University of Groningen, The Netherlands, P O Box 716, 9700 AS Groningen, The Netherlands.
J Med Ethics. 2011 Jan;37(1):29-33. doi: 10.1136/jme.2010.037267. Epub 2010 Oct 28.
In the Netherlands, using drugs to deliberately end the life of a severely defective newborn baby who is in extreme suffering can be permissible under very precise circumstances. This does not mean that all Dutch neonatologists are willing to engage in such behaviour. This paper discusses the use of neuromuscular blockers (NMBs) in connection with abstention decisions in neonatology and the boundaries between 'deliberate ending of life' and other end-of-life decisions. These boundaries are of paramount importance because, of all end-of-life decisions, only 'deliberate ending of life' must be reported by the responsible doctor and exposes him to the risk of being prosecuted.
14 Dutch neonatologists were presented with a hypothetical case of a severely asphyxiated baby who faces a long dying process after withdrawal of 'medically futile' (zinloos) life-sustaining ventilation. Doctors were asked whether it is acceptable to administer NMBs in this situation and whether such behaviour should be reported.
Doctors' responses were heterogeneous, showing that the acceptability of using NMBs in certain situations and the boundaries between end-of-life decisions are currently a subject of discussion among Dutch neonatologists. Many respondents reported feeling threatened by the potential involvement of the criminal law authorities in the system of control over 'deliberate ending of life'.
在荷兰，在非常特殊的情况下，使用药物故意结束患有严重缺陷且极度痛苦的新生儿的生命是可以被允许的。这并不意味着所有荷兰新生儿科医生都愿意采取这种行为。本文讨论了在新生儿科中使用神经肌肉阻滞剂（NMBs）与放弃治疗的决定之间的关系，以及“故意结束生命”和其他临终决策之间的界限。这些界限至关重要，因为在所有临终决策中，只有“故意结束生命”必须由负责医生报告，并使他面临被起诉的风险。
向 14 名荷兰新生儿科医生介绍了一种假设情况，即一名严重窒息的婴儿在停止“无意义”的生命维持通气后，面临着漫长的死亡过程。医生们被问及在这种情况下是否可以使用 NMBs，以及这种行为是否应该报告。
医生的反应存在差异，表明在某些情况下使用 NMBs 的可接受性以及临终决策之间的界限目前是荷兰新生儿科医生讨论的主题。许多受访者报告说，他们感到受到刑法当局在“故意结束生命”控制系统中参与的威胁。
