Deliberations Continue On Complex Topic Of Infant Euthanasia

Main Category: Pediatrics / Children's Health
Article Date: 16 Jul 2008 - 2:00 PDT

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The legal and ethical debate about infant euthanasia continues to rage on worldwide, with countries adopting vastly different laws for cases involving newborns with devastating illnesses.

In the May-June 2008 issue of Pediatric Nursing journal, Anita J. Catlin and Renee Novakovich analyze this controversial issue and describe how a protocol in The Netherlands has influenced opinions in the United States.

After caring for an infant girl with a fatal skin disease in The Netherlands, Dr. E. Verhagen, a clinical director at the University Medical Center in Groningen, felt he failed to humanely end the child's suffering. Fearing legal consequences, Verhagen sent the child home and she died six months later. The case inspired him to become an advocate for infant euthanasia in extreme cases and he developed the Groningen Protocol. As a result, an advisory committee in The Netherlands now reviews cases for compliance with the protocol and euthanasia is allowed, albeit under stringent circumstances.

In the United States and most other nations, however, "direct medical euthanasia of infants (as distinct from withholding or withdrawal of certain life-prolonging therapies) is not legal," according to Catlin and Novakovich. Because the issue is so complex, the American Nurses' Association (ANA) has been working to define for nurses the differences between euthanasia, assistance in dying and palliative care, with the last two being mandatory actions for all nurses.

While opponents of the Groningen Protocol label it "murder" and supporters consider it "beneficence," countries must continue to examine the moral, medical, ethical and legal aspects, the authors write. This will help health care professionals provide the most "dignified, loving, and comfortable living and dying experiences for infants and support for their families." (The Groningen Protocol: What Is It, How Do the Dutch Use It, and Do We Use It Here?; Anita J. Catlin, DNSc, FNP, FAAN; Renee Novakovich, RN; Pediatric Nursing, May-June 2008, http://www.pediatricnursing.net)

Online Support Groups Can Help Asthma Caregivers Cope

Asthma is an unpredictable and chronic condition. While doctors and nurses provide health care for their pediatric patients, managing the disease day-to-day falls upon parents, a responsibility that can be extremely demanding.

In the May-June 2008 issue of Pediatric Nursing journal, Claire F. Sullivan examines an online asthma caregiver group to tap into their frustrations and challenges. The goal of her analysis was to help health care professionals better understand and address patient care and family concerns.

Sullivan found that five common themes emerged:

1. Monitoring. The most common caregiver was the child's mother. These individuals were frustrated by the constant surveillance needed due to their child's exposure to environmental triggers.

2. Fitting the pieces together. Medications, testing and equipment use caused confusion among the mothers.

3. Second guessing the doctor and the doctor second guessing caregivers. Mothers wrote often about communication problems and lack of guidance about treatment.

4. Responsibility. The mothers were overwhelmed and many did not get support from their husbands.

5. Bonding. The online group provided validation and empathy. The contact reduced mothers' feelings of isolation and gave them a forum to vent their frustration and share experiences.

According to Sullivan, nurses may encourage caregivers to participate in online support groups to help increase their empowerment and knowledge. In addition, nurses may benefit from participating in the online groups themselves and reading the discussions to better understand caregivers' issues. While misinformation is possible among these groups, Sullivan writes that "online support groups may be the next major advance in e-health services for patients and caregivers." (Cybersupport: Empowering Asthma Caregivers [Continuing Nursing Education Series]; Claire F. Sullivan, PhD; Pediatric Nursing, May-June 2008, http://www.pediatricnursing.net)

Pediatric Nursing is a clinically-based journal focusing on the needs of professionals in pediatric practice, research, administration and education.

Pediatric Nursing