Emily Graves spoke with Dr Peter Saunders about Belgium, the Netherlands and England

Emily: Since 2005 the Netherlands have not prosecuted doctors who have performed euthanasia on minors as long as the doctor's act is in accordance with a set of medical guidelines dubbed The Groningen Protocol. Please could you tell us more about that?

Peter: The Groningen Protocol is named after a large town in the Netherlands where it was developed. This is something quite different really. In the Netherlands it is supposedly illegal to offer euthanasia to minors and to babies, but what they have created is a system whereby babies who are disabled or who have severe illnesses, such that they are unlikely to survive, can have euthanasia involuntary. This is obviously long before they are capable of making any decisions for themselves. What happens is that if the doctor can tick a series of boxes, the judiciary basically turns a blind eye and allows them to get on with it. This is hugely controversial.

When it was first written up in a peer-reviewed medical journal in 2005 they reported on 22 cases of babies with spina bifida who'd been given lethal injections over a seven year period and said that there were probably many more. In fact the Dutch Medical Association has just issued a report saying that they think there are around 650 babies every year that could be given lethal injections under this protocol. It seems to have been accepted in the Netherlands now that if you are a baby with special needs then your life is not worth living, so you can effectively be bumped off by doctors, with the consent of your own parents as well. Many parents are giving consent for this and you can imagine the Disability Rights Lobby is absolutely incensed and up in arms about this. They are saying, you are saying my life is not worth living, because this child with the same condition as me has been killed without having any say in it whatsoever. It's a very dangerous and worrying precedent that first of all people are saying that such a life is not worth living and allowing others to make that judgement about people; but secondly, that in the Netherlands one of the main things seeming to be driving this is the supposed suffering that it causes to the family. If you're burdened in the family with someone with an illness then it's alright to kill them.

Emily: Do you think that this protocol has encouraged Belgium to look at the child euthanasia bill?

Peter: Yes. I suppose the difference is that under the Groningen Protocol in the Netherlands we're talking about disabled babies. Whereas in the Belgium situation it's more minors, teenagers younger than 18, so it's a different sort of thing. In Belgium it's going to be legalised, whereas in the Netherlands it's not legal but the judiciary turns a blind eye. There are some differences, but what we've seen is that wherever euthanasia and assisted suicide is legalised, you get what we call incremental extension; a slippery slope. You get more and more cases every year; in fact in Belgium there's been a 5,000% increase in the number of annual cases recorded since the first year in 2002. It goes steadily up every year. In the Netherlands since 2006 there's been a 15%-20% increase every year. In the Netherlands they're now talking about patients with dementia having it and the first ones have already had euthanasia there. There are a large number of people in the Netherlands now, one in eight deaths is due to what we call terminal sedation, where they withhold fluid and food and give huge doses of sedatives, with the deliberate intention that the patient will not come out of it and will not survive. There's a real case of incremental extension and the slippery slope operating in the Netherlands.

Emily: Going back to Belgium, this is a very significant step if this bill is passed, as Belgium would be the first country to legalise child euthanasia. How will this impact the country?

Peter: What we see whenever a new law comes in is the first thing is that people start to practice up to the new law; so there will be child euthanasia. The second thing that happens is that people go beyond the new law; they push the boundaries and you see it being applied in less severe cases. It's not going to be long before someone raises the question about babies as they have in the Netherlands. The third thing and perhaps the most worrying thing that happens is that the public conscience begins to change, so that things that would have horrified people in one generation just don't bother people much at all in the next generation. We've seen this in the parallel case of abortion, where 50 or 60 years ago for most people in Britain abortion would have been absolutely unthinkable; but now we have 200,000 cases a year and one in five pregnancies ending in abortion. There is no doubt in my mind that the same thing will happen with euthanasia once it becomes more widely practiced. As I say it all starts with the idea that there's a life not worth living, combined with the idea that if someone is creating a burden for us, then we can encourage them to end their life or make that decision for them.

Emily: Looking a bit closer to home, what is the perspective on euthanasia in the UK at this time?

Peter: There's been a lot of pressure to change the law here for many years. There have been three attempts; two in Westminster Parliament and one in Scotland over the last six years and all of them have failed. All of them have attempted to legalise assisted suicide rather than euthanasia when a doctor helps them kill themselves. The reason that British parliaments have opposed these laws is primarily about their concern for public safety. If you change the law for a small number of people that some may regard as deserving, then inevitably what happens is that vulnerable people feel pressured to end their lives and I mean people who are elderly, who are sick, who are depressed, who are perhaps disabled; people who feel for whatever reason that their lives constitute some kind of emotional or financial burden for others. That's why British parliaments have universally blocked it, but of course the pressure goes on and on. We've got two bills coming later this year; another one in the House of Lords and another one in Scotland, which will attempt to push those boundaries yet again.

Emily: Please could you tell us more about these bills?

Peter: There's a bill introduced by Lord Falconer into the House of Lords. It's had it's first reading, which means it's been printed and viewed and it will have it's second reading either in July or more likely in October when it will be debated by the House of Lords. Then if it's passed it will go to the committee stage third reading and then on to the House of Commons. It would have to pass through both Houses of Parliament to become law.

Lord Falconer wants to legalise assisted suicide, but not euthanasia, for mentally competent adults who've got six months or less to live. The Scottish bill is being introduced by a member of parliament, Margo MacDonald; she's tried it before and failed. She's got the 18 signatures she needs to take a bill forward and she's held a consultation and we think it's going to be assisted suicide for mentally competent adults similar to Falconer. We haven't seen the bill printed yet, so we don't know exactly what's in it. We expect it will come out in the summer. We're just waiting to see, but we hope that there will be a huge amount of opposition against both of these bills, because we don't want to go down the Belgian or the Dutch route.

Emily: For those who don't know, could you tell us a little bit more about assisted suicide?

Peter: Assisted suicide is really euthanasia one step back. Euthanasia is where the doctor gives the patient a lethal injection; assisted suicide is where the doctor prescribes lethal drugs for the patient to take under their own steam.