Abstract
In 2014, Belgium became the first country in the world to legislate euthanasia for children. The decision evoked questions and criticisms in Belgium and in the world at large: should children have the right to ask to die? Are children able to make reasoned and independent choices on such an important matter? Does maturity matter? Are children as autonomous as adults? Is it a logical move to grant terminally ill children who are in intolerable pain this right? What happens if there is a conflict of wishes between the child and parents? This article argues that these questions should be addressed while legislators are fully aware of the relevant medical data regarding child development. The article weighs arguments for and against euthanasia for children, dis cussing patients' autonomy, competence, age and maturity, pressure and abuse, and palliative care. It is suggested that the option of pediatric palliative care should be exhausted before proceeding to euthanasia, and that psychological counselling be made available to both children and guardians. It is further argued that the law should explicate the age of children, and that it should insist on consensus between children and parents.
Highlights
In 2014, Belgium became the first country in the world to allow euthanasia of minors, irrespective of their age
The prenatal period is from conception to birth; infancy is between the time of birth to 18-24 months; early childhood extends from the end of infancy to 6 or 7-year-old of age
We establish age of consent and limit the voting age as we believe that some issues are better reserved to a later stage of life, when we develop our mental and physical faculties and could cope with partnership, sexuality, desires, the raising of children and the duties of citizenship
Summary
In 2014, Belgium became the first country in the world to allow euthanasia of minors, irrespective of their age. In February 2014, after many legislative proposals to amend the Act and further extensive hearings, the Belgian parliament voted to extend the euthanasia law to include minors under the age of 18. In her comments on a draft of this paper, Professor Jutte Van der Werff Ten Bosch wrote that “physicians can discuss euthanasia and initiate the discussion” Testifying about her own experience, she said that “I always take it along in a discussion on end of life care decisions, explaining to parents if or if not their child could possibly ask for euthanasia”.8. When such a request is initiated by the medical team, this may affect the voluntariness of the decision. A commission oversees the practice of euthanasia to ensure compliance with the governance procedures (Editorial 2014)
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