Dutch Court Decisions on Nonvoluntary Euthanasia Critically Reviewed

Issues in Law and Medicine

Volumn 13, Issue 4, 1998, Pages 447-458

  Jochemsen, Henk ^a  

^a Profdr GA Lindeboom Instituut   (Netherlands)

Author keywords

[No Author keywords available]

Indexed keywords

ACTIVE EUTHANASIA; ARTICLE; BEHAVIOR; BRAIN DISEASE; COMPARATIVE STUDY; CULTURAL FACTOR; CUSTODY; DEATH AND EUTHANASIA; ETHICS; EUTHANASIA; HANDICAPPED CHILD; HUMAN; JURISPRUDENCE; LEGAL APPROACH; LEGAL ASPECT; MEDICAL ETHICS; MENTAL STRESS; MISCELLANEOUS NAMED GROUPS; MORALITY; NETHERLANDS; NEWBORN; PALLIATIVE THERAPY; PARENTAL CONSENT; TREATMENT WITHDRAWAL; VULNERABLE POPULATION;

DEATH AND EUTHANASIA; LEGAL APPROACH;

BRAIN DISEASES; CROSS-CULTURAL COMPARISON; DISABLED CHILDREN; DOUBLE EFFECT; ETHICS; EUTHANASIA; EUTHANASIA, ACTIVE; HUMANS; INFANT, NEWBORN; INTENTION; JUDICIAL ROLE; LEGAL GUARDIANS; MORAL OBLIGATIONS; NETHERLANDS; PALLIATIVE CARE; PARENTAL CONSENT; PERSONS; STRESS, PSYCHOLOGICAL; VULNERABLE POPULATIONS; WEDGE ARGUMENT; WITHHOLDING TREATMENT;

EID: 0032017986     PISSN: 87568160     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (51)

