Saturday, February 15, 2014

The Question of Euthanasia for Children

Extremely ill children, some with diseases or disorders which will continue to move them on a downward spiral of incapacity and intolerable pain, are a concern for all of us. For parents I can only think it must be like their worst nightmares and I have difficulty seeing any good coming from it. But some parents, and even some kids, verbalize sentiments that run counter to my thinking and I cannot find anything wrong with that. Neither I nor anyone else has a right to say what’s right for anyone to perceive in these matters.

The death of a child, too, moves all of us because of our beliefs that the young should have the right to live a full and happy life. Many of us try to do everything we can to make that possible for them. We sacrifice in ways too numerous to name and find ourselves wishing or praying that they will be well or get well, whichever the case may be.

Ending a person's life in the face of terrible illness and intolerable symptoms, for anyone, is not something anyone considers easily. For some it is immoral, for others it is illegal and yet others believe that there are times where this should be a choice left to the sufferer. When it comes to a child, however, who should make this decision?

Scientists tell us, and psychologists too, that children do not come into their full cognitive/emotional maturity until a few years after their 20th birthday. This, then, would make it extremely difficult for anyone to determine that a child can make a choice regarding their own end-of-life decision.  We do not see children as being fully capable of this action and yet one country, Belgium, is now waiting for its king to sign this bill into law. Will he do it?  Indications are that the matter has wide support in the country and the law passed 86 to 44 with 12 abstentions which would seem to support the prevalent belief about the matter.

For Belgium, this is not a new course of action open to the gravely ill. In fact, in 2002, according to a report on CNN, anyone in "constant and unbearable physical or mental suffering that cannot be alleviated" may request assistance in ending their life. This latest legal measure lowers the age at which this course of action will now be available for those under 18.

How can anyone erase all doubt about a child’s ability to make this life-ending decision rationally? To my mind, that seems something unknowable even to those in the mental health field. True, the parents and, if needed, guardians would be involved in the decision, but who will take full responsibility for an act that many may find reprehensible? I do not believe children should suffer but I could not see myself, as a psychologist or a citizen of a civilized world, putting my stamp of approval on this. No, I do not hold myself up as “holier than thou” in this but I know that I could not find comfort in taking a child’s life, but perhaps I do not what I would do in all situations. Certainly, there must be circumstances and many times we do not know how we will act until the actual time for action arrives.

I recall being in a physician’s office many years ago discussing a simple medical matter when he was interrupted by a phone call despite having indicated not to put calls through to him. I sat and listened as his voice grew somber and his face clouded over. As I recall, he said something like, “In that case, you put the baby in a bassinet and leave it on the side of the nursery. Nature will take its course.” The baby, it turned out, has been born anencephalic meaning it had no brain. The medical exam, just shining a light into the baby’s eyes, confirmed it when the light could be seen on the back of the skull. But I can imagine how that pediatrician must have struggled with what he knew would be the recommendation. He needed, however, to hear someone he respected confirm it for him so that he alone didn’t make the call.

The words of the Hippocratic oath, “first do no harm,” must have been echoing in his mind as he made that call.  I’m sure it will be no easier for anyone who is called upon to consult or participate in a case of this kind in Belgium.