British council rejects 'active euthanasia' for newborns

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WASHINGTON — A British bioethics council rejected a suggestion for "active euthanasia" of severely disabled infants but recommended babies born before 22 weeks into pregnancy not be treated.

The Nuffield Council on Bioethics issued its report Nov. 15 after a request by the Royal College of Obstetricians and Gynecologists produced worldwide anticipation. The ob-gyn group urged the Nuffield council "to think more radically about non-resuscitation, withdrawal of treatment decisions, the best-interests test and active euthanasia." As a result, the bioethics council agreed to include euthanasia of "extremely premature and seriously ill babies" in its consultation.

The Nuffield council rejected "active euthanasia," saying it "concluded the active ending of life of newborn babies should not be allowed, no matter how serious their condition. The professional obligation of doctors is to preserve life where they can. If doctors were to be permitted actively to end the lives of seriously ill newborn babies, there is a risk that the relationship between parents and doctors would be negatively affected."

The council, however, established week-by-week recommendations for care of early born babies:

• Babies born before 22 weeks should not receive "intensive care."

• Children born between 22 and 23 weeks, who leave the hospital alive only 1 percent of the time, should not normally receive such care "unless parents request it after a thorough discussion of the risks and if the doctors agree."

• Parents, after a complete discussion with health providers, should make the final decision on "intensive care" for babies born between 23 and 24 weeks.

• Babies born between 24 and 25 weeks normally should receive such care "unless the parents and the doctors agree that there is no hope of survival or if the level of suffering outweighs the baby's interest in continuing to live."

• After 25 weeks, babies should normally receive "[i]ntensive care."

"Natural instincts are to try to save all babies, even if the baby's chances of survival are low," said Margaret Brazier, chair of the committee that drafted the guidelines for the council. "However, we don't think it is always right to put a baby through the stress and pain of invasive treatment if the baby is unlikely to get any better and death is inevitable."

Wesley Smith, a lawyer and pro-life specialist in biomedical issues, said the "very good news is that [the Nuffield council] rejected infanticide out of hand."

Of the week-by-week guidelines, Smith wrote on the weblog at bioethics.com that he is "not comfortable with such guidelines in that each patient should be evaluated and treated as an individual, not as part of a group. Of course, knowing the odds of survival at any given stage would be part of that agonizing decision making process. I also worry that futile care theory could seep into this process and that infants would be denied treatment because they would be disabled.

"Still, it could have been worse," Smith noted.