Assessment procedures regarding end-of-life decisions in neonatology in the Netherlands

Medicine and Law

Volumn 24, Issue 4, 2005, Pages 803-829

  Dorscheidt, Jozef H H M ^a  

^a UNIVERSITY OF GRONINGEN   (Netherlands)

Author keywords

Dutch law; ECHR; End of life; Neonatology

Indexed keywords

ADVISORY COMMITTEE; ARTICLE; COURT; EUTHANASIA; HUMAN; HUMAN RIGHTS; INFANTICIDE; INTERDISCIPLINARY COMMUNICATION; LAW; MEDICAL ASSESSMENT; MEDICAL DECISION MAKING; MEDICAL ETHICS; MEDICAL PRACTICE; MORTALITY; NETHERLANDS; NEWBORN; NEWBORN DISEASE;

EID: 30744449542     PISSN: 07231393     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (88)

1. Meldingsprocedure euthanasie, Medisch Contact (Medical Contact; Journal of the Royal Dutch Medical Association) 52, 1997, nr. 13, pp. 420-425.
2. Toetsing als spiegel van de medische praktijk (Assessment as a mirror of medical practice). Report of the consultant group on the assessment of careful medical practice regarding the end of life of neonates. Publication of the Minister of Health Care, Welfare & Sport, Rijswijk September 1997.
3. Court of Appeals Amsterdam, November 7th, 1995, Tijdschrift voor Gezondheidsrecht (Dutch Journal of Health Law) 20, 1996, nr. 1996/1, pp. 30-36.
4. Court of Appeals Leeuwarden, April 4th 1996, Tijdschrift voor Gezondheidsrecht (Dutch Journal of Health Law) 20, 1996, nr. 1996/35, pp. 284-291.
5. Supreme Court April 28th 1989, Tijdschrift voor Gezondheidsrecht (Dutch Journal of Health Law) 13, 1989, nr. 6, 1989/51;
6. NJ (Dutch Jurisprudence) 1990, 46.
7. G. van der Wal, A. van der Heide, B.D. Ontwuteaka-Philipsen, P.J. van der Maas: Medische besluitvorming aan het einde van het leven. De praktijk en de toetsingsprocedure euthanasie. (Medical decision making at het end of life. The practice and the assessment procedure on euthanasia) Utrecht: De Tijdstroom 2003.
8. G. van der Wal, e.a., o.c., pp. 118-122.
9. Decision of April 29th 1994, Stb. (Statute Book) 1994, 321.
10. A general review of this procedure offers A. Kors: Regeling, inhoud en strekking van de meldingsprocedure, in J. Legemaate & R.J.M. Dillmann (eds.): Levensbe?indigend handelen door een arts: tussen norm en praktijk, (Termination of life by a physician: between norm and practice) Houten/Diegem: Bohn Stafleu Van Loghum, 1998, pp. 45-60.
11. In Dutch jurisprudence and an earlier ministerial regulation it was already accepted that the physician who deliberately terminates life is not allowed to declare that the patient died of a natural cause. By delivering a declaration of natural death in case of a deliberate termination of life the physician commits a crime under Art 228 of the Dutch Penal Code. See District Court Rotterdam March 20, 1985, NJ (Dutch Jurisprudence) 1985,627; Court of Appeals's Gravenhage April 2nd, 1987, NJ (Dutch Jurisprudence) 1987, 756 and Supreme Court December 15th, 1987, NJ (Dutch Jurisprudence) 1988, 811. In later court decisions this line was continued.
12. To this purpose the use of a special form required; Decision of March 6st 2002, Stb. (Statute Book) 2002, 140.
13. Decision of December 17th 1993, Stb. (Statute Book) 1993, 688 (Annex A & B).
14. Recommendations as to a decision to prosecute in case of active termination of life on request, Stcrt. (Statute Journal) 2003, 248.
15. Tweede Kamer (Lower House of the Dutch Parliament), 1991-1992, 22572, nr. 6, p. 11.
16. This study revealed, among other things, only a small amount of reported cases in which the life of disabled newborn children was deliberately terminated. See G. van der Wal, P.J. van derMaas (red.): Euthanasie en andere medische beslissingen rond het levenseinde. (Euthanasia and other medical decisions regarding the end of life) Den Haag: SDU, 1996, pp. 237 and 238.
17. The Royal Dutch Medical Association (KNMG) supported the idea of establishing a MAC; see Meldingsprocedure euthanasie, Medisch Contact (Medical Contact) 52, 1997, nr. 13, p. 424.
18. Tweede Kamer (Lower House of the Dutch Parliament) 1996-1997, 23877, nr. 13, p. 5 en 6;
19. Tweede Kamer (Lower House of the Dutch Parliament)1996-1997, 23877, nr. 14, p. 2.
