Interview With Neonatologist Carlo Bellieni
SIENA, Italy, 6 MAY 2005 (ZENIT)The desire to do away with personal
suffering is one of the driving forces behind euthanasia, an attitude
described as "handiphobia," says an Italian neonatologist.
In this interview with ZENIT, Dr. Carlo Bellieni, of the Le Scotte
Polyclinic of Sienna, talks about the phobia of handicap and the real
reasons for incidences of euthanasia.
Q: The Groningen declaration (an agreement between the Dutch judicial
authorities and Groningen's university clinic that authorized euthanasia
in children under 12 without their consent) brought back to the center
the problem of euthanasia in regard to newborns. How does a doctor of
neonatology feel about such a possibility?
Bellieni: The first incredulity lies in the fact that today we have
available in the area of neonatology analgesic drugs of such strength
that to think that recourse is taken to euthanasia in cases of
unacceptable pain is really anachronistic. The problem is that analgesic
drugs must be used, but there are still resistances.
Q: But suffering is not only pain but also psychic distress.
Bellieni: Indeed! But while one can speak of suffering in an adult when
faced with an ill-fated prognosis, this reasoning doesn't apply in the
case of a newborn: It is obvious that suffering about one's future is
not posed in the case of someone who is unable to reason about himself,
or understand data, ideas and symbols.
Q: However, in time, once the neonatal age is passed, the pain and
suffering of a child can manifest themselves.
Bellieni: Yes, but this will never make the state "not human," or "not
worth living." We have testimonies of gravely ill patients who are more
serene than certain "healthy ones." Suffering exists and it is a
challenge, but not a "black hole" of meaningless tragedy.
Q: What is being said, then, about the suffering of someone for whom the
cure proposed is euthanasia?
Bellieni: Perhaps something is being said about our own suffering. Why
discuss the possibility of euthanasia with parents? ("It is vital to
have an exact prognosis and discuss it with the parents," writes
Verhagen in connection with the Groningen protocol). To involve the
parents means that we are not on a path encased in certainties, but
still subject to human passions, doubts and uncertainties.
That is why I say that euthanasia does not respond to the suffering of
the patient, but of the one who decides. And it is really tragic.
Instead, the point is to understand that it is in this area that our
responsibility is at stake: To help to face or to run away from the
problem.
Suffering must be addressed, supported; it is not resolved by running
away; it's not even resolved by death. Yet consider how liberating and
positive it is, also therapeutically, to understand the child's worth
beyond the illness or malformation.
We know from scientific readings that the way a handicapped child is
accepted depends very much on the character of the parents, but also on
the human environment that surrounds him. Obviously, this does not mean
the opposite evil, namely, that the doctor is the absolute arbiter of
life; I would like to make it understood how much uncertainty is
involved.
Q: Did Terri Schiavo's case cause apprehension?
Bellieni: Of course, but the problem remains identical. What suffering
is being attended in a person who "does not feel anything?" It is
apparently a contradiction! The fact is that it remains too much on the
surface: a "state" is witnessed that we would not like to be in and by
induction we think that it is a state that is impossible to live in. The
fact is we have such a narrow idea of our life that we think that it is
possible to be worth living only if it has certain characteristics.
Q: Then why is there pressure in favor of euthanasia?
Bellieni: I think this is explained well with the word "handiphobia."
This is phobia toward handicaps, phobia of what is not under control,
which impedes thinking with serenity of the handicapped. Perhaps we
think of them out of compassion, but not as those who are essentially
identical to those who are not handicapped.
It seems paradoxical, but imagined reality causes greater fear than true
reality. How many families do we know who are terrified to have a child
with serious paralysis, or serious mental retardation, and the moment
this circumstance manifested itself, they understood something
fundamental: their lives changed, but did not end! "Handiphobia" instead
is fear of what we don't know how to control, calculate and measure, and
as with all phobias, must be made to disappear.
Q: Are there more problematic areas?
Bellieni: Doubts about the certainty of the diagnosis, which is really
arduous in the prenatal period.
J.M. Lorenz, of neonatology of Columbia University, evaluating the pros
and cons of the efforts at resuscitation, wrote in the "Pediatrics"
review in 2004: "The efforts to reduce the number of handicapped
survivors through selective neonatal resuscitation lead to a diminution
of handicapped survivors, but some children who would have survived
without handicap will die."
In addition, there is the ethical doubt. According to an article in the
"Journal of the American Medical Association," Peter Singer justifies
infanticide on the basis of "total utility": "When the death of a
handicapped child leads to the birth of another child with better
prospects of a happy life, the total quantity of happiness will be
greater if the handicapped child is killed."
Q: What solution is there in the case of a seriously brain-damaged
child?
Bellieni: Not to leave him alone. Not to leave him or his family alone.
The child needs his family, and his family needs support from the
doctors and nurses, who must help to identify a path to therapy. And if
a therapy is not possible that will give health back, there must at
least be a way to understanding, to a rational addressing of the
circumstance, so that the parents are not overwhelmed by feelings of
guilt or impotence. And the participation of the community and the
authorities should also be envisioned that opens all channels of support
and facilities for the family.
To hear talk of euthanasia is not comforting to families who chose this
path years ago! In any case, guidelines are needed to help distinguish
between someone who is undoubtedly dying, and someone, instead, who is
seriously damaged to the degree of running the risk of handicap, but not
of death, and, finally, one who has, for the time being, only a serious
risk of being so. ZE05050620
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