1. The new legal regulation (Bill no. 22 572) amends the law on the disposal of the dead (article 10); the law as amended provides the legal basis both for the certification of natural death and the notification of all cases of euthanasia, assisted suicide and life-terminating action without request. The forms themselves are set out in an enactment ['Algemene Maatregel van Bestuur', AMvB]. This AMvB has been published in the STAATSBLAD, an official publication of the government, on Dec. 28, 1993, see Besluit van 17 Dec. 1993, STAATSBLAD 688.
2. H.J.J. Leenen, Dying with Dignity: Developments in the Field of Euthanasia in the Netherlands, 8 MED. & L. 517 (1989).
3. Acts of Second Chamber of Parliament, TK44 at 3286, 3319, 3324 (Feb. 2, 1993).
4. The results of the survey for the year 1990 have been published in P.J. van der Maas et al., Euthanasia and Other Medical Decisions Concerning the End of Life, 22 HEALTH POL'Y 1 (1992); see also L. PIJNENBORG, END-OF-LIFE DECISIONS IN DUTCH MEDICAL PRACTICE (1995) (thesis, Rotterdam). For a discussion of these data and of the legal regulation, see H. Jochemsen, Euthanasia in Holland: An Ethical Critique of the New Law, 20 J. MED. ETHICS 211 (1994); J. Keown, Euthanasia in the Netherlands: Sliding Down the Slippery Slope, in EUTHANASIA EXAMINED: ETHICAL, CLINICAL, & LEGAL PERSPECTIVES (J. Keown, ed. 1995). On neonatal euthanasia see NEDERLANDSE VERENIGING VOOR KINDERGENEESKUNDE, DOEN OF LATEN? GRENZEN VAN HET MEDISCH HANDELEN IN DE NEONATOLOGIE (Utrecht, 1992) [Dutch Association for Pediatrics, Doing or Leaving? Limits of Medical Care in Neonatology].
5. The results of the survey for the year 1990 have been published in P.J. van der Maas et al., Euthanasia and Other Medical Decisions Concerning the End of Life, 22 HEALTH POL'Y 1 (1992); see also L. PIJNENBORG, END-OF-LIFE DECISIONS IN DUTCH MEDICAL PRACTICE (1995) (thesis, Rotterdam). For a discussion of these data and of the legal regulation, see H. Jochemsen, Euthanasia in Holland: An Ethical Critique of the New Law, 20 J. MED. ETHICS 211 (1994); J. Keown, Euthanasia in the Netherlands: Sliding Down the Slippery Slope, in EUTHANASIA EXAMINED: ETHICAL, CLINICAL, & LEGAL PERSPECTIVES (J. Keown, ed. 1995). On neonatal euthanasia see NEDERLANDSE VERENIGING VOOR KINDERGENEESKUNDE, DOEN OF LATEN? GRENZEN VAN HET MEDISCH HANDELEN IN DE NEONATOLOGIE (Utrecht, 1992) [Dutch Association for Pediatrics, Doing or Leaving? Limits of Medical Care in Neonatology].
6. The results of the survey for the year 1990 have been published in P.J. van der Maas et al., Euthanasia and Other Medical Decisions Concerning the End of Life, 22 HEALTH POL'Y 1 (1992); see also L. PIJNENBORG, END-OF-LIFE DECISIONS IN DUTCH MEDICAL PRACTICE (1995) (thesis, Rotterdam). For a discussion of these data and of the legal regulation, see H. Jochemsen, Euthanasia in Holland: An Ethical Critique of the New Law, 20 J. MED. ETHICS 211 (1994); J. Keown, Euthanasia in the Netherlands: Sliding Down the Slippery Slope, in EUTHANASIA EXAMINED: ETHICAL, CLINICAL, & LEGAL PERSPECTIVES (J. Keown, ed. 1995). On neonatal euthanasia see NEDERLANDSE VERENIGING VOOR KINDERGENEESKUNDE, DOEN OF LATEN? GRENZEN VAN HET MEDISCH HANDELEN IN DE NEONATOLOGIE (Utrecht, 1992) [Dutch Association for Pediatrics, Doing or Leaving? Limits of Medical Care in Neonatology].
7. The results of the survey for the year 1990 have been published in P.J. van der Maas et al., Euthanasia and Other Medical Decisions Concerning the End of Life, 22 HEALTH POL'Y 1 (1992); see also L. PIJNENBORG, END-OF-LIFE DECISIONS IN DUTCH MEDICAL PRACTICE (1995) (thesis, Rotterdam). For a discussion of these data and of the legal regulation, see H. Jochemsen, Euthanasia in Holland: An Ethical Critique of the New Law, 20 J. MED. ETHICS 211 (1994); J. Keown, Euthanasia in the Netherlands: Sliding Down the Slippery Slope, in EUTHANASIA EXAMINED: ETHICAL, CLINICAL, & LEGAL PERSPECTIVES (J. Keown, ed. 1995). On neonatal euthanasia see NEDERLANDSE VERENIGING VOOR KINDERGENEESKUNDE, DOEN OF LATEN? GRENZEN VAN HET MEDISCH HANDELEN IN DE NEONATOLOGIE (Utrecht, 1992) [Dutch Association for Pediatrics, Doing or Leaving? Limits of Medical Care in Neonatology].
