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If you close your eyes and picture a housewife with a bucket of hot water and a bristle brush, scrubbing away at her front doorstep, the small line of type at the lower corner of your imagination reads "The Netherlands." That's the Dutch: tidy, polite, reasonable and compassionate.

"Tidy" and "compassionate" can intersect in a strange way, however, when it comes to handling the tragedies of life. Three years ago, the Dutch Parliament shocked the world by passing a law allowing "mercy killing" under certain circumstances. The patient had to be in intractable pain, and to request it personally. In such a case, his doctor could deliver a lethal injection of sedatives and muscle relaxants.

Lay aside the question of whether there is such a thing as "intractable pain;" as Eric Chevlen and Wesley J. Smith explain in their useful book, Power over Pain: How to Get the Pain Control You Need, advances in medicine mean that it's now possible to manage even severe chronic pain. But from the perspective of the healthy physician or family member standing at the bedside, it might well look like a person would be better off dead. It doesn't take patients long to get the message that their unsightly, untidy existence distresses those who love them, and that it's time to clear out. That's only good manners.

The question at the time the law was passed was how young a patient could be deemed capable of making such a decision. At present, a Dutch sixteen-year-old can order himself terminated, even against his parents' wishes. A proposal to drop the age of autonomy for self-annihilation to twelve did not pass.

Thank God for small favors, you may say. But now it appears that the thoughtful, compassionate Dutch have found a way to begin tidying up at the other end. What about people who are incapable of deciding for themselves, such as the mentally ill or comatose? What about babies? Isn't it unfair to exclude them from the right to die?

The Groningen Academic Hospital recently revealed that it had been quietly exploring this question, and euthanized four babies in 2003. The guidelines they used included requirements that pain be intractable (as above), that there be no hope for improvement, and that the parents agree. A number of potential conditions were cited that could allow for the compassionate snuff, such as extreme prematurity and diseases that would require permanent life support.

There's a puzzler. Aren't we already dealing with cases where a newborn is premature, or needs life support? We do it by treating the premature condition as best we can, and supplying the support necessary. And sometimes the damage exceeds our ability to help, and the child dies. No one is obligated to use painful and pointless treatments when a condition is incompatible with life, but isn't it enough just to let nature take its course? Why the rush to kill?

Over the years, as a pastor's wife and as a childbirth teacher, I've encountered tragic situations where a newborn came into the world dying. In a couple of cases, it was known ahead of time; sonography revealed that the child had a condition that could be accommodated in the weightless symbiosis of the womb, but that from the moment the cord was cut the child would begin to die.

In light of such news, families began making plans. Grandparents, aunts and uncles would be waiting nearby. As soon as the child was born, all would gather to hold and kiss her. Photos would be taken, wrinkled hands surrounding a tiny, gasping form. Prayers were said and hymns were sung. When the end came, the child who had so recently felt secure in the womb was secure in her mother's arms.

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December (Web-only) 2004, Vol. 48