I apologize.)
The ‘slippery slope’ argument is often flawed. (If we continue to remove rocks from the moon at the present rate, the moon will be gone in only three billion years.)
Here I suspect it is correct and important. I came across this realization many years ago when I (accidently) visited the U.S. Holocaust Museum. Nazi mass murder began by perfectly reasonable-sounding steps that blurred and then erased the bright lines we use to make moral decisions.
I fear that with this hospital’s reasonable-sounding actions we have forgotten the lessons of history and find ourselves in a dangerous place (again). If we do not take steps down one path, we most certainly will take them down another.
As I said, this is a serious moral issue that requires serous thought and discussion.
(Kind of shame some of us seem unwilling to do that.)
Purification.
Purification, through pain.
That’s wrong, or at best the scale is way off. The Nazis didn’t start with debates that will affect a handful of people a year. They didn’t think that small.
Does this sound like steps down a path to you?
That all happened in 1933. That’s not steps, it’s running. Unlike the open-ended sort of policies you’ll find in a dictatorship, this policy in the Netherlands has very clear limitations. It applies only to people with terminal illnesses who are in pain and cannot make a decision for themselves. If you want to argue it would be awful if it was applied to larger group of people, go ahead, but there’s nothing to indicate it would happen. The Nazis made no effort to be reasonable, the Dutch have.
If I may quote from the same source as the OP’s
In other words: It happens everywhere. We’re just honest about it.
Yep. There are a lot of Nazi’s around, these days.
What Marley said.
Also, does anyone have a cite for the claim that the Nazi “euthanasia” programs ever pretended to be for ending the suffering of the terminally ill. So far as I can tell, the T4 program began and ended as a way to weed out the “inferior” so as to keep them from being a burden on the state and deluting the Aryan race. Hitler was advocating this as far back as Mein Kampf in the 1920’s. In other words the Nazi’s didn’t slide slowly down a slope by following resonable sounding steps, they started with an idea that today is seen as obviously insane and then ran with it.
And as further evidence that eugenics was applied immeditly and not “phased in”, apparently one of Hitler’s first acts upon gaining power in 1933 was to pass the “The Law for the Prevention of Hereditarily Diseased Offspring” which ordered that the birth of disabled children be reported to the gov’t and then sterilized.
You’re right, probably. But do you want to take a chance that you are wrong? The stakes are terribly high. It would be best to think this through before we give doctors and parents the right to quiet little homicides.
From my book, copyright me:
T.4 (GER 41) Nazi euthanasia program directed against the deformed, incurable, insane and the otherwise “defective.” In the case of children both with serious defects, the goal was to murder the children as soon as possible after birth to prevent the mothers from developing close bonds with their offspring. Over then thousand people, mostly Germans, were killed under this program. As the activity spread, the use of lethal injections and other “medical” means of death became impractical; centralized facilities with gas chambers were developed. The most infamous of these was located at Gorden. The Health Ministry, which administered the killings, insisted all the murders be supervised by a licensed physician. Hitler, in a unique move prompted by public outrage led by the German clergy, canceled the program on 24 August, 1941. The murders continued secretly throughout the Nazi regime. The operation name was derived from the address of a Health Ministry office, at Number Four Tiergartenstrasse, Berlin.
Nazi’s nazi’s everywhere and not a drop of water…
Well certainly we want to think it through and provide for plenty of oversight and transparency. But then this is true with any state sanctioned killing, wheter it be via the death penalty, warfare, law enforcement, euthanasia, etc.
But again, my understanding is that the T4 programs only similarity with the Dutch case was that they both were both called euthanasia (in English). Other then that what the Nazi’s did was not similar to what the Dutch are doing in origin, motivation, practice, practitioners, level of public debate or any other of a dozen categories. In German, even the word isn’t the same anymore.