8. The results of the survey for the year 1990 have been published in P.J. van der Maas et al., Euthanasia and Other Medical Decisions Concerning the End of Life, 22 HEALTH POL'Y 1 (1992); see also L. PIJNENBORG, END-OF-LIFE DECISIONS IN DUTCH MEDICAL PRACTICE (1995) (thesis, Rotterdam). For a discussion of these data and of the legal regulation, see H. Jochemsen, Euthanasia in Holland: An Ethical Critique of the New Law, 20 J. MED. ETHICS 211 (1994); J. Keown, Euthanasia in the Netherlands: Sliding Down the Slippery Slope, in EUTHANASIA EXAMINED: ETHICAL, CLINICAL, & LEGAL PERSPECTIVES (J. Keown, ed. 1995). On neonatal euthanasia see NEDERLANDSE VERENIGING VOOR KINDERGENEESKUNDE, DOEN OF LATEN? GRENZEN VAN HET MEDISCH HANDELEN IN DE NEONATOLOGIE (Utrecht, 1992) [Dutch Association for Pediatrics, Doing or Leaving? Limits of Medical Care in Neonatology].
9. The results of the survey for the year 1990 have been published in P.J. van der Maas et al., Euthanasia and Other Medical Decisions Concerning the End of Life, 22 HEALTH POL'Y 1 (1992); see also L. PIJNENBORG, END-OF-LIFE DECISIONS IN DUTCH MEDICAL PRACTICE (1995) (thesis, Rotterdam). For a discussion of these data and of the legal regulation, see H. Jochemsen, Euthanasia in Holland: An Ethical Critique of the New Law, 20 J. MED. ETHICS 211 (1994); J. Keown, Euthanasia in the Netherlands: Sliding Down the Slippery Slope, in EUTHANASIA EXAMINED: ETHICAL, CLINICAL, & LEGAL PERSPECTIVES (J. Keown, ed. 1995). On neonatal euthanasia see NEDERLANDSE VERENIGING VOOR KINDERGENEESKUNDE, DOEN OF LATEN? GRENZEN VAN HET MEDISCH HANDELEN IN DE NEONATOLOGIE (Utrecht, 1992) [Dutch Association for Pediatrics, Doing or Leaving? Limits of Medical Care in Neonatology].
10. Apart from decisions to stop treatment, including tube feeding of patients in a persistent vegetative state (PVS), which in some cases (viz., where the doctor's purpose is to shorten life) can be seen as nonvoluntary euthanasia. A well-known case in the Netherlands is the Stinissen case, concerning a woman who died after sixteen years in a coma because of the withdrawal of food and fluids. The Court of Appeal in Arnhem condoned this withdrawal; see Zaak Stinissen, Gerechtshof Arnhem d.d. 31 October 1989, 14.1 TIJDSCHRIFT VOOR GEZONDHEIDSRECHT 79 (1990); and Staking toediening van vocht en voeding onrechtmatig? Court of Appeal Arnhem d.d. 16 January 1990, 14.2 TIJDSCHRIFT VOOR GEZONDHEIDSRECHT 167 (1990)
11. Apart from decisions to stop treatment, including tube feeding of patients in a persistent vegetative state (PVS), which in some cases (viz., where the doctor's purpose is to shorten life) can be seen as nonvoluntary euthanasia. A well-known case in the Netherlands is the Stinissen case, concerning a woman who died after sixteen years in a coma because of the withdrawal of food and fluids. The Court of Appeal in Arnhem condoned this withdrawal; see Zaak Stinissen, Gerechtshof Arnhem d.d. 31 October 1989, 14.1 TIJDSCHRIFT VOOR GEZONDHEIDSRECHT 79 (1990); and Staking toediening van vocht en voeding onrechtmatig? Court of Appeal Arnhem d.d. 16 January 1990, 14.2 TIJDSCHRIFT VOOR GEZONDHEIDSRECHT 167 (1990)
12. Geen vervolging euthanasie op wilsonbekwamen, NRC-HANDELSBLAD, Apr. 5, 1996 [no prosecution for euthanasia with incompetent]. Before the District Court in Groningen, the public prosecutor even spoke of a pseudo-legislative process. Speech of Prosecution in the Case Against K., District Court Groningen d.d. 30.10.1995, nr. 18. 070093/95, at 3.
