A child just two years old underwent euthanasia in the Netherlands, in the first known case in the country of a child under the age of 12 undergoing assisted dying.

The case became known following the publication of a report by the Review Committee for Late-Term Abortion and Termination of Life in Newborns and Children, which examined the circumstances under which the procedure was carried out.

According to the report, the child was almost 24 months old and had been born prematurely, at just 26 weeks of gestation.

During their short life, they experienced serious health problems, including cerebral palsy, severe visual impairment, epileptic seizures that did not respond to medication, as well as a build-up of mucus in the lungs that significantly impaired their breathing.

The child’s doctors and parents concluded that their condition could not be treated with any other medical interventions.

The committee’s assessment

The relevant committee found that the doctor who carried out the euthanasia had acted in accordance with the prescribed protocols and had exercised due care.

The report states that the doctor had sought the opinion of independent specialists for a second assessment.

The first doctors who examined the case assessed that, despite the severity of the condition, the child was not experiencing “continuous intolerable suffering”, as the epileptic seizures, although causing severe distress, were not continuous. At the same time, they noted that some alternative options remained, such as palliative care and different drug treatments that might have been able to alleviate the symptoms.

However, following a new medical assessment, another doctor concluded that the child’s “intolerable suffering” was evident and that the conditions for ending their life had been met.

The committee accepted this assessment, noting that all aspects of the child’s human functioning – from motor skills to behaviour and personality – had been severely affected and that no improvement was expected. “Despite all medical and non-medical interventions, the parents and the doctor observed no improvement in the child’s condition and were convinced that the child was suffering with no prospect of relief,” the report stated.

The legal framework for euthanasia in the Netherlands

Two years ago, the Netherlands allowed assisted dying for children aged between one and 12 who suffer from serious and incurable illnesses. Before this change, euthanasia was permitted only for newborns and for people over the age of 12.

Under Dutch law, for children under the age of 12, the consent of the parents is required, the child must be experiencing intolerable suffering and there must be no prospect of recovery.

In other cases of euthanasia in the Netherlands, the request must come from the patient themselves, and the doctor must establish that the suffering is unbearable and without prospect of improvement. A second medical opinion is also required, along with confirmation that the patient is not acting under pressure.

The Netherlands became the first country in the world to legalise euthanasia for patients with incurable illnesses in 2002. The issue continues to enjoy broad social acceptance in the country, while the extension of the framework to children aged one to 12 became the subject of intense public debate, as until then there had been no clear policy for this age group.