False Compassion and True: What the Netherlands Child Euthanasia Case Reveals

The Netherlands confirmed its first life-ending procedure involving a child between the ages of 1 and 12 in late 2025. Dutch Health Minister Sophie Hermans disclosed the case in a June 22 letter to the House of Representatives, writing that the medical-legal review committee had received one such report and forwarded an advisory opinion to prosecutors, who retain independent authority over next steps.

The regulatory framework that made this possible took its current shape in 2024, when the Netherlands closed a legal gap between its existing provisions for newborns under exceptional circumstances and its separate track for minors aged 12 and older. The new rules permit life-ending procedures for children aged 1 through 11 when the child is terminally ill, when suffering is described as unbearable with no prospect of improvement, and when no reasonable treatment alternative or palliative option exists.

The language is compassionate in register. That is precisely the problem worth examining.

Two shapes of compassion

Compassion, as a moral concept, has a specific structure. It does not mean the removal of the suffering person. It means entering into proximity with the person who suffers. These are not variations on the same impulse; they move in opposite directions.

Palliative care research bears this out in ways that bear directly on the Dutch framework. Studies across pediatric oncology and end-of-life settings consistently find that requests for hastened death correlate more strongly with undertreated psychological distress, loss of perceived dignity, and fear of abandonment than with unmanageable physical pain alone. The category of 'unbearable suffering' is not a fixed clinical threshold. It is a relational and contextual condition, one that responds to the quality of presence surrounding the patient.

This is where the Dutch framework's core assumption warrants scrutiny. When a regulatory committee evaluates whether suffering is unbearable 'with no reasonable alternative,' it is making a judgment that is partly medical and partly philosophical — and the philosophical part concerns what kind of accompanying presence has actually been offered, and what kind of institutional will exists to provide it.

The Catholic anthropological claim

Catholic bioethicists cited in EWTN News reporting on the case characterized it as a grave ethical violation, arguing that the proper response to suffering is skilled care and genuine presence, not the intentional ending of a human life.

This position is grounded in a specific understanding of personhood. The Catholic model holds that the human person carries irreducible worth at every stage of life and in every condition of capacity — worth that is not a function of cognitive performance, prognosis, or the absence of suffering, but is constitutive of the person prior to any institutional assessment.

From this vantage point, the legal threshold of 'unbearable suffering with no reasonable alternative' is not merely a medical finding. It is a claim about when a life ceases to warrant its own continuation. That claim relocates the source of human dignity from the person to the committee evaluating the person's condition. Once that relocation is accepted, the eligible conditions tend to expand. The Netherlands' own record makes this visible: from adults with terminal illness in 2002, to newborns under exceptional circumstances, to minors aged 12 and older, to now children aged 1 through 11.

What palliative care can actually do

The hospice and palliative care movement, with roots in the Catholic charitable tradition, was built on the conviction that dying well is achievable when the right interdisciplinary supports are in place. Modern pediatric palliative medicine has produced evidence-based protocols for symptom management, family accompaniment, and psychological support that address many of the conditions Dutch policy describes as beyond remedy.

The therapeutic alliance — the quality of the collaborative relationship between a care provider and a patient or family — is among the most reliable predictors of positive outcomes in serious illness, including the patient's experienced sense of dignity and meaning. A strong therapeutic alliance does not eliminate suffering. It transforms the experience of suffering into something that remains connected to human meaning rather than severing it.

Viktor Frankl's clinical finding that human beings can endure almost any what if they have a why is not a consolation. It is a result with decades of empirical support in trauma, oncology, and end-of-life literature. When a child, or any person, is surrounded by a community whose choices communicate that they will not be abandoned, the calculus of unbearable suffering shifts — not because pain is diminished by declaration, but because the human context in which pain is experienced has changed.

The question before medicine, law, and psychology is not only whether euthanasia for children should be permitted under certain circumstances. The prior question is what kind of presence society is willing to build for those who suffer most acutely. Skilled care, genuine accompaniment, and the refusal of abandonment are not alternatives to medicine. They are its most demanding expression.

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