Abstract
Many of us are probably familiar with the concept of Ciconia, or the stork.l The Dutch used to tell their children, “the stork will be visiting soon”; a relevant piece of information, since storks delivered babies. The stork didn’t always deliver babies as desired, however. Nor did babies always live. Even so, nobody ever thought twice about taking up the responsibility of caring for the newborn child. This care was considered meaningful, since this new human being was accepted as a member of the human race. In those days, having children was still considered a natural process.
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Notes
From the ciconiidae family; the Dutch name for stork, “ooievaar”, comes from the thirteenth century word “odevare” or “bringer of luck”: a heron type of bird (white feathers with jet black flight feathers and long, bright red beak/legs, flies slowly and calmly (with a stretched out and slightly bent down neck), walks with careful steps and nests on roofs, chimneys, haystacks and at times in trees.
Apart from that, there is a growing acceptance of life-terminating interventions on incompetent patients. In the Netherlands, an estimated 1.000 times a year, life-termination takes place without explicit request. G.H. Blijham and J.J.M. van Delden, “Actieve levensbeëindiging bij wilsonbekwame volwassenen: Aandachtspunten voor zorgvuldig handelen” (Active Life Termination of Incompetent Adults: Criteria for Careful Decisions), in: Medisch Contact Vol 54, nr. 10 (1999), pp. 344–347. Active life-termination without request seems to be contrary to article 2 of the European Declaration of Human Rights and fundamental Freedom. A Dutch District Court recently decided that these cases belong in the category, “emergencies” and can therefore not be overruled by European rules.
J. Janssens, “Verloskunde en gynaecologie in de laatste 40 jaar” (Obstetrics and Gynaecology in the Past Forty Years), Nederlands Tijdschrift voor Geneeskunde, Vol. 141, no. 1 (1997), pp. 26–32.
T.W.J. Schulpen and A. van Enk, “Mortaliteit naar etniciteit bij kinderen in Nederland” (Mortality and Ethnicity of Children in the Netherlands), Nederlands Tijdschrift voor Geneeskunde, Vol. 140 (1996), pp. 2489–92.
H.H. de Haan, “De pathofysiologie van perinatale asfyxie en cerebrale beschadiging” (The Pathophysiology of Perinatal Asphyxia and Cerebral Trauma), Nederlands Tijdschrift voor Geneeskunde, Vol. 139, no. 33 (1995), pp. 1673–6.
Premature infants (gestation of 26–32 weeks) and immature infants (gestation of 24–26 weeks). Cf. M.C. Allen, P.K. Donohue, and A.E. Dusman, “The limit of viability — neonatal outcome of infants born at 22 to 25 weeks’ gestation”, New England Journal of Medicine, Nr. 329 (1993), pp. 1597–1601.
The division of neonatology is subdivided into intensive care (in cases of serious threat or needed support in one or more vital functions, including respiratory, cardiac, circulatory, and excretory systems), high care (nursing of seriously ill neonates without direct threat to vital functions) and medium care (newborns who do not need 24 hour per day observation).
The Royal Dutch Association of Medicine wrote the discussion report, Levensbeéindigend handelen bij wilsonbekwame patiënten. Deel I.: zwaar-defecte pasgeborenen (Life-terminating Interventions with Incompetent Patients, Part 1: Severely Defective Newborns). Utrecht: Koninklijke Nederlandsche Maatschappij tot Bevordering der Geneeskunst, 1990. The Dutch Association for Paediatrics issued Doen of laten? Grenzen van het medisch handelen in neonatologie (To Act or Not to Act: Limits of Medical Care in Neonatology). Utrecht: Nederlandse Vereniging voor Kindergeneeskunde, 1992.
M.J.K. de Kleine, R. de Leeuw, L.A.A. Kollée, and H.M. Berger, “Voortzetten of staken van levensverlengend handelen bij pasgeborenen: een onderzoek in 4 centra voor neonatale intensieve zorg” (Continuing or Withdrawal of Life Sustaining Treatment of Newborns: a Survey in Four Centers of Intensive Neonatal Care), Nederlands Tijdschrift voor Geneeskunde, Vol. 137, no.10 (1993), pp. 496–9.
Cf. T.L. Beauchamp and J.F. Childress, Principles of Biomedical Ethics. New York, Oxford: Oxford University Press, 1983, pp. 14–7;
Cf. T.L. Beauchamp and J.F. Childress, Principles of Biomedical Ethics. New York, Oxford: Oxford University Press, 1983, pp. 131–2.
W.W. Eigner, H. Knol, Th. Neuer-Miebach, M.H. Rioux, C. van de Vate, and M. Bunch, Just Technology? From Principles to Practice in Bio-ethical Issues. Brussels: International League of Societies for Persons with Mental Handicaps/ L’Institut Roeher Institute, 1994.
H.M. Evenhuis, R.A. van Beek, K. Cuperus-Suithof, C.H.A. van Schie, and F. Schuckinck Kool, “Medische zorg voor verstandelijk gehandicapten: een eigen vakgebied” (Medical Care for People with Mental Retardation as a Profession of Its Own), in: Medisch Contact, Vol. 49, no. 42 (1994), pp. 1317–8.
