On 28th April 2018, 23 month old Alfie Evans died, after suffering from an unidentified degenerative neurological condition that was deemed incurable. Despite being in a semi-vegetative state, medical staff only removed life support after Alfie’s parents lost their final appeal against the hospital in court.
Within the UK, Alfie’s story has received an overwhelming level of support from the general public, with a large number of supporters gathering outside Alder Hey Children’s Hospital to protest the European Court of Human Rights refusal to intervene.
Meanwhile other supporters took to Twitter to argue against the decision, with one user stating the ruling was “not theirs not to make.”
More recently, ex-MP Nigel Farage added fuel to the flames by going as far as to declare the court ruling “state sponsored euthanasia“, after it was decided continued life support would cause the toddler unacceptable pain and suffering. In spite of the inflammatory nature of the remarks, the controversy has inspired an important conversation of the reality and circumstances of child euthanasia.
Officially, Alfie Evans’ passing was neither child euthanasia nor passive euthanasia. By UK law, neither are permitted. The NHS outline this, stressing that withdrawing life sustaining treatment, if it is in the interest of the patient, can be part of good palliative care and is not considered euthanasia. This focus on the purpose of palliative care has been brought up by defenders of the medical staff, such as Prof. Wilkinson, who emphasises the foundation of palliative care being “intensive caring” rather than intensive medical care.
Euthanasia remains illegal under British Law, regardless of age, and this legal technicality is likely the source of upset amongst Alfie’s supporters. There are exceptionally few countries in the world that permit any level of euthanasia, and even fewer who allow minors to make the same choice.
- Euthanasia is legal in Belgium, Luxembourg, the Netherlands, and Colombia
- Assisted suicide is legal in Belgium, Luxembourg, the Netherlands, Switzerland, Canada, Germany and the United States*
- Child/infant euthanasia is legal in just Belgium and the Netherlands
*only within Oregon, Washington, Vermont, Montana, and New Mexico
Euthanasia is perhaps one of the last remaining choices that we deny others, out of ongoing debate over its moral standing. This is especially true in the circumstances of child euthanasia, where the individual in question is not able to consent, and must rely on the will of their parents.
Euthanasia is one of the last remaining choices that we deny others.
Opinions on the matter vary from Eric Kodish declaring the possibility of child euthanasia as a form of “accepted medical standard” for infanticide, to Alberto Giubilini and Francesca Minerva arguing it should be “permissible in all the cases where abortion is, including cases where the newborn is not disabled.” Regardless of this kind of polarity, most people accept the possibility in cases where a child is born with severe birth defects, considering it almost as a “mercy killing.” This only serves to open more questions regarding how we can truly determine an individual’s quality of life.
A possible alternative to the moral panic surrounding child euthanasia, is by looking at who actually uses the system. In 2014, Belgium became the first, and remains the only, country to legalise voluntary child euthanasia without an age limit. The first time the law came into use was two years later, in 2016, when a critically ill 17 year old made the choice.
To come under Belgian law, a child must be terminally ill, face “unbearable physical suffering,” and make multiple requests to die before euthanasia can be carried out. Mental health is controversially excluded from this, with euthanasia not being permitted for psychiatric problems.
Overall, the number of minors the law applies to is extremely small, but it grants power and control to those who might not otherwise possess it. Maybe we need to focus less on accusing hospitals of unwanted euthanasia, and more on the realities of what that means. As Mr Distelmans highlights, “there are very few children who are considered but that does not mean we should refuse them the right to a dignified death.”
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