POLICY: Medpundit totally misreads the euthanasia debate in Europe, and is incredibly insulting to boot.

I tread gently around criticizing Sydney at Medpundit because her blog is so good even if her politics are increasingly "out of the mainstream" and the evidence she uses to support them is often incomplete, nay baffling. (See this piece reviewed by Ross on how Kerry planned to put everyone into Medicaid, although her argument rested on the ridiculous assumption that all employers would simply stop offering health benefits if Medicaid eligibility were expanded–even though there’s nothing stopping them from dropping benefits now, theoretically).

But in her Tech Central Station piece on the euthanasia issue in the Netherlands she has crossed the line and needs to be repudiated. The issue is that some Dutch doctors have decided after consultation with parents and the judiciary to euthanize terminally-ill babies rather than withdraw care and feeding and have them starve to death. It seems to be done with the utmost care and sensitivity:

"It is for very sad cases," said a hospital spokesman, who declined to be identified. "After years of discussions, we made our own protocol to cover the small number of infants born with such severe disabilities that doctors can see they have extreme pain and no hope for life. Our estimate is that it will not be used but 10 to 15 times a year."A parent’s role is limited under the protocol. While experts and critics familiar with the policy said a parent’s wishes to let a child live or die naturally most likely would be considered, they note that the decision must be professional, so rests with doctors. The protocol was written by hospital doctors and officials, with help from Dutch prosecutors. It’s being studied by lawmakers as potential law. Under the protocol, assisted infant deaths are investigated, but so far all of them have been determined to have been in the patients’ best interests.

Both the Dutch and philosopher Peter Singer feel that their actions are morally similar to abortion when a foetus has no hope for life. No doubt Syd disagrees with this, and probably (although I don’t know) with the legality of abortion too. Many who share her views on that also disagree with contraception, and even male masturbation as depriving the possibility of life (for a lot more on the social repression of masturbation up to the firing of Jocelyn Elders for mentioning it see here, but be warned there are some graphic pictures).

Disagreement over these issues is bound to happen and be controversial. However, Sydney goes on in her article to equate the behavior of the Dutch doctors, judges and parents as being the moral equivalent of the people who have committed genocide in Germany, the former Yugoslavia and the Sudan. That is a reprehensible thing to say. And there is a shiningly clear difference. The people in the Netherlands are clearly trying to do what they believe to the best thing for the children concerned. Syd may not agree that what they did was in the best interests of the children, but that is what the Dutch believe. I don’t know if Syd approves of the conventional treatment here of withdrawing food and care and allowing terminally ill kids to starve to death, but to me morally they amount to the same thing. Coincidentally, this week’s Pediatrics journal has an article on Do Not Resucitate orders for children undergoing surgery, which included a survey of pediatric surgeons and anesthesiologists. It finds that:

The majority of anesthesiologists (86%) and surgeons (94.7%) were willing to withdraw life support at the request of the family a few days after surgery if a child suffered an arrest in the operating room, was resuscitated, and had an adverse change in quality of life. The majority of anesthesiologists (55.1%) felt that the perioperative period ended when the child left the recovery room, with only 38.2% of surgeons agreeing (P = .0037). Many anesthesiologists (22.4%) and surgeons (39.5%) felt that the perioperative period should be extended until 24 hours after surgery.

Given that withdrawing life support means that the terminally ill child will die, there’s logically little difference between this and the direct euthanizing that’s happening in a few cases in the Netherlands. I’d argue that there’s no real "slope" whether slippery or not between these actions but there is a vast series of huge steps down to genocide. And logically if that’s the case then Sydney’s accusing the vast majority of physicians in this survey of being on the same moral stature as those involved in genocide.

That type of accusation has no place in our relatively civilized corner of the blogosphere, and if Syd won’t make that clear, the rest of us have a responsibility to call her out on it.

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