Are we asking the right questions?

doi:10.1136/bmj.39212.710093.3A

BMJ 2007;334:1072 (26 May), doi:10.1136/bmj.39212.710093.3A

Letters

Euthanasia in neonates

Are we asking the right questions?

The first 150 words of the full text of this article appear below.

Costeloe dismisses some of the key issues and draws attentionaway from the dangers and limitations of the current approach.¹I question our current interpretation of "active" and "passive"euthanasia. How exactly is extubating a child with serious pulmonarydisease (which may or may not improve) different from givinghim or her a lethal injection? The former action is legal, acceptedpractice, the latter is not—does this make sense?

Cases such as the above example are usually covered by a concurrentopiate infusion. This is administered under the so called doctrineof double effect. When a baby or child is taking terminal gaspsor making similar movements the care team will often increasethe infusion to reduce distress. Do they genuinely know thechild is in distress or are they responding to the family'sand perhaps their own distress? If the latter the action maywell be entirely appropriate—but it . . . [Full text of this article]

Peter-Marc Fortune, consultant paediatric intensivist

Royal Manchester Children's Hospital, Manchester M27 4HA

peter-marc.fortune@manchester.ac.uk