Abstract
The Groningen Protocol, introduced in the Netherlands in 2005 and accompanied by revised guidelines published in a report commissioned by the Royal Dutch Medical Association in 2014, specifies conditions under which the lives of severely ill newborns may be deliberately ended. Its publication came four years after the Netherlands became the first nation to legalize the voluntary active euthanasia of adults, and the Netherlands remains the only country to offer a pathway to protecting physicians who might engage in deliberately ending the life of a newborn (DELN). In this paper, I offer two lines of argument. The first is a positive argument for the Protocol, grounded in the good of the newborn as unanimously determined by those in a position to determine it. The second addresses the widely shared belief that the killing of newborns is morally prohibited, where I offer two arguments—one grounded in the fact that the kinds of cases the Protocol is meant to govern are very rare and highly unusual, and the other focused more broadly on the role of pre-theoretical beliefs in moral reasoning—meant to undermine the strong role that the critic of the Protocol affords this belief. I argue that, given this second line of argument, the beliefs underlying my positive argument for the Protocol are in fact more secure than the widely shared belief underlying the critic’s position.
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Notes
This former strategy is suggested by Vanden Eijnden and Martinovici, who argue that newborns who the GP seems designed to address neither suffer nor are in pain (Vanden Eijnden and Martinovici 2013). This is an empirical assertion which can be rebutted if there exists some (at least one) medical condition, suffered by some (at least one) newborn child, whose severity is such that it inflicts on the child an extreme level of pain (and so suffering in the sense that Verhagen and Sauer have in mind). Given that this is extremely plausible given our best understanding of pain, and is brought to life in the case of epidermolysis bullosa, I pass by this objection.
This deeper interpretation of the slippery slope argument is potentially vulnerable to a deeper kind of empirical response, showing that end-of-life medical practice in neonatology is not fundamentally different than in other countries, even in those where euthanasia of any form is illegal, and even though the GP is unique to the Netherlands. And, in fact, the empirical evidence supports this response (Moratti 2010).
It is worth noting that this first argument fits with, though does not rely on, a common account of personhood. By this line of argument, personhood is a moral status requiring certain relatively sophisticated facts, typically psychological, to obtain about a being (Tooley 1972, Warren 1973, Singer 1993, McMahan 2002). Someone endorsing this kind of account would understand my first argument here in the following terms: while we have strong beliefs about the many newborns that are likely to grow into full human persons, our beliefs are weaker about newborns who will never develop in this way.
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Tedesco, M. Dutch Protocols for Deliberately Ending the Life of Newborns: A Defence. Bioethical Inquiry 14, 251–259 (2017). https://doi.org/10.1007/s11673-017-9772-2
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DOI: https://doi.org/10.1007/s11673-017-9772-2