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Document Details :

Title: Vulnerable Care
Subtitle: The Debate on Euthanasia for Decisionally-Competent Minors in Flanders and the Netherlands
Author(s): DRAULANS, Veerle , VAN DER GIESSEN, Eline
Journal: Ethical Perspectives
Volume: 21    Issue: 4   Date: 2014   
Pages: 479-512
DOI: 10.2143/EP.21.4.3062017

Abstract :
More than ten years after the introduction of euthanasia legislation in the Netherlands and Belgium, the debate has become topical once again. The political and social discussion frequently centres on people unable to give informed consent, such as very young children and persons developing dementia. In this article, the focus lies on decisionally-competent minors. The Belgian parliament passed an act of law on February 13th 2014 that provides an opportunity to permit euthanasia for decisionally-competent minors, without stipulating an age limit. In the Netherlands, euthanasia is legally permitted for children aged twelve and over, although Dutch records show that euthanasia has very rarely been carried out among minors. Inspired by a care-ethical approach, we were curious about the experiences of specialist doctors in their actual care practices with regard to seriously ill minors. A care-ethical perspective draws attention to specific aspects: human interconnectedness, unicity, vulnerability and relational autonomy – rather than the ideal of individual autonomy – are considered to be at the core of humanity. A relational, care-ethical perspective offers scope for the question whether adults, parents and practitioners, can handle the suffering in the specific context of young people, for young people’s future-oriented thinking, their relationships with the people around them, and for the acknowledgement of their developing autonomy. This contribution presents the results of an exploratory empirical investigation into the experience of this problematic issue acquired by nine Belgian and two Dutch doctors in actual care practices at university hospitals and specialist care centres. Their experience demonstrates that decisionally-competent minors who suffer unremittingly rarely request euthanasia. Essentially, young people with a serious illness do not want to end their life, but they want to end the unbearable nature of their symptoms. The interview respondents involved express their experiences in language and images that are closely aligned with a care-ethical approach. They ask for more attention to be paid to terminology in the public debate, as well as recognition of the fact that providing good end-of-life care to children and minors requires specific skills.

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