13. G. VAN DER WAL & P.J. VAN DER MAAS, EUTHANASIE EN ANDERE MEDISCHE BESLISSINGEN ROND HET LEVENSEINDE. DE PRAKTIJK EN DE MELDINGSPROCEDURE (Den Haag, 1996) [Euthanasia and Other Medical Decisions Concerning the End of Life. Practice and Reporting Procedure]. For a summary see P.J. van der Maas et al., Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995, 335 NEW ENG. J. MED. 1699 (1996); G. van der Wal et al., Evaluation of the Notification Procedure for Physician-Assisted Death in the Netherlands, 335 NEW ENG. J. MED. 1706 (1996). For a discussion of these results see Richard Fenigsen, Dutch Euthanasia Revisited, 13 ISSUES IN LAW & MED. 301 (1997); and H. Jochemsen, Lessons From the Dutch: Does the Regulation Work? in LIFE AT RISK: A CLOSE LOOK AT ASSISTED SUICIDE (R.M. Doerflinger ed., in press).
14. G. VAN DER WAL & P.J. VAN DER MAAS, EUTHANASIE EN ANDERE MEDISCHE BESLISSINGEN ROND HET LEVENSEINDE. DE PRAKTIJK EN DE MELDINGSPROCEDURE (Den Haag, 1996) [Euthanasia and Other Medical Decisions Concerning the End of Life. Practice and Reporting Procedure]. For a summary see P.J. van der Maas et al., Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995, 335 NEW ENG. J. MED. 1699 (1996); G. van der Wal et al., Evaluation of the Notification Procedure for Physician-Assisted Death in the Netherlands, 335 NEW ENG. J. MED. 1706 (1996). For a discussion of these results see Richard Fenigsen, Dutch Euthanasia Revisited, 13 ISSUES IN LAW & MED. 301 (1997); and H. Jochemsen, Lessons From the Dutch: Does the Regulation Work? in LIFE AT RISK: A CLOSE LOOK AT ASSISTED SUICIDE (R.M. Doerflinger ed., in press).
15. G. VAN DER WAL & P.J. VAN DER MAAS, EUTHANASIE EN ANDERE MEDISCHE BESLISSINGEN ROND HET LEVENSEINDE. DE PRAKTIJK EN DE MELDINGSPROCEDURE (Den Haag, 1996) [Euthanasia and Other Medical Decisions Concerning the End of Life. Practice and Reporting Procedure]. For a summary see P.J. van der Maas et al., Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995, 335 NEW ENG. J. MED. 1699 (1996); G. van der Wal et al., Evaluation of the Notification Procedure for Physician-Assisted Death in the Netherlands, 335 NEW ENG. J. MED. 1706 (1996). For a discussion of these results see Richard Fenigsen, Dutch Euthanasia Revisited, 13 ISSUES IN LAW & MED. 301 (1997); and H. Jochemsen, Lessons From the Dutch: Does the Regulation Work? in LIFE AT RISK: A CLOSE LOOK AT ASSISTED SUICIDE (R.M. Doerflinger ed., in press).
16. G. VAN DER WAL & P.J. VAN DER MAAS, EUTHANASIE EN ANDERE MEDISCHE BESLISSINGEN ROND HET LEVENSEINDE. DE PRAKTIJK EN DE MELDINGSPROCEDURE (Den Haag, 1996) [Euthanasia and Other Medical Decisions Concerning the End of Life. Practice and Reporting Procedure]. For a summary see P.J. van der Maas et al., Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995, 335 NEW ENG. J. MED. 1699 (1996); G. van der Wal et al., Evaluation of the Notification Procedure for Physician-Assisted Death in the Netherlands, 335 NEW ENG. J. MED. 1706 (1996). For a discussion of these results see Richard Fenigsen, Dutch Euthanasia Revisited, 13 ISSUES IN LAW & MED. 301 (1997); and H. Jochemsen, Lessons From the Dutch: Does the Regulation Work? in LIFE AT RISK: A CLOSE LOOK AT ASSISTED SUICIDE (R.M. Doerflinger ed., in press).
17. G. VAN DER WAL & P.J. VAN DER MAAS, EUTHANASIE EN ANDERE MEDISCHE BESLISSINGEN ROND HET LEVENSEINDE. DE PRAKTIJK EN DE MELDINGSPROCEDURE (Den Haag, 1996) [Euthanasia and Other Medical Decisions Concerning the End of Life. Practice and Reporting Procedure]. For a summary see P.J. van der Maas et al., Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995, 335 NEW ENG. J. MED. 1699 (1996); G. van der Wal et al., Evaluation of the Notification Procedure for Physician-Assisted Death in the Netherlands, 335 NEW ENG. J. MED. 1706 (1996). For a discussion of these results see Richard Fenigsen, Dutch Euthanasia Revisited, 13 ISSUES IN LAW & MED. 301 (1997); and H. Jochemsen, Lessons From the Dutch: Does the Regulation Work? in LIFE AT RISK: A CLOSE LOOK AT ASSISTED SUICIDE (R.M. Doerflinger ed., in press).
