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December 1992

Medical Decisions Concerning the End of Life in Children in the Netherlands

Author Affiliations

Department of Pediatrics University Hospital Sophia Children's Hospital PO Box 70029 3000 LL Rotterdam, the Netherlands; Dutch Health Council PO Box 90517 2509 LM The Hague, the Netherlands; Department of Medical Ethics Erasmus University Faculty of Medicine PO Box 1738 3000 DR Rotterdam, the Netherlands

Am J Dis Child. 1992;146(12):1429-1431. doi:10.1001/archpedi.1992.02160240039017

In this issue of AJDC, Orlowski et al1 discuss pediatric euthanasia in the Netherlands. We are disappointed about this article for several reasons. Orlowski et al have not reviewed, in a balanced way, the complex issue of euthanasia in adults and children. The authors seem to pretend otherwise, but in the Netherlands adult euthanasia and pediatric euthanasia are treated separately because of the fundamentally different medical, ethical, legal, and emotional grounds. Why did the authors not compare the discussions of pediatric euthanasia in the Netherlands with those in the United States? The article lacks factual accuracy. Furthermore, we do not agree with the two main conclusions of the authors, namely, that euthanasia is not needed if more effective pain control and psychological support for the dying are available and that the Dutch find themselves on a slippery slope.

We first point out