Severely disabled toddler euthanized in the Netherlands under new rules on the controversial practice

A severely disabled 1-year-old child has been euthanized by doctors in the Netherlands, a government review board has confirmed. It is the first case reported by authorities that was guided by new rules allowing for the termination of life of seriously ill children between the ages of 1 and 12 in the European nation. 

The child, whose sex and identity have not been disclosed, had extensive and irreversible brain damage, severe cerebral palsy, epilepsy and visual impairment, according to the assessment published by the Netherlands’ Review Committee on Late-term Abortions and Termination of Life of Neonates and Children aged under 12, which is responsible for reviewing such cases.

The committee said the child was born extremely prematurely, at 26 weeks and three days, while the family was abroad. The child then had serious complications, including multiple infections leading to sepsis. An MRI later revealed extensive brain damage. 

The child developed spastic cerebral palsy and was believed to have cerebral visual impairment. At 8 months, the child was also 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. 

Not all the doctors who assessed the child agreed with the decision to use euthanasia over the course of their treatment.

The doctor leading care for the child sought an independent opinion from “physicians from outside his own region,” who concluded “the child was not continuously suffering unbearably” and that “there were still reasonable alternatives, such as palliative options and other medications that could possibly result in better control of the epileptic seizures,” according to the review committee.

Further treatment was attempted, but the committee said it caused additional side effects so was halted. Another independent doctor subsequently concluded that the child’s suffering was clear and unbearable, and that the requirements for termination of life under the nation’s rules had been met.

The committee ultimately concluded that the physician involved in administering the euthanasia “acted with due care.”

The Netherlands introduced the rules in 2024, which apply to children suffering unbearably with no prospect of improvement, and for whom doctors conclude there is no reasonable alternative to ending their suffering.

The doctor who ended the child’s life has since spoken publicly about the case, saying on the NOS/Nieuwsuur current affairs program that the unprecedented nature of the procedure had left him feeling vulnerable.

“As a doctor, you are in an extremely vulnerable position, because this has never happened before,” he said. “It still feels as if a sword of Damocles has been hanging over your head for almost a year.”

The doctor said he hoped the ruling would help other families facing similar circumstances discuss the option with their physicians.

“I think there are parents out there who have never dared to discuss the option of ending their [child’s] lives before,” he said. “Hopefully, this ruling provides support to these parents to discuss this option with their treating physician.”

He described allowing termination of life in such circumstances as “a kind of emancipation of the child.”

The Netherlands became the first country in the world to legalize euthanasia in 2002, with the law also allowing children aged 12 and over to request it under strict conditions. Doctors who perform euthanasia unlawfully in the Netherlands risk up to 12 years in prison and a fine.

“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 committee said.