C. van de Vate, “Parental Ethics,” in J.M. Berg et al., Report on the European workshop “Bioethics and Mental Handicap. “ Utrecht: Bishop Bekkers Foundation, 1992.
Under commission of the association’s Heeren Loo, the Center for Bioethics and Health Law of the University Utrecht researched medical decisions regarding the ending of life in healthcare of people with mental retardation. G.M.W. van Thiel, A.K. Huibers, and K. de Haan, Met zorg besluiten: beslissingen rond het levenseinde in de zorg voor mensen met een verstandelijke handicap (Deciding Wisely: End of Life Decisions in the Care or People with Mental Retardation). Assen: Van Gorcum, 1997. In this study, 89 physicians reported a total of 859 cases of death. In several situations, physicians did not discuss their medical decisions surrounding the death with the parents, sometimes not even with anyone. There were four cases in which life was ended without request (0.5%). The study indicated that the active ending of life within the health care sector occurs one to two times per year. (Cf. J. Stolk, “Euthanasie bei geistig Behinderten: eine Bewertung der aktuellen Euthanasie-Diskussion in den Niederlanden” (Euthanasia and People with Mental Retardation: An Evaluation of the Recent Discussion in the Netherlands), Geistige Behinderung, Vol. 29, no. 4 (1990), pp. 386–93.
A.Th.G. van Gennep, “Wat is goed doen? ‘Levensperspectief’ voor een pasgeborene met een ernstige handicap” (What is Beneficence? ‘Life-Perspective’ of Newborns with Serious Handicaps), in: T. van Willigenburg and W. Kuis, Op de grens van leven en dood: afzien van behandelen en levensbeëindiging in de neonatologie (On the Verge of Life and Death: Refraining from Treatment and Life Termination in Neonatology). Assen: Van Gorcum, 1995, pp. 42–51.
H.A.M. Alpine, “Geen uitzicht op menswaardig bestaan” (No Prospects for a Liveable Life), Tijdschrift voor Geneeskunde en Ethiek, Vol. 5, No. 1 (1995), pp. 23–9.
Cf. baby K. and Willy in chapter 8.
Cf. J.J. Rotteveel, R.A. Mullaart, F.J.M. Gabreëls, and J.J. van Overbeeke, “Actieve levensbeëindiging bij pasgeborenen met spina bifida?” (Life Termination of Newborns with Bifid Spine?), Nederlands Tijdschrift voor Geneeskunde, Vol. 140, No. 6 (1996), pp. 323–4.
Cf. Chapter 9.
J.S. Reinders, Moeten wij gehandicapt leven voorkomen? Ethische implicaties van beslissingen over kinderen met een aangeboren of erfelijke handicap (Should We Prevent Handicapped Life? Moral Implications of Decisions about Children with Congenital or Hereditary Conditions). Utrecht: Nederlandse Vereniging voor Bioethiek, 1996. According to Reinders, judgments about the future of a child with a handicap are rooted in our personal identity. On the basis of how we understand our own humanity, would we not come to the conclusion that the existence of people with mental retardation should have a quality that signifies a good life?
Gelijke kansen: medisch handelen rond pasgeborenen met een (verstandelijke) handicap. Utrecht: Vereniging Federatie van Ouderverenigingen, 1993.
Derived from the Latin word, “abstinentia” = abstinence; not using (anymore), not giving something to someone (anymore). This idea cannot be associated with actively terminating someone’s life. Further treatment is abandoned because at the patient’s request or because the treatment offers no chance medically. Meanwhile, nursing and general care are provided as usual.
U. Eibach, Medizin und Menschenwürde. Ethische Probleme in der Medizin aus christlicher Sicht. (Medicine and Human Dignity: Moral Problems in Medicine from a Christian Perspective). Wuppertal: Brockhaus, 19975
G.A. Lindeboom, Euthanasie in historisch perspectief (Euthanasia: a Historical Overview). Amsterdam: Rodopi, 1978.
Two people, deeply moved by human suffering, react in two completely different ways. In a way, these two figures in the dimmed stable of Turin have a symbolic significance. The soldier appears out of society and immediately acts, deeply moved, with deliberateness of mind. But behind the appearance of the no less sympathetic Paré, Professor Lindeboom sees as it were the face of Hippocrates (460–375 BC). It is in his name that one finds the 25 century old creed of physicians, which states without hesitation the primary clause: “I will not administer a deadly remedy to anyone, even not upon his request, and will not offer any advice in that nature.” These words want to give solidity to the conscience of the physician that at times can face doubts in the face of unexpected situations.
The Bible, Luke 10:25–37.
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Seldenrijk, R. (2000). Meaning in Medical Care for People with Mental Retardation. In: Stolk, J., Boer, T.A., Seldenrijk, R. (eds) Meaningful Care. Springer, Dordrecht. https://doi.org/10.1007/978-94-015-9516-2_6
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