20. Tweede Kamer (Lower House of the Dutch Parliament) 1995-1996, 23877, nr. 13, p. 6. At first Parental Federations were rather sceptical about the use and exact position of a MAC.
21. See Tweede Kamer (Lower House of the Dutch Parliament) 1995-1996, 23877, nr. 15, pp. 23-26.
22. Toetsing als spiegel van de medische praktijk (Assessment as a mirror of medical practice), o.c., see note 2.
23. See note 15.
24. Toetsing als spiegel van de medische praktijk, (Assessment as a mirror of medical practice) o.c., pp. 11, 12 en 39.
25. Toetsing als spiegel van de medische praktijk, (Assessment as a mirror of medical practice), o.c., p. 37.
26. In equal terms H.D.C Roscam Abbing in: H.D.C. Roscam Abbing, R.J.M. Dillmann: Gezondheidsrecht en gezondheidsethiek; een dialoog (1), Medisch Contact (Medical Contact; Journal of the Royal Dutch Medical Association) 52, 1997, nr. 7, p. 220-224, i.c. pp. 220/221.
27. Leenen did not explain what was meant by this. Obviously, he thought that criminal prosecution in these cases was not appropriate. See H.J.J. Leenen: Regulering van euthanasie, melding en commissies, Medisch Contact (Medical Contact; Journal of the Royal Dutch Medical Association) 52, 1997, nr. 2, p. 45-48;
28. H.J.J. Leenen: Euthanasie, strafrecht, melding en toetsing, in: J. Legemaate & R.J.M. Dillmann (red.): Levensbe?indigend handelen door een arts: tussen norm en praktijk (Termination of life by a physician: between norm and practice), Houten/Diegem: Bohn Stafleu Van Loghum, 1998, pp. 235-248.
29. Toetsing als spiegel van de medische praktijk (Assessment as a mirror of medical practice), o.c., pp. 33 & 37.
30. P. van Dijk, G.J.H. van Hoof, et al.: Theory and Practice of the European Convention on Human Rights, o.c., p. 296-308;
31. Jacobs & White: European Convention on Human Rights, third edition.(C. Ovey & R.C.A. White), Oxford/New York: Oxford University Press, 2002, pp. 42-57.
32. An analysis of the protection of the viable unborn child from a children's rights perspective offers J.H.H.M. Dorscheidt: The unborn child and the UN-Convention on Children's Rights; the Dutch perspective as a guideline, The International Journal of Children's Rights 7, 1999, nr. 4, pp. 303-347.
33. B.G. Ramcharan: The drafting history of Article 2 of the European Convention on human rights, in B.G. Ramcharan (ed.): The right to life in international law, Dordrecht/Boston/Lancaster: Martinus Nijhoff Publishers, 1985, pp. 57-62.
34. D.H.M. Meuwissen: De Europese Conventie en het Nederlandse recht (The European Convention and Dutch Law). Leiden: Sijthoff, 1968, pp. 203/204;
35. H.J.J. Leenen: Levensbe?indiging bij ernstig gehandicapte pasgeborenen. Van neonatologie naar neothanatologie? Medisch Contact ((Medical Contact; Journal of the Royal Dutch Medical Association) 43, 1988, nr. 36, pp. 1050-1052;
36. H.J.J. Leenen: Mag een zorgvuldig handelende arts het leven be?indigen zonder verzoek?, Tijdschrift voor Geneeskunde en Ethiek (Dutch Journal of Medicine and Ethics) 2, 1992, nr. 2, pp. 47-48;
37. H.J.J. Leenen: Artikel 2, in J.K.M. Gevers (ed.): Het EVRM en de gezondheidszorg (The ECHR and health care), Nijmegen: Ars Aequi Libri, 1994, pp. 27-40, i.c. p. 35 and 39;
38. H.J.J. Leenen: Handboek gezondheidsrecht. Deel I: Rechten van mensen in de gezondheidszorg (Handbook on health law, Part I: Rights of people in health care) 4th revised edition, Houten/Diegem: Bohn Stafleu Van Loghum, 2000, p. 314;
39. H.J.J. Leenen: Levensbe?indiging zonder verzoek, Medisch Contact (Medical Contact; Journal of the Royal Dutch Medical Association) 56, 2001, nr. 20, pp. 775-777.
40. Pretty v. United Kingdom (Appl.nr. 2346/02)29april 2002, ECHR 2002, 35 EHRR 1.
41. Tweede Kamer (Lower House of the Dutch Parliament) 2002-2003, Aanhangsel, nr. 183, p. 383-384.
