Do Children Have A Right To Die?

Late last week, Belgian lawmakers overwhelmingly passed a measure that would allow euthanasia for terminally ill children. Ben White and Lindy Willmott explain:

Belgium has removed the age limits to access its assisted dying regime and this has been reported as a world first. This is true, but it is also important to note that the scheme in the Netherlands permits access for children as young as 12, provided various conditions are met. So, the key difference in Belgium is that access to euthanasia is not limited by age. A child will only be eligible to access the legislation if all of the following conditions are satisfied:

The child must be “conscious” and display “a capacity of discernment”. This refers to a child who is competent to decide for themselves. …
The child must “be in a hopeless medical situation of constant and unbearable suffering that cannot be eased and which will cause death in the short-term”.
The child must be counselled by doctors and a psychiatrist or psychologist, and the child’s decision must be approved by his or her parents.

What is apparent is that the cohort of children who may access euthanasia in Belgium is narrow: terminally ill children who cannot otherwise be helped and who are capable of making a considered decision about seeking assistance to die. The capacity aspect serves as an indirect limit related to age, as only older, mature children would be able to satisfy that criterion.

Eugene Kontorovich fiercely objects:

Allowing minors to take their lives, or have them been taken, necessarily makes assumptions about their capacity that is at odds with many liberal features of international law.

International treaties, including the Rome Statute of the ICC, make the recruitment of child soldiers a crime, and European countries have been active in promoting the expansion of these norms. Being a child soldier (under 15) is not a crime, only enlisting them. Crucially, the consent of the child, her parents or any psychologists is not a defense. Indeed, consent is presumed, as the crime covers accepting voluntary enlistees. As the Special Court for Sierra Leone put it:

The act of enlisting presupposes that the individual in question voluntarily consented to be part of the armed force or group. However, where a child under the age of 15 years is allowed to voluntarily join an armed force or group, his or her consent is not a valid defense.

But is this still a far cry from euthanasia? Not if the underlying issue is one of capacity to make life-imperiling decisions.

The Belgians, who overwhelmingly approve of euthanasia for adults, seem to have been caught off guard by the international outcry. As Clare Wilson reports, even Belgian kids seem to support euthanasia, at least in certain cases:

There is some research on how children themselves view euthanasia. Take Femke, a fictional 14-year-old girl who has terminal bone cancer, cannot tolerate the pain and wants to die. Her hypothetical case was presented to 1,769 Belgian teenagers aged around 14 at 20 secondary schools. Of these, 61 per cent said Femke should be offered euthanasia, compared with only 18 per cent for Nathalie, a girl with severe but not life-threatening burns. In another study, 90 per cent of adolescent cancer survivors interviewed said terminally ill children should be free to make end-of-life decisions. ”Most children say they would want to make the decision on their own,” says Johan Bilsen of the end-of-life care research group at the Free University of Brussels and Ghent University, who co-authored both studies, “but would want their parents involved.”