NETHERLANDS — The Netherlands Review Committee on Late-term Abortions and Termination of Life of Neonates and Children aged under 12 has confirmed that a physician performed euthanasia on a 1-year-old child in accordance with due care procedures. This marks the first official case under new 2024 guidelines permitting the practice for children between 1 and 12 years old who suffer unbearably with no prospect of improvement. "The guiding principle for termination of life in children aged under 12 is that the physician must have come to the conclusion that according to prevailing medical opinion termination of life is the only reasonable way to end the child's unbearable suffering without prospect of improvement," the Netherlands Review Committee on Late-term Abortions and Termination of Life of Neonates and Children aged under 12 said.

The committee ultimately concluded that the physician involved in administering the euthanasia acted with due care. The child had extensive and irreversible brain damage, severe cerebral palsy, epilepsy, and visual impairment. At 8 months, the child was diagnosed with infantile epileptic spasms syndrome, a severe form of epilepsy.

Just before the child turned 2, doctors estimated their developmental age to be around 6 weeks. "Every facet of 'being human' in terms of motor skills, behavior and personality was severely affected, and there would be no improvement," the committee said. The epilepsy led to a severe sleeping disorder, coughing fits, and a swallowing disorder.

In the months prior to the child’s death, seizures increased when the child was eating. The child had very severe developmental delay, and the prognosis indicated lifelong dependence on support for all daily activities. The baby faced a significantly elevated risk of breathing infections, and physicians determined there was a very high probability of early death due to complications.

The physician fully informed the child’s parents about the process, obtained their consent, consulted with at least one independent doctor, and exercised due care. The doctor who ended the child's life spoke publicly about the case on the NOS/Nieuwsuur current affairs program. "As a doctor, you are in an extremely vulnerable position, because this has never happened before," the doctor said.

"It still feels as if a sword of Damocles has been hanging over your head for almost a year," the doctor said. The doctor described allowing termination of life in such circumstances as "a kind of emancipation of the child." "I think there are parents out there who have never dared to discuss the option of ending their [child's] lives before," the doctor said.

Why It Matters

This confirmation represents the first implementation of the 2024 regulations extending euthanasia eligibility to children aged 1 to 12, a group previously excluded from explicit statutory provisions despite existing neonatal practices. The decision sets a precedent for how medical professionals and review bodies will assess the criteria of unbearable suffering and lack of improvement in non-verbal patients within this age range.

The case illustrates the procedural safeguards required under Dutch law, including mandatory consultation with an independent physician and adherence to a six-point checklist before any life-ending intervention. By validating the physician's actions, the committee reaffirmed the legal framework shielding doctors from criminal liability when they follow established due care standards, while underscoring the serious consequences for those who do not.

Timeline

The Netherlands became the first country to legalize euthanasia in 2002. Belgium has permitted doctor-assisted death for children of all ages since 2014. Canada legalized medical assistance in dying in 2016. In 2024, the Netherlands introduced rules allowing euthanasia for children aged 1 to 12 who are experiencing unbearable suffering with no hope of improvement and for whom doctors determine there is no reasonable alternative to ending their suffering.

What's New

Additional details show that physicians must follow a six-point checklist under the Termination of Life on Request and Assisted Suicide (Review Procedures) Act before proceeding with euthanasia. Medical evaluations indicated a realistic expectation that the child’s condition would worsen. Doctors concluded there was no feasible way to alleviate or end the child’s suffering except by terminating the child’s life.

The epilepsy caused a severe sleeping disorder, coughing fits, and a swallowing disorder. In the months before the child’s death, seizures intensified during feeding.

How Sources Differ

On review procedures and committee confirmation, the Netherlands Review Committee on Late-term Abortions and Termination of Life of Neonates and Children aged under 12 confirmed that a 1-year-old child was euthanized by doctors. In contrast, the Termination of Life on Request and Assisted Suicide (Review Procedures) Act states that doctors must consult a six-point checklist before deciding whether to end a patient's life under the Termination of Life on Request and Assisted Suicide (Review Procedures) Act.

Regarding age thresholds in Dutch euthanasia law, the Dutch model for regulating paediatric euthanasia notes that the 2024 law allowing euthanasia for children aged 1–12 built on earlier Dutch regulations for neonatal euthanasia, which had been permitted since 2002 under strict medical oversight. Meanwhile, the Termination of Life on Request and Assisted Suicide (Review Procedures) Act specifies that children aged 12 and over may request euthanasia under strict conditions.