An e-mail:

As a pediatrician and medical geneticist I’ve had to deal with the issue of newborns with fatal malformation or syndromes on a few occasions, and this whole euthanasia thing in the Netherlands really makes my skin crawl. About 1 in every 7 or 8,000 newborns has trisomy 13 or 18, for example (think Down syndrome, only a lot worse). These conditions are almost always lethal in the first few months of life and are characterized by a variety of birth defects, everything from cleft lip and palate to complex congenital heart disease, to structural brain malformations and severe retardation. Very few live more than a few years. These are terrible conditions, but they’re not painful, except, of course to the family. Counseling in these situations usually involves spelling out the facts (obviously in much more detail) and, in my experience, most families accept the situation, understand their baby is going to have a short life, and enjoy the time with their baby as much as possible. I’ve never heard anyone suggest euthanasia. However, medical intervention is often tailored to the situation, for example, in an otherwise healthy newborn with complex congenital heart disease, corrective surgery would be arranged. However, if the infant has trisomy 13, it’s difficult to justify the expense, resources and pain required to fix the heart, if the ultimate outcome won’t be altered. So if no amount of medical intervention is going to lengthen their life, why put them thru it?
It’s always seemed to me that the humane thing to do in these hopeless cases is to just let nature take its course, and I don’t mean exposure on a hillside, but rather provide food, comfort, love and attention, and understand that medical technology can only do so much. I don’t see how any active measures to “speed things along” could ever be justified on the basis of sparing the infant unnecessary suffering, because I really don’t think they are suffering. While I’m sure there is a financial incentive driving this, as every day in the NICU costs thousands of dollars, I think it’s clear that one reason infants are being euthanized in the Netherlands to spare their parents (and the “caregivers”) needless suffering. Once we start justifying infanticide to make ourselves feel better, what’s next?