The Groningen Protocol for neonatal euthanasia: Our perspective

Introduction: The Netherlands has pioneered the implementation of recommendations and laws regulating voluntary active euthanasia. Since 2002 it has allowed active euthanasia in children aged 12 and over. The Groningen Protocol, established in 2005, introduced the possibility of ending the life of newborns who fulfill certain specific criteria. It was drafted by Verhagen and Sauer at the University Medical Centre in Groningen and was granted authorization for national implementation from the Dutch Association of Pediatric Care. Methods: A literature search was conducted to analyze the Groningen Protocol and arguments supporting and opposing it. Results: Seemingly competing tenets of principalism – respect for autonomy, beneficence, nonmaleficence, and justice – are invoked as core arguments both for and against the protocol. The scale hangs in the sense of opposition to the protocol, essentially because of the weight of some of the arguments presented. Conclusion: From our perspective, the Groningen Protocol seems to have been built primarily to allow deliberately ending the life of a newborn baby without fear of criminal prosecution. In addition, included criteria are prone to subjectivity and may lead to abuse. The protocol’s proposal to regulate a very rare practice such as the anticipation of death in a seriously ill newborn promotes acceptance of active euthanasia for those who are most vulnerable and cannot express their own will.