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Title: P e r s p e c t i v e o f M e d i c a l , I s l a m i c a n d L a w


1
P e r s p e c t i v e o f M e d i c a l , I
s l a m i c a n d L a w
Euthanasia
Ezuwan EzaniMohd Syamirulah RahimAhmad Mahfudz
MukriIrfan Mohd Ghazali
2
What is Euthanasia?
  • the intentional killing by act or omission of a
    dependent human being for his or her alleged
    benefit.
  • The key word here is "intentional". If death is
    not intended, it is not an act of euthanasia.

3
"... we must be wary of those who are too willing
to end the lives of the elderly and the ill. If
we ever decide that a poor quality of life
justifies ending that life, we have taken a step
down a slippery slope that places all of us