18. G. VAN DER WAL & P.J. VAN DER MAAS, EUTHANASIE EN ANDERE MEDISCHE BESLISSINGEN ROND HET LEVENSEINDE. DE PRAKTIJK EN DE MELDINGSPROCEDURE (Den Haag, 1996) [Euthanasia and Other Medical Decisions Concerning the End of Life. Practice and Reporting Procedure]. For a summary see P.J. van der Maas et al., Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995, 335 NEW ENG. J. MED. 1699 (1996); G. van der Wal et al., Evaluation of the Notification Procedure for Physician-Assisted Death in the Netherlands, 335 NEW ENG. J. MED. 1706 (1996). For a discussion of these results see Richard Fenigsen, Dutch Euthanasia Revisited, 13 ISSUES IN LAW & MED. 301 (1997); and H. Jochemsen, Lessons From the Dutch: Does the Regulation Work? in LIFE AT RISK: A CLOSE LOOK AT ASSISTED SUICIDE (R.M. Doerflinger ed., in press).
19. See supra notes 4 & 7 for further proof of this conclusion.
20. Vonnis Arrondissementsrechtbank te Alkmaar d.d. 26 April 1995, in the case against P, 19.5 TIJDSCHRIFT VOOR GEZONDHEIDSRECHT 292-301 (1995).
21. Vonnis Rechtbank te Groningen d.d. 13 November 1995, in the case against K, 3.1 PRO VITA HUMANA 29-32 (1996).
22. Arrest Gerechtshof te Amsterdam d.d. 7 November 1995, in the case against P, 3.1 PRO VITA HUMANA 25, ¶ 8 (1996).
23. Arrest Gerechtshof te Leeuwarden d.d. 4 April 1996, in the Case Against K, 20.5 TIJDSCHRIFT VOOR GEZONDHEIDSRECHT 284, ¶ 9 (1996).
24. See supra note 9, at 294.
25. See supra note 11, at ¶ 19.
26. J.J. Rotteveel, et al., Actieve levensbeëindtging bij pasgeborenen met spina bifida? 140.6 NED TIJDSCHR GENEESKUNDE 323 (1996) [Active Termination of Life of Newborn Babies With Spina Bifida?].
27. H.J.J. Leenen, Actieve levensbeëindiging bij een ernstig gehandicapte baby, 23 NED JURISTENBLAD 851 (1995).
28. See supra note 10, at 30 (by stating this, the court does not mean to deny that physicians and relatives make decisions that affect the life and moment of death, it means to say that a decision to intentionally terminate the life of a patient can never be taken by a proxy).
29. See supra note 12, at ¶ 12.10.
30. See supra note 9, at 293.
31. Id. at 300.
32. See supra note 11, at 27, ¶ 15.
33. See supra note 9, at 300.
34. See supra note 10, at 32.
35. See supra note 11, at ¶ 22, and note 12, ¶ 12.11 (this is a more or less standard formulation that courts use in justifying the acceptance of the appeal to the defense of necessity by a physician who performed euthanasia).
36. See supra note 10, at 32.
37. See supra note 12, at ¶ 19.
38. Chabot is a psychiatrist who assisted a mentally suffering patient in committing suicide. His case ultimately came before the Supreme Court. The Supreme Court decision of June 21, 1994 was published in 69 NED JURISTENBLAD 895 (1994). For an extensive discussion of this case see H. Hendin, Seduced by Death: Doctors, Patients, and the Dutch Cure, 10 ISSUES IN LAW & MED. 123 (1994). For the position of the ministers of Justice and of Health Care, see W. Sorgdrager & E. Borst-Eilers, Euthanasie. De stand van zaken, 50 MEDISCH CONTACT 381 (1995) [Euthanasia. The State of the Art]. The position of the KNMG has been published in W.R. KASTELEIN, STANDPUNT HOOFDBESTUUR KNMG INZAKE EUTHANASIE (1995) [Position General Committee KNMG on Euthanasia].
39. Chabot is a psychiatrist who assisted a mentally suffering patient in committing suicide. His case ultimately came before the Supreme Court. The Supreme Court decision of June 21, 1994 was published in 69 NED JURISTENBLAD 895 (1994). For an extensive discussion of this case see H. Hendin, Seduced by Death: Doctors, Patients, and the Dutch Cure, 10 ISSUES IN LAW & MED. 123 (1994). For the position of the ministers of Justice and of Health Care, see W. Sorgdrager & E. Borst-Eilers, Euthanasie. De stand van zaken, 50 MEDISCH CONTACT 381 (1995) [Euthanasia. The State of the Art]. The position of the KNMG has been published in W.R. KASTELEIN, STANDPUNT HOOFDBESTUUR KNMG INZAKE EUTHANASIE (1995) [Position General Committee KNMG on Euthanasia].
40. Chabot is a psychiatrist who assisted a mentally suffering patient in committing suicide. His case ultimately came before the Supreme Court. The Supreme Court decision of June 21, 1994 was published in 69 NED JURISTENBLAD 895 (1994). For an extensive discussion of this case see H. Hendin, Seduced by Death: Doctors, Patients, and the Dutch Cure, 10 ISSUES IN LAW & MED. 123 (1994). For the position of the ministers of Justice and of Health Care, see W. Sorgdrager & E. Borst-Eilers, Euthanasie. De stand van zaken, 50 MEDISCH CONTACT 381 (1995) [Euthanasia. The State of the Art]. The position of the KNMG has been published in W.R. KASTELEIN, STANDPUNT HOOFDBESTUUR KNMG INZAKE EUTHANASIE (1995) [Position General Committee KNMG on Euthanasia].
41. Chabot is a psychiatrist who assisted a mentally suffering patient in committing suicide. His case ultimately came before the Supreme Court. The Supreme Court decision of June 21, 1994 was published in 69 NED JURISTENBLAD 895 (1994). For an extensive discussion of this case see H. Hendin, Seduced by Death: Doctors, Patients, and the Dutch Cure, 10 ISSUES IN LAW & MED. 123 (1994). For the position of the ministers of Justice and of Health Care, see W. Sorgdrager & E. Borst-Eilers, Euthanasie. De stand van zaken, 50 MEDISCH CONTACT 381 (1995) [Euthanasia. The State of the Art]. The position of the KNMG has been published in W.R. KASTELEIN, STANDPUNT HOOFDBESTUUR KNMG INZAKE EUTHANASIE (1995) [Position General Committee KNMG on Euthanasia].
42. Waar de wegen van twee kinderartsen scheiden, REFORMATORISCH DAGBLAD, annex RD/Accent, Apr. 20, 1996, at 8 [Where the Paths of two Pediatricians Separate].
43. Interview with G. van Bruggen & H.A.A. Brouwers, Pediatricians, EO-Tijdsein Radio (Apr. 18, 1996) (Discussion about the case of Doctor K).
44. Cf. G. van der Wal, et al., Bij justitie gemelde euthanasie en hulp bij zelfdoding, 47 MEDISCH CONTACT 1023 (1992) [Two Juridicial Authorities Reported Euthanasia and Assisted Suicide]. See also G. VAN DER WAL & P.J. VAN DER MAAS, supra note 7, ch. 11.
45. Cf. G. van der Wal, et al., Bij justitie gemelde euthanasie en hulp bij zelfdoding, 47 MEDISCH CONTACT 1023 (1992) [Two Juridicial Authorities Reported Euthanasia and Assisted Suicide]. See also G. VAN DER WAL & P.J. VAN DER MAAS, supra note 7, ch. 11.
46. See also H. Jochemsen, Life-Prolonging and Life-Terminating Treatment of Severely Handicapped Newborn Babies: A Discussion of the Report of the Royal Dutch Society of Medicine on 'Life-Terminating Actions with Incompetent Patients: Part 1: Severely Handicapped Newborns,' 8 ISSUES IN LAW & MED. 167 (1992).
47. D. Callahan, When Self-Determination Runs Amok, HASTINGS CENTER REP., Mar./Apr. 1992, at 52; and D. Callahan, Can We Return Death to Disease? HASTINGS CENTER REP., Special Supp., Jan./Feb. 1989, at 4.
48. D. Callahan, When Self-Determination Runs Amok, HASTINGS CENTER REP., Mar./Apr. 1992, at 52; and D. Callahan, Can We Return Death to Disease? HASTINGS CENTER REP., Special Supp., Jan./Feb. 1989, at 4.
49. See supra When Self-Determination Runs Amok, note 32, at 54; see also supra note 7.
50. See, e.g., WHICH BABIES SHALL LIVE? HUMANISTIC DIMENSIONS OF THE CARE OF IMPERILED NEWBORNS (T.H. Murray & A.L. Caplan eds. 1985); Special Issue on Imperiled Newborns, HASTINGS CENTER REP., 1987, at 1.
51. See, e.g., WHICH BABIES SHALL LIVE? HUMANISTIC DIMENSIONS OF THE CARE OF IMPERILED NEWBORNS (T.H. Murray & A.L. Caplan eds. 1985); Special Issue on Imperiled Newborns, HASTINGS CENTER REP., 1987, at 1.