42. Preambules of several UN Human Rights instruments express a passage that states '...recognition of the inherent dignity and of the equal and inalienable (curs. JD) rights of all members of the human family is the foundation of freedom, justice and peace in the world!. As the word 'inalienable' is not contained by any Convention's text it remains unclear which rights are meant by this phrase or what the inalienability of these rights legally reflects. '...recognition of the inherent dignity and of the equal and inalienable (curs. JD) rights of all members of the human family is the foundation of freedom, justice and peace in the world!. As the word 'inalienable' is not contained by any Convention's text it remains unclear which rights are meant by this phrase or what the inalienability of these rights legally reflects.
43. D.H.M. Meuwissen: De Europese Conventie en het Nederlandse recht, (The European Convention and Dutch Law), o.c., p. 438;
44. T.M. Schalken: Euthanasie en de rechtspolitiecke betekenis van een gewetensconflict, Nederlands Juristenblad (Dutch Journal of Law) 59, 1984, afl. 2, pp. 38-50, i.c., p. 44;
45. M. de Blois: Het recht op de persoonlijke integriteit in het internationale recht, (The right to personal integrity in international law) Amsterdam Thesis, 1988, pp. 259-263;
46. Jacobs & White: European Convention on Human Rights, third edition, o.c., p. 55.
47. E.A. Alkema: De Europese Conventie voor de rechten van de mens en de Nederlandse rechtsorde, in: D.H.M. Meuwissen/E.A. Alkema: De Europese Conventie en het Nederlandse recht, (The European Convention and Dutch Law), Kluwer 1976, p. 131.
48. Less explicit is P. van Dijk, G.J.H. van Hoof, et al.: Theory and Practice of the European Convention on Human Rights, o.c., p. 303.
49. Eerste Kamer (Upper House of the Dutch Parliament) 2000-2001, 26691, nr. 137d, p. 3.
50. W. Strasser: The relationship between substantive rights and procedural rights guaranteed by the European Convention on Human Rights, in F. Matscher & H. Petzold (eds.): Protecting Human Rights: The European Dimension, Studies in honour of G?rard J. Wiarda, K?ln/Berlin etc.: Carl Heymanns Verlag, 1988, pp. 595-604.
51. Klass & others v. Federal Republic of Germany, September 6st, 1987, ECHR, Series A vol. 28, par. 64.
52. Platform "?rzte f?r das Leben", 21 June 21st 1988, ECHR, Series A vol. 139, par. 24-39.
53. Silver v. United Kingdom, March 25th 1983, ECHR Series A, nr. 61, par. 113;
54. Leander v. Sweden, March 26th 1987, ECHR Series A, nr. 116, par. 77 under a.
55. Also F.J Hampson: The concept of an 'arguable claim' under Article 13 of the European Convention on Human Rights, International and Comparative Law Quaterly 39, 1990, pp. 891-899.
56. Zie T. Barkhuysen: Artikel 13 EVRM: effectieve nationale rechtsbescherming bij schending van mensenrechten (Art. 13 ECHR: effective national remedy in case of a violation of human rights), Lelystad: Koninklijke Vermande, 1997, pp. 55-71.
57. T. Barkhuysen: Artikel 13 EVRM: effectieve nationale rechtsbescherming bij schending van mensenrechten (Art. 13 ECHR: effective national remedy in case of a violation of human rights), o.c., p. 41.
58. Keenan v. United Kingdom (Appl.nr. 27229/95) April 3rd, 2001 (2001), 33 EHRR 913.
59. McCrann and others v. United Kingdom September 27th, 1995, (1996) 21 EHRR 97, par. 161; ?aciki v. Turkey (Appl.nr. 23657/94) July 8th, 1999, (2001) 31 EHRR 133.
60. Jacobs & White: European Convention on Human Rights, third edition, o.c., pp. 48-51.
61. Keenan v. United Kingdom, o.c., par. 122.
62. Kaya v. Turkey (Appl.nr. 22729/93) February 19th, 1998, (1999) 28, EHRR 1, par. 86 en 107.
63. In regard of the investigational duty resulting from Art. 2 ECHR. Also Edwards vs. United Kingdom, June 14th 2002, (2002) 35 EHRR 487, par. 74.
64. Compare also M. Boone in NJCM-Bulletin 28, 2003, nr. 5, pp. 641-652.
65. See Golder v. United Kingdom, February 21st, 1975, ECHR, Series A vol. 18, par. 33;
66. Klass & others v. Federal Republic of Germany, September 6st, 1987, ECHF, Series A vol. 28, par. 67.
67. As for a comprehensive reflection of the requirement of effectivity, see T. Barkhuysen: Artikel 13 EVRM: effectieve nationale rechtsbescherming bij schending van mensenrechten (Art. 13 ECHR: effective national remedy in case of a violation of human rights), o.c., pp. 113-151.
68. Compare Toetsing als spiegel van de medische praktijk, (Assessment as a mirror of medical practice), o.c. pp. 33 and 37.
