Euthanise children without parental consent, say doctors from children's hospital
25 September 2018
The Canadian doctors think that children are capable of consenting to being killed.
They also want to "reduce social stigma"
In a horrifying example of how far down the euthanasia slippery slope Canada is travelling, a group of doctors at a children's hospital have written a policy on how they would implement the euthanasia of children, and seem to conclude that it could happen without parental consent.
Since Canada legalised "medical aid in dying (MAID)" as it is known in 2016, the issue of euthanasia for "mature minors" has been debated. The government has asked the Council of Canadian Academies to produce a report on this issue, as well as euthanasia for mental health issues and advance directives, by December this year.
Just the same as palliative care?
However, a working group at the Hospital for Sick Children in Toronto have published an essay detailing the forming of their policy on MAID in a paediatric setting - at present, just for those patients who are 18 or over, but arguing that it could apply to younger children.
First, the doctors decided to consider MAID as "practically and ethically equivalent to other medical practices that result in the end of life"; in other words saying that deliberately killing someone by euthanasia is morally the same as palliative care practices such as use of pain-relieving drugs or withdrawal of inappropriate interventions that sometimes result in the end of life, but are not carried out with that intention.
The authors then explain that in Ontario, "young people can be and are found capable of making their own medical decisions, even when those decisions may result in their death". If MAID is a normal medical procedure, then children should also be considered capable to decide on euthanasia.
What about parents?
Usually, the paper says, family are intimately involved in end of life decisions. However, if "a capable patient explicitly indicates that they do not want their family members involved in their decision-making...confidentiality must be respected. If we regard MAID as practically and ethically equivalent to other medical decisions that result in the end of life, then confidentiality regarding MAID should be managed in this same way."
The authors admit that "this conclusion set our working group distinctly on edge. Would we really allow a capable patient receiving care in our paediatric hospital to receive MAID without the knowledge or consent of their parents?"
Given that their draft flowchart for the process of initiating a request for euthanasia and carrying it out only mentions family in the very last stage, where the doctor who is to carry it out "meets with patient and family to discuss their preferences and educate family about what to expect during provision of MAID", it appears their answer is yes.
Reducing social stigma
The paper concludes by saying that the hospital will "as an institution, publicly discuss the provision of MAID in an effort to normalise this procedure and reduce social stigma for everyone involved."
In other words, the hospital seeks to destigmatise the euthanisation of children without parent consent, as they radically depart from fundamental medical ethics, genuinely informed consent and basic care.
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