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As many as 650 babies are euthanized every year in the Netherlands because they are believed to be suffering or because a newborn's imminent natural death is emotionally distressing for the parents, reports the Royal Dutch Medical Association (KNMG).

In the organization’s policy statement “Medical decisions about the lives of newborns with severe abnormalities,” it explains that a lethal injection to euthanize a baby is ethically permitted if “the period of gasping and dying persists and the inevitable death is prolonged, in spite of good preparation, and it causes severe suffering for the parents.”

In 2002, the Netherlands became the first country in the world after the downfall of the Nazi regime to legalize euthanasia, but the law at the time restricted the practice to those 18 and older.

Since 2005 the country has not prosecuted doctors who euthanized children as long as the doctors acted in accordance with a set of medical guidelines called the Groningen Protocol, drafted by Dr. Eduard Verhagen in 2004.

Dr. Verhagen, who is one of the authors of the KNMG policy statement, explained to Volkskrant, a leading Dutch newspaper, why parental anguish is relevant to the decision to kill their child.

He argued that doctors should spare parents the “abomination” of seeing their child die in distress, saying that it is part of good palliative care.

“These children are gray and cold, they get blue lips and suddenly every few minutes they take extremely deep breaths. That's very nasty to see, and it can go on for hours and sometimes days,” Verhagen said.

The KNMG policy statement said that out of the 175,000 babies born in the Netherlands each year, 650 are candidates for euthanasia because these children are likely to die anyway.

“These babies, despite very intensive treatment, will certainly die in the short term. They have a poor prognosis and a very bleak life perspective. They may not be dependent on intensive care but they face a life of serious and hopeless suffering. Doctors and parents face the exceedingly profound question of whether to start or continue treatment or even whether a good action may actually be a harm, in view of the suffering and disability that may result from the poor health of the child.”

Dr. Verhagen says he himself is unsure about whether a child who is “gasping” is actually suffering. “It may feel pain and discomfort, but suffering is a complex social and psychological phenomenon without scientifically validated criteria,” he said.

While Dr. Verhagen is well known for his continuing support of euthanasia in the Netherlands, other experts have changed their minds after seeing the escalation of administered death in their country.

Dutch ethicist Professor Theo Boer, who is on record for having said that a “good euthanasia law” would produce relatively low numbers of deaths, told the British House of Lords in 2014 that he now believes that the very existence of a euthanasia law turns assisted suicide from a last resort into a normal procedure.

“I was wrong – terribly wrong, in fact to have believed regulated euthanasia would work. I used to be a supporter of the Dutch law. But now, with 12 years of experience, I take a very different view,” he said.

“Euthanasia is now becoming so prevalent in the Netherlands, that it is on the way to becoming a default mode of dying for cancer patients,” he continued. “Assisted deaths have increased by about 15 per cent every year since 2008 and the number could hit a record 6,000 this year.  Campaigns for doctor-administered death to be made ever easier will not rest until a lethal pill is made available to anyone over 70 who wishes to die. Some slopes truly are slippery.”

Wesley J. Smith, a senior fellow at the Discovery Institute’s Center on Human Exceptionalism, wrote in The National Review that the argument for euthanasia based on elimination of suffering due to terminal illness is a dangerous illusion.

“Stop pretending assisted suicide is about terminal illness and admit it is much more about disability–which is why the disability rights movement remains so opposed as they are the primary targets.  It is about allowing killing as an acceptable answer to many causes of suffering, whether terminal or chronic disease, disability, mental illness, or existential despair,” he wrote.

“Indeed, as we have seen in Switzerland, Netherlands, and Belgium, once the fundamental premise [of euthanasia] is accepted, the sheer force of logic leads to permission for virtual death-on-demand.”