The age limit for euthanasia requests in the Netherlands: a Delphi study among paediatric experts
Humans; Child; Consensus; Netherlands; Delphi Technique; Minors; Euthanasia
Background The Dutch Euthanasia Act applies to patients 12 years and older, which makes euthanasia for minors younger than 12 legally impossible. The issue under discussion specifically regards the capacity of minors to request euthanasia. Objective Gain insight in paediatric experts’ views about which criteria are important to assess capacity, from what age minors can meet those criteria, what an assessment procedure should look like and what role parents should have. Methods A Delphi study with 16 experts (paediatricians, paediatric nurses and paediatric psychologists) who work in Children Comfort Teams in Dutch academic hospitals. The questionnaire contained statements concerning criteria for capacity and procedural criteria. Consensus was defined as ≥80% agreement. Results The experts agreed that five criteria for capacity, found in a previous literature study, are all important. They agreed that some children between ages 9 and 11 could meet all the criteria. Consensus was reached for the statements that the entire medical team should be involved in the decision making and that a second independent expert must assess the case. Experts agreed that the parents’ opinion is relevant and should always be taken into account, but it need not be decisive. Conclusion This study shows that the age limit of 12 years in the Dutch Euthanasia Act is too strong according to paediatric experts. Letting go of the age limit or lowering the age limit combined with adequate capacity assessment for minors younger than 12 are options that should be discussed further.
de Keijzer SC; Widdershoven G; Verhagen AAE; Pasman HR
Journal of Medical Ethics
2023
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1136/jme-2022-108448" target="_blank" rel="noreferrer noopener">10.1136/jme-2022-108448</a>
Self-requested euthanasia for children in Belgium
Humans; Young Adult; Palliative Care; Mental Competency; Personal Autonomy; Euthanasia; Choice Behavior; Minors; Europe; Belgium; Patient Rights; quality of life; adolescent; decision making; Active; Voluntary; Wedge Argument
In the complex patient—doctor relationship, the principle of personal autonomy has gradually acquired more weight against medical paternalism, both in clinical practice and in bioethical thinking. 1 In many countries, this change has been incorporated into national legislation in the past 20 years. The Belgian Act on Patients' Rights was promulgated in 2002. In the same year, the Belgian Act on Palliative Care was adopted, which grants access to palliative care that focuses on improving quality of ...
2014-02
Dan B; Fonteyne C; de Cléty Stéphan Clément
Lancet
2014
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/S0140-6736(14)60110-0" target="_blank" rel="noreferrer">10.1016/S0140-6736(14)60110-0</a>
Ensuring that difficult decisions are honored--even in school settings
Child; Humans; United States; Adult; Parents; Choice Behavior; Minors; adolescent; Death and Euthanasia; decision making; Chronic disease; ICU Decision Making; Students; Cardiopulmonary Resuscitation/contraindications; Disabled Children/legislation & jurisprudence; Emergency Medical Services/ethics/legislation & jurisprudence/standards; Resuscitation Orders/ethics/legislation & jurisprudence; School Health Services/ethics/legislation & jurisprudence/standards; Schools/ethics/legislation & jurisprudence/standards; State Government
2005
Levetown M
The American Journal Of Bioethics
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1080/152651690927926" target="_blank" rel="noreferrer">10.1080/152651690927926</a>
Non-communicating children's pain checklist: better pain assessment for severely disabled children
Child; Pain Measurement; Pain; Child Psychology; Developmental Disabilities; Mental Disorders; Cognition Disorders; Minors; Child Development Disorders; Mental Retardation; Child Behavior Disorders; Child Development Deviations
Advances in the treatment of pain for children with severe disabilities have lagged behind that for other children. This is due, in part, to a lack of valid assessment tools for their pain. The non-communicating children's pain checklists are observational pain tools that were developed specifically for children with severe disabilities who are unable to communicate verbally. The non-communicating children's pain checklist-revised has been validated for use with a wide range of pain types in the home. The non-communicating children's pain checklist-postoperative version is used for pain following surgery in the hospital setting. Scores for determining the presence of pain have also been developed. They are appropriate for children with varying degrees of physical, cognitive and communicative impairments.
2003
Breau LM
Expert Review Of Pharmacoeconomics And Outcomes Research
2003
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1586/14737167.3.3.327" target="_blank" rel="noreferrer">10.1586/14737167.3.3.327</a>
Ethical issues in the pediatric intensive care unit
Child; Humans; United States; Parental Consent; Pediatrics; Withholding Treatment; Social Values; Intensive Care; Minors; Tissue and Organ Procurement; Ethics; Uncertainty; Medical; adolescent; Preschool; Professional Patient Relationship; infant; ICU Decision Making; Critical Illness/psychology; Judicial Role; Value of Life
Advanced technology and better scientific understanding of mechanisms of disease now permit intensive care personnel to extend life beyond what some patients and families consider reasonable, leading, in part, to the "patients' rights" movement and the articulation of legal and moral guidelines for foregoing life support. In the case of pediatrics, commentaries on a few of the topics that have arisen most frequently or have provided the greatest challenge in the authors' experience are provided.
1994
Frader JE; Thompson A
Pediatric Clinics Of North America
1994
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/s0031-3955(16)38879-4" target="_blank" rel="noreferrer">10.1016/s0031-3955(16)38879-4</a>