The Groningen Protocol: is it necessary? Is it scientific? Is it ethical?
OBJECTIVE
To explore whether the Groningen Protocol is clinically necessary, scientific, and ethically justified.


RESULTS
The Groningen Protocol is clinically unnecessary because the withdrawal of life-sustaining treatment from seriously ill infants is already ethically accepted globally without the need for the Protocol and because spina bifida, to which the Protocol has been most often applied, can be detected by ultrasound before viability, affording pregnant women the opportunity of termination of pregnancy. The Groningen Protocol is unscientific because it does not meet the accepted standards of evidence-based reasoning concerning the four clinical criteria for its application. The Groningen Protocol is unethical because it does not meet the standards of argument-based ethics in defining its four clinical criteria.


CONCLUSIONS
The Groningen Protocol is clinically unnecessary, unscientific, and unethical. Physicians should condemn its use. The Dutch Association of Paediatrics should revoke its approval and adoption of the Groningen Protocol.
Chervenak
Frank A
FA
Department of Obstetrics and Gynecology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, USA. fac2001@med.cornell.edu
McCullough
Laurence B
LB
Arabin
Birgit
B
D002985:Clinical Protocols; D028601:Euthanasia, Active / Q000941:ethics*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011788:Quality of Life; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging; D020458:Third-Party Consent; D016216:Ultrasonography, Prenatal