The Demand for Euthanasia for Children

There is no demand from parents for intentional killing and the matter is raised more by ethicists and theoreticians than by anyone in the practical field. The majority of paediatricians are against intentional killing and medically assisted suicide, but there is a small group who would support its introduction.

One report indicates that children have been supplied with a lethal injection and have been encouraged to administer this to themselves 'when all eslse has failed'. In such a situation, you wonder whether compassion and care had indeed failed the child!

Unconscious Children
These are usually sufferers from trauma, head injury, and brain lesions of various kinds. The most freqeunt problem encountered is head injury related to traffic accidents. They have often been dealt withi in adult intensive care units until recently, when paediatric units have been opened. The criteria for brainstorm death are the same as in adults. Similar debates occur over brainstem death in children as in adult cases. 'Switch-off' decisions are generally made on the same grounds of negative expectation of recovery, but practice varies.

The parents have the veto and often wish to continue life support initially, but may reach a point of acceptance of the futility of this after an opportunity to come to terms with the realities of the situation. Improved resucitation techniques have really introduced these problems, since many would have died without these being applied.

Where the life support requires to be switched off, this is usually done with the parents present, one of them helding the child in the period after the switch off.

The normal expectation is that death will occur. However the expectation of death may not always be fulfilled, and a brain damaged child requiring a major level of support remains. In one incident following which the child was fosteres in a loving home with excellent care, major guilt still produces problems for the parents. The case for euthanasia in such cases would rest more upon the suffering of the parents rather than that of the child.

Additional readings
Some of these readings might be useful
Shepperdson, B. (1983). Abortion and Euthanasia of Down's Syndrome Children. the Parents view.

Journal of medical Ethics

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Engelhardt, T (1989). Ethical Issues in Aiding the Death of Young Children.An excerpt is available here.

Macdonald WL (1998)> Situational factors an attitudes towards voluntary euthanasia. The abstract is available here.





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