In the Netherlands, the life of a child of almost 24 months with severe brain damage, spastic cerebral palsy, serious visual impairment and difficult-to-control epilepsy was terminated. The special commission, which examines cases of termination of life of newborns and children between 1 and 12 years old, has found that the doctor complied with the requirements for medical care.
The case is the first publicly known in the Netherlands with a child under 12 years old since the rules changed two years ago, reported “Plovdiv Daily“. The child was born prematurely at 26 weeks of gestation and three days during a holiday abroad. He was initially treated in a neonatal intensive care unit outside the Netherlands, and at four and a half months old he was transferred for treatment in the country.
Severe injuries and uncontrolled epilepsy
A magnetic resonance imaging scan showed severe brain damage, including lesions of the white matter of the brain, associated with spastic cerebral palsy. Damage to the occipital cortex was also found, leading to serious visual impairment.
At the age of eight months, the child was diagnosed with a severe epileptic syndrome. The seizures continued despite drug treatment, and some of the drugs caused severe agitation, inconsolable crying and severe sleep disturbances. The epilepsy was accompanied by coughing and problems with swallowing, with the seizures intensifying during feeding.
At almost two years old, the child's development was assessed as approximately corresponding to a six-week-old. He had no speech development and could only communicate minimally. He also suffered from difficulty clearing secretions from his lungs, shortness of breath, and the risk of food or stomach contents getting into his airways.
The decision was discussed with parents and specialists
After repeated discussions about the diagnosis, prognosis, and treatment options, the parents asked the doctor to end the child's life. The decision was discussed in the multidisciplinary medical team, and the doctor sought opinions from independent specialists.
The initial consultants indicated that there were palliative options and other medications that could improve seizure control. Another independent doctor assessed that the suffering was clearly evident and that there was no reasonable way to reduce or eliminate it other than by terminating life.
The commission accepted that the child's general condition, the lack of prospect of improvement and the expected deterioration allowed the doctor to conclude that the suffering was unbearable and without prospect of change. “The commission accepted that the doctor acted with the necessary medical care“, the assessment states.
There are still no separate criteria for terminating life in children between 1 and 12 years of age in the Netherlands in the current regulation. In examining the case, the commission used as a starting point the rules for newborns and the criteria approved by the Dutch Association of Pediatrics in October 2024.
Sources: Plovdiv Daily