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A Standardized Pig to Macaque Heterotopic Heart Xenotransplantation Model

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Published on: November 4, 2025

A case against justified non-voluntary active euthanasia (the Groningen Protocol).

Alan Jotkowitz¹, S Glick, B Gesundheit

¹Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. ajotkowitz@hotmail.com

The American Journal of Bioethics : AJOB

|December 9, 2008

Summary

The Groningen Protocol permits euthanasia for severely ill newborns, but critics argue it considers future quality of life, unlike claims it only applies to terminally ill infants. This ethical debate questions its alignment with medical codes and societal values.

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Area of Science:

Medical Ethics
Neonatal Care
Bioethics

Background:

The Groningen Protocol outlines conditions for active euthanasia in neonates experiencing unbearable suffering.
Proponents claim the protocol is for terminally ill infants and excludes quality-of-life considerations.
A historical parallel is drawn to the Nazi Euthanasie Program's premise of lives unworthy of living.

Purpose of the Study:

To critically analyze the Groningen Protocol's application and ethical underpinnings.
To investigate discrepancies between the protocol's stated aims and its actual implementation.
To evaluate the protocol against traditional medical ethics and societal moral values.

Main Methods:

Textual analysis of the Groningen Protocol.
Ethical review of the protocol's criteria and justifications.
Comparative analysis with established medical ethical codes.

Main Results:

The Groningen Protocol does not exclusively refer to terminally ill infants.
The protocol implicitly or explicitly considers the future quality of life of the infant.
The protocol's framework raises concerns regarding potential violations of medical ethics and societal values.

Conclusions:

The Groningen Protocol's consideration of future quality of life contradicts claims of its exclusive application to terminal cases.
The protocol's ethical basis is questioned due to its potential conflict with traditional medical ethics.
There are significant ethical concerns regarding the Groningen Protocol's alignment with global moral values.