FactCheck Q A: Were 550 babies killed last year under Dutch euthanasia laws?

The Conversation is fact-checking claims made on Q&A, broadcast Mondays on the ABC at 9:35pm. Thank you to everyone who sent us quotes for checking via Twitter using hashtags #FactCheck and #QandA, on Facebook or by email.

Excerpt from Q&A, November 9, 2015.

LUKE FORMOSA: .. Findings from the Netherlands Euthanasia Report in 2014 indicate… 550 newborn babies with diseases or disabilities were killed.

ANDREW DENTON:… I completely dispute and question your assertion that 550 babies have been killed. Under Dutch law, there is a thing called the Groningen Protocol, which sounds very sinister but which, in fact, applies to very, very rare conditions of extreme spina bifida and a thing called EB, where your skin is literally flaking off, and it has applied to maybe a dozen babies. So I don’t know where you got that figure of 550 from but I think it’s not correct. – Q&A audience member, speaking with broadcaster Andrew Denton, November 9, 2015.

There is no credible evidence to support Formosa’s statement about 550 newborn babies being killed. While a similar claim does appear on some websites, it is not backed by reliable official data.

Neither the 2013 nor the 2014 annual reports by the Dutch Regional Euthanasia Review Committee contain the figure 550.

Formosa told The Conversation by email that he could not provide an accurate source for the figure of 550 newborn babies “but it is also impossible to know for sure how many cases have been unreported.”

He sent a series of websitesandjournalarticles he said supportedhisconcerns.

You can read Formosa’s full reply here.

When asked by The Conversation to comment on Formosa’s assertion, the General Secretary of the Netherland’s Regional Euthanasia Review Committee, Nicole E.C. Visée, said the committee’s 2014 report did not say 550 newborn babies were killed, and referred readers to a fact sheet on the issue.

Andrew Denton told The Conversation by email that the author of the Groningen Protocol, Dr Eduard Verhagen from the University Medical Centre Groningen, told him in a recent interview that that since just before 2007, the lives of only two newborn infants had been ended under the Groningen Protocol (not “maybe a dozen”, as he said on Q&A).

You can read Denton’s full reply here.

The Groningen Protocol

End-of-life decisions involving babies in the Netherlands has been governed since 2005 by very stringent conditions known as the Groningen Protocol. Dr Verhagen developed the protocol in 2004 and published it in the New England Journal of Medicine in 2005.

The Euthanasia Act came into effect in the Netherlands in 2002. Between 2005 and the introduction of the amendment to the legislation in 2007, adherence to the Groningen Protocol criteria was a defence for doctors involved in end-of-life decisions for babies.

In 2007, the Dutch government set up a legal provision which allows “the use of drugs by a physician with the explicit intention to end the life of a severely affected newborn” without being prosecuted if certain criteria are met, as outlined in a recent paper in the Journal of Medical Ethics.

The criteria include:

• the child is suffering unbearably and hopelessly
• the parents are fully informed about diagnosis and prognosis
• the paediatricians and parents together have reached the conclusion that there are no other reasonable ways to relieve the suffering of the child
• the parents have given consent and an independent physician has been consulted.

A further requirement of the rules is that a physician who ends the life of a newborn in this way must also report this act to an expert commission (consisting of three paediatricians, a lawyer and an ethicist) that reviews these cases based on the criteria of due care.

The expert committee has to inform the public prosecutor of its assessment, and the public prosecutor ultimately decides whether or not to prosecute (for murder or manslaughter).

A decreasing trend

University researchers conducted nationwide surveys relating to euthanasia in the Netherlands in 1995, 2001, 2005 and 2010.

They found that:

In 2010, 63% of all deaths of children under one year of age were preceded by an end-of-life decision – a percentage comparable to other times when this study was conducted (1995, 2001, 2005). These end-of-life decisions were mainly decisions to withdraw or withhold potentially life-sustaining treatment. In 2010, the percentage of cases in which drugs were administered with the explicit intention to hasten death was 1%, while in 1995 and 2001, this was 9% and in 2005, this was 8%… The 2010 sample included only two cases where physicians indicated that they had administered drugs with the explicit intention to hasten death.

In both of those cases, the physician’s actions were estimated to have shortened the babies' lives by a week at most, such was the seriousness of their health problems.

The researchers suggested that a decreasing frequency of end-of-life decisions for babies appears to correlate to the 2007 introduction of routine 20 week prenatal screening, at which point spina bifida can be detected. Some women decide at that point to terminate the pregnancy.

The Netherlands' euthanasia rate for adults in 2010, though higher than in 2005, was comparable with those in 2001 and 1995, a 2012 paper found.

A recent paper on this question concluded that:

National recommendations in the Netherlands for end-of-life decisions in newborns suggest that treatment should generally be seen as conditional. If treatment fails, it should be abandoned. In those cases, palliative care should be directed at both infant and parental suffering. Sometimes, this may permit interventions that hasten death.

Verdict

There is no credible evidence to support the claim that 550 babies were killed last year under Dutch euthanasia laws. While this claim does appear on some websites, it is not backed by reliable official data. – Colleen Cartwright

Review

This is a sound review. The author has provided useful links to official reports and policy documents. The issue of euthanasia is an emotional one, with the potential for ideological perspectives to outweigh reasoned analysis. It is vital that public debate be informed by reference to reliable data. – Lorana Bartels

The verdict is correct. I have two additions to this sound analysis. Providing euthanasia to babies is legal but not incorporated in law in the Netherlands. Specific governmental regulation was published to legalise and regulate newborn euthanasia. The criteria in the article are all correct but one should be added, namely: the newborn diagnosis must be certain. – Jan F. Koper.

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Colleen Cartwright has received funding from the RADGAC and ARC. She is a board member of Council on the Ageing NSW. For research purposes, she subscribes the Exit newsletter but is not an active member and does not attend their meetings.

Jan F. Koper and Lorana Bartels do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.