Weinig pijn bij neonaten met spina bifida

Recently, a study in the Dutch Journal of Medicine showed that it is possible to treat pain in newborn infants with spina bifida pain. In their article, the investigators argue that their findings imply that the Groningen Protocol needs rethinking. This implication seems unfounded. The Groningen Protocol was developed to guide decision making for newborn infants who suffer severely and have a very bad prognosis. It is good to know that most spina bifida patients do not fit these criteria. However, that does not exclude the possibility that some spina bifida patients meet the criteria, or that children suffering from other conditions do so. The fact that no case of active ending of life of a newborn infant with spina bifida has been reported since the introduction of the Groningen Protocol in 2001 raises questions that are also related to these recent research results. One question is whether the introduction of ultrasound screening at 20 weeks of pregnancy influences the severity of the spina bifida of the patients who are born.

Conflict of interest: the institute of the authors received a grant from the Netherlands Organisation for Health Research and Development (ZonMw). Financial support for this article: S. van de Vathorst received an attendance fee as a member of a committee set up by the Royal Dutch Medical Association (KNMG) on medical end-of-life decisions for newborn infants with very severe birth defects.