Doctors who have been treating Dutch Prince Johan Friso at a hospital in Innsbruck, Austria, said on Friday that the prognosis for his recovery is bleak. The prince suffered severe brain damage after he was trapped under an avalanche while skiing one week ago.

He may never emerge from his coma. Even if he does regain consciousness, the doctors say any rehabilitation will take months if not years. The bad news about the prince has shocked the country. During the week since the accident, there had been hope that Friso could recover. That hope has now all but vanished.

Prime Minister Mark Rutte told Queen Beatrix by telephone that the Netherlands sympathises deeply with the royal family. The Queen, for her part, said the family has been moved by all the messages of sympathy they have received from the Dutch public.

Personal drama
Prince Friso’s situation has no constitutional consequences. He is Queen Beatrix’s second son, but has not been in line to the throne since his marriage to Mabel Wisse Smit in 2004. Crown Prince Willem-Alexander is next in line, followed by his three daughters.

Needless to say, Prince Friso’s accident and gloomy prognosis have major consequences for his family.

Implications for succession
The potential loss of the middle of her three sons has hit Queen Beatrix hard. At 73, she is already the oldest reigning Dutch monarch. Speculation about her abdication in favour of Willem-Alexander has increased steadily in recent years.

Ben Kolster, royalty expert for Radio Netherlands Worldwide, says the Queen had wanted to allow Willem-Alexander as much time as possible with his three young daughters before he became king. Now Prince Friso’s condition could convince her to step down sooner than she had planned.

Rehabilitation
The family must now decide where to take Prince Friso for continuing treatment. Doctors say there is still a chance that he could recover, but it may take months before the situation becomes clear. The prince has been living in London with his wife and daughters of 5 and 6 years old. He is financial director of a company which produces enriched uranium.

The family could choose to place him in a clinic in England, in the Netherlands, or even in Austria or Germany, closer to where his accident took place.

End of life measures
Journalists and medical experts are already speculating about whether the royal family would ever decide to end the prince’s life, if he remains in a coma.

Euthanasia has been legal in the Netherlands since 2002, although it was unoffically tolerated before that. A key element in the protocols governing euthanasia is that the patient must request it him or herself. A patient in a coma is thus, by definition, not a candidate for euthanasia.

In addition, according to Mr Kolster, the Dutch royal family’s identification as Protestant Christians could prevent them from seeking any form of artificial cessation of life. Some denominations of Protestants believe euthanasia or assisted suicides are proscribed by God.

Prince Friso’s wife, Princess Mabel, is also a well-known advocate for organ donation. She has lobbied for a change in policy in the Netherlands whereby organ donation would be th default option, unless one actively opts out. The situation under present Dutch law is precisely the opposite.

Queen’s Day
While the prince's own future remains a matter of speculation, no one expects the national celebration of Queen’s Day at the end of April to go ahead as usual. Prince Friso rarely takes part in public ceremonies, but every year on Queen’s Day he joins his family in the public celebrations. This year the royal family is due to visit the towns of Veenendaal and Rhenen. Those towns will at the very least scale down their plans, if not cancel them altogether.

(ld/rk/mw/jn)