Extend assisted suicide to children? Belgium says yes; so should we.

The Belgian government this week approved new measures allowing the euthanasia of terminally ill children, a decision that on first reading would make most of us gasp.

It is a distressing concept, and the idea of helping a child die sounds incredibly cold and morally and ethically unsound — until you dive into the issue. While it raises painful and conflicting emotions, and choices, the Belgians — who have pushed assisted suicide to the edge before — are on the right, groundbreaking track.

As one might expect, it was a highly controversial issue, and the bill was opposed by the Roman Catholic Church as well as some pediatricians. From the Guardian:

The law lifts Belgium’s age restrictions on euthanasia and can sanction it where children have a terminal and incurable illness, are near death, and suffering “constant and unbearable physical” pain, and where parents and professionals agree to the choice.

The law was opposed by some Belgian paediatricians and the country’s leading Roman Catholic cleric.

The law will come into effect when signed by Belgium’s monarch, King Philippe, who is not expected to oppose the measure.

The decision to proceed with each proposal of euthanasia will also have be agreed to by a treating physician and an outsider brought in to give a second opinion.

Children will have to be interviewed by a pediatric psychiatrist or psychologist, who must determine that the child possesses “the capacity of discernment,” and then certify that in writing.

The issue boils down to what steps should be allowed to alleviate the suffering of terminally ill patients who are in great pain and choose to end their lives at a timing of their own choosing, rather than waiting for nature (medically extended as it might be) to take its course. Five U.S. states recognize physician-assisted suicide, or “aid in dying,” as proponents call it. California is not among them, despite several attempts to get such laws through the legislature. The Times’ editorial board has gone on record supporting the right of terminally ill patients to end their lives on their own terms, and I hope state lawmakers — or voters — eventually agree.

And that right should extend to children, in tightly controlled circumstances and with legal protections. I suggest a system, much like the Belgians approved, in which the child (first and foremost), the child’s parents or guardians, the attending physician and a court-appointed lawyer, medical doctor or psychologist acting as the child’s agent all agree that assisting the death is the humane thing to do.

It’s not an easy conclusion to reach. But if we believe that it is humane to give terminally ill adults the right to end their lives with medical help, how can we not extend that ability to terminally ill minors? Because of their age, they should be forced to suffer more than an adult?

Yes, there are sound reasons why we do not entrust the young with significant life decisions, and why we carve out exceptions for criminal behavior in recognition of their inability to often not understand the full weight and repercussions of their actions. But for a child facing death in the short term, and in agony, we as a society should enable the child’s right to die with the least amount of suffering — under the protocol (or a variation) suggested above.

Even if the concept chills us to the bones.

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