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.
Now you have to think about why someone would prefer to whisk the child away to a steel table and a lethal injection. I think it has to do with the intersection of those two admirable virtues, tidiness and compassion. Tidiness requires that people who are damaged be scrubbed away. Compassion murmurs that this is what they, themselves, actually wish. If they can't say so, we'll strongly wish it for them.
But what is the ultimate outcome of a world where only the perfect survive? Yes, I know that at present there are plenty of imperfect specimens around. Yet this kind of thinking has a tendency to creep. I'm not sure, for example, what is envisioned by this line in the Associated Press report on the Groningen Protocol: infant euthanasia for "diseases where a child could survive only on life support for the rest of its life, such as severe cases of spina bifida." What's "severe"? I've known people with spina bifida and so have you, and they prefer being alive, thank you. If it's dramatically more severe than that, can't we just let nature take its course? And as to the ambiguous phrase "for the rest of its life"first of all, can we at least say "his"? Second, how long a "rest of his life" are we talking aboutdecades? And what is "support"assistance with respiration, nutrition, surgery, a wheelchair?
If you were reading a history book you might be less shocked to find incidents of termination of the ill, elderly, and unwanted children in a time of famine or distress, but it seems to be our very success, our comfort and safety, that makes us deem these imperfect ones disposable. Everyone on TV looks so fine and healthy; everyone we pass while shopping looks well-fed. Surely that's the standard. Those who fail to meet it unsettle or disgust us. Surely they'd prefer to be put to sleep.
This season celebrates the bright moment of a birth in a stable in Bethlehem. But that birth was shadowed immediately with death, lots of it, as Herod wiped out hundreds of newborn children in his futile attempt to get at the one he feared. He cleaned up Bethlehem the way the Marshall cleans up Dodge City.
Herod was searching for the Perfect One, the Christ, who was prophesied to be his downfall. In the process hundreds of "imperfect" children were ripped from their mothers' arms and sacrificed. A similar quest for the "perfect" child now drives this impulse to scrub away the "imperfect" children who fail to meet our expectations. When we greet the sick and dying with speedy annihilation we replicate the ruthlessness of Herod. But what would Christ have us do? Picture him holding a dying child in his arms. What action would he take?
Death looks superficially like such a compassionate thing to do. But that's a projection on the part of the strong and healthy, who find the sight of the weak and dying unsettling. We wish to "put them out of their misery" as we would a pet. But it's really our misery that we're trying to end. Death is an efficient way to solve lots of problems, no doubt about it. It cures poverty, illness, and unpopular opinions. It's tidy, and can certainly be presented as compassionate. But this time-tested means of problem-solving has been opposed, throughout all history, by Christians. Herod's Slaughter of the Innocents was exposed by St. Luke, and believers ever since have honored the memory of those children as a warning of what too much zeal for tidiness can do. It's a Christmas tradition well worth preserving.
Copyright © 2004 Christianity Today. Click for reprint information.
The lectionary readings for the Slaughter of the Innocents are available from TextWeek.
The passage from Matthew 2:13-23 is available from BibleGateway.
News elsewhere on the Dutch euthanasia includes:
Secret killings of newborn babies trap Dutch doctors in moral maze | Call for new rules to end dilemma for medical and legal professions. (The Guardian, UK, Dec. 21, 2004)
Dutch medics call for wider euthanasia laws | A commission of experts assembled by the Royal Dutch Medical Association on Thursday have called for a widening of the guidelines for allowing euthanasia in the Netherlands, to include mercy killings for patients who are tired of living. (Independent Online, South Africa, December 17 2004)
Call to allow 'suffering from life' mercy killings | Dutch doctors should be allowed under very strict conditions to help with mercy killings or euthanasia of patients who are not ill, but who are suffering from life, a special commission has advised. (Expatica, Netherlands, Dec 16, 2004)
Dutch consider infant euthanasia | Doctors in the Netherlands are calling for new laws allowing them to end the lives of newborn babies with intolerable and incurable illnesses. (BBC, December 14, 2004)
Euthanasia troubles Oregon doctors | Physicians say the practice in the Netherlands fails to give terminally ill newborns a chance to survive (The Oregonian, Dec 6, 2004)
Dutch hospital OK'd baby euthanasia | The revelation comes as the nation grapples with whether to allow mercy killings for those who can't decide for themselves (The Oregonian, Dec 1, 2004)