69. A settlement without interference of criminal law has been argued by E.Ph.R. Sutorius: Invloed van het recht op de kwaliteit van leven en sterven, in: L. Boon (red.): Beslissen over leven & dood. (Deciding on life and death) Dilemma's bij wilsonbekwame ernstige gehandicapte pasgeborenen, coma-pati?nten, zwakzinnigen en psycho-geriatrische pati?nten, Amstelveen: Stichting Sympoz. 1989, p. 25.
70. Griffiths et al. stressed the need for settlement by the medical profession, for instance through interference of disciplinary law.
71. Griffiths et al. stressed the need for settlement by the medical profession, for instance through interference of disciplinary law. See J. Griffiths, A. Bood, H. Weyers: Euthanasia and Law in the Netherlands, Amsterdam: Amsterdam University Press 1998, pp. 284-295.
72. A similar settlement of deliberate termination of newborn life as currently in use for cases of euthanasia and physician assisted suicide was argued by P.M. Sauer, A.A.E. Vethagen: Arts moet kind uit uitzichtloos hiden kunnen verklossen, NRC Handelsblad (NRC Newspaper) 9 februari 2002.
73. See also E. Vermeulen: Uit nood geboren. Levensbe?indigend handelen in de Belgische en Nederlandse neonatologie, in M. Adams, J. Griffiths, G. den Hartogh (red.): Euthanasie. Nieuwe knelpunten in een voortgezette discussie (Euthanasia. New bottlenecks in a prolonged discussion) Kampen: Kok 2003, pp. 296 and 297.
74. According to the Minister of Justice Korthals in Tweede Kamer (Lower House of the Dutch Parliament), 2000-2001, 26691, nr. 22, p. 64.
75. Tweede Kamer (Lower House of the Dutch Parliament) 1999-2000,26691, nr. 5, pp. 71/72;
76. Tweede Kamer (Lower House of the Dutch Parliament) 1999-2000, 26691, nr. 6, pp. 99/100.
77. B.H. ter Kuile: Nederlandse euthanasiewetgeving. Een juridische beschouwing, (Dutch regulations on euthanasia. A legal reflection) SI-EUR-Reeks 30, Rotterdam: Sanders Instituut/Kluwer, 2002, pp. 61-65;
78. J.J.H. Suyver: De positie van de toetsingscommissies onder de nieuwe euthanasiewet, Tijdschrift voor gezondheidsrecht (Dutch Journal of Health Law) 2003, nr. 4, p. 254-258.
79. As for the nature and content of the legislator's obligation to reasonably motivate regulations that consern fundamental human rights issues, see K. Waaldijk: Motiveringsplichten van de wetgever, (Motivational duties of the legislator) Lelystad: Koninklijke Vermande, 1994, pp. 47-61 and pp. 355/356.
80. (2001) UN Doc. CCPR/CO/72/NET, par. 6.
81. CRC/C/15/Add.227, par. 33 en 34. (Unedited version).
82. As for the requirements of careful practice, see Toetsing als spiegel van de medische praktijk (Assessment as a mirror of medical practice), o.c., pp. 25-31.
83. This agreement became known as the 'Groningen Protocol'. The content of this protocol is discussed in A.A.E. Verhagen, PJJ Sauer: The Groningen protocol - Euthanasia in severly ill newborns, New England Journal of Medicine, 2005, 352, pp. 959-962.
84. See also A.A.E. Verhagen, PJJ Sauer: End-of-life decisions in newborns; an approach from the Netherlands, Pediatrics Vol. 116, (2005), no. 3, pp. 736-739.
85. J.H.H.M. Dorscheidt, A.A.E. Verhagen; Een centrale toetsingscommissie voor beslissingen rond het levenseinde bij pasgeborenen: een brug te ver, Nederlands Juristenblad (Dutch Law Journal) 79, 2004, afl. 41, pp. 2141-2147.
86. A.A.E. Verhagen, J.J. Sol, O.F. Brouwer, P.J.J. Sauer: Actieve levensbe?indiging bij pasgeborenen in Nederland: analyse van alle 22 meldingen uit 1997/'04, Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) 149, 2005, nr. 4, pp. 183-188.
87. E.J.O. Kompanje, T.H.R. de Jong, W.F.M. Arts, J.J. Rotteveel: Problematische basis voor 'uitzichtloos en ondraaglijk lijden' als criterium voor actieve levensbe?indiging bij pasgeborenen met spina bifida, Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) 149, 2005, nr. 37, pp. 2067-2069.
88. In respons A.A.E. Verhagen, J.J. Sol, O.F. Brouwer, P.J.J. Sauer and a reply by E.J.O. Kompanje, T.H.R. de Jong, W.F.M. Arts, J.J. Rotteveel in Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) 149, 2005, nr. 38, pp. 2136.