Thursday, December 02, 2004

Groningen Protocol

Hugh Hewitt was one of the people I started reading during the election madness season, when the political landscape turned magnetic and bloggers gravitated to the poles. He's an evangelical conservative, who holds many convictions I do not share, but we were in the same trenches, he in a much larger way than I. And he reminds me of the conservative gentlemen I used to deal with when I was a young firebrand liberal newspaper editorial writer in West Chester -- they were avuncular, warm-hearted, intelligent, and courteous, even when we were in serious disagreement. You would not be ashamed to have such men on your side, even when you did not see the world through their eyes.

Now that the election is passed, the magnet is switched off to some extent and I've drifted back to more temperate climes and more contrarian positions toward many of the Bush Administration's policies. Yet I still read Hewitt, and I learn things that I would not know.

One of the hot-button topics in the evangelical blogosphere now is the so-called Groningen Protocol, whereby doctors in the Netherlands have the power to kill a newborn, or other child if they determine it is suffering unbearably from some incurable medical condition.

Four times in recent months, Dutch doctors have pumped lethal doses of drugs into newborns they believe are terminally ill, setting off a new phase in a growing European debate over when, if ever, it's acceptable to hasten death for the critically ill.

Few details of the four newborns' deaths have been made public. Official investigations have found that the doctors made appropriate and professional decisions under an experimental policy allowing child euthanasia that's known as the Groningen University Hospital protocol.

But the children's deaths, and the possibility that the protocol will become standard practice throughout the Netherlands, have sparked heated discussion about whether the idea of assisting adults who seek to die should ever be applied to children and others who are incapable of making, or understanding, such a request.

This is from a Knight-Ridder article, not a James Dobson scare-piece. But it's pretty scary in its own right.

The protocol is likely to be used primarily for newborns, but it covers any child up to age 12. ... A parent's role is limited under the protocol. While experts and critics familiar with the policy said a parent's wishes to let a child live or die naturally most likely would be considered, they note that the decision must be professional, so rests with doctors.

I wonder whether this applies to the Muslim population that comprises 10 percent of the Netherlands. Do Moroccan parents have to allow a Dutch doctor to determine if their child should live or die? Finally, the most cynical twist in the story is that the euthanasia policies could serve a practical purpose in the ruthless calculation of managed health care:

What happens to vulnerable people is a particularly sharp issue in a continent where birthrates have declined, populations have aged and five nations have more old than young. Euthanasia opponents fear that as costs increase for long-term intensive care and health-care budgets become more strained, financial reasons could creep into euthanasia debates.

I do support the stoic right of terminally ill or unbearably suffering adults to end their lives with dignity. But anyone who remembers arguing with an HMO about coverage in the bad old days can do the mental gymnastics on Groningen. What if it wasn't just about getting a second opinion on that sprained ankle? What if it was whether your child should live or die? And you had no choice, the bureaucrats held the life-strings in their hands? Feel that freezer-chill on your spine at the mere thought?

I have a co-worker with a daughter who, through some tragic incompetence of the hospital where she was born, is severely brain-damaged, immobile except for involuntary twitches, incapable of feeding herself or speaking. The doctors at her birth told the parents she would die soon, but 10 years later she's still here. It's a burden on the family; she requires constant care. Gods forbid that such a tragedy should happen to anyone. But I also know they love her, and somehow, when I've seen them together, I sense that she knows and feels and even expresses more than you would imagine from someone who might otherwise be put into the "vegetable" bin. I also know their other daughter has learned a great deal about love and developed a capacity she never would have had otherwise, because of her sister's presence.

While it's not hard to say the Netherlands is making a tragic mistake here, that discussion dovetails into the current U.S. political scene on the topic of abortion. "If not that, then why this? If you can condemn that, how do you justify this?" Which is a time-honored tactic of the anti-abortion movement. I remember an ardent abortion opponent and devout Catholic who used to write to my paper insisting that, not only was it wrong to kill a fetus after conception, it was just as evil to spill one's seed without intent of procreation. In either case, you thwarted God's plan and purpose for bringing a new soul into the world and into the hope of salvation. So after we ban abortion, next we ban masturbation (for males)? Talk about mission-creep.

A non-Christian reluctant conservative like me approaches anything like a "right-to-life" position unwillingly. My image of that faction remains Randall Terry with a bullhorn shouting down whithering brimstone onto scared and confused young women. I covered anti-abortion protests at Women's Suburban Clinic in Paoli, Pa., in the 1980s, and acquired an extreme distaste for the Operation Rescue movement and its vulgar public presentation.

Yet I also remember feeling puzzled by the protesters who turned out to oppose them. I understood their fixation with the idea that this was, below the rhetorical surface, a battle for control of women's sexualities. If Randall Terry had lived 500 years before, I could easily see him as a witch-hunter in the literal sense.

But I also now think of someone very dear to me, who was born to a teen-age mother who got knocked up by the extremely unstable singer for a struggling rock band in what must have been, essentially, a one-night stand. I don't know what options were pondered before her birth, but I'm glad she came into the world. And I remember the miscarriages we had during my marriage. Even those of us who would not make abortion illegal, and who would protect women from the Randall Terrys of the world, should remember that every abortion, like every war, is a tragedy. If it's a necessary evil (as war sometimes is, too), it should be remembered as such, in equal measure. Never forget the "evil" in it. Never make it a point of pride to advocate it.