End-of-life decisions in newborns and the ‘Groningen protocol’

Department:  Pediatrics (Beatrix Children’s Hospital), UMCG
Supervisor:  Eduard Verhagen, MD JD PhD

Technological developments have provided tools to deal with many consequences of premature birth and congenital anomalies. However, there are still conditions that we cannot treat and cases where treatment fails. The decision when to start and when to withhold or withdraw treatment in individual cases is very difficult. Even more difficult are the decisions regarding end of life measures in infants who have no hope for improvement and lead a life of severe suffering that can not be alleviated.

This workshop will introduce the participants to the daily life on a Neonatal Intensive Care Unit  (NICU): the clinical challenges of prematurity, neonatal diseases and congenital anomalies, the treatment successes and the disappointments. End-of-life decisions are very much part of the daily reality of the medical and nursing staff. These decisions involve medical, ethical en legal aspects. The much-debated ‘Groningen protocol’ about active ending of life (newborn-euthanasia) seems to have a position in the spectrum of medical decisions regarding the end of life. Find out what it is, what it isn’t and form your own opinion about it.

The objectives of the workshop are:
• To develop an awareness of the medical issues in the care of newborn infants, particularly with respect to withholding or withdrawal of intensive care treatment and futility.
• To understand the different types of end-of-life decisions in newborns
• To have an understanding of ethical and legal principles that are relevant to end-of life decisions
• To understand the background and use of the Groningen protocol
• To use the understanding of the decision making process in discussions on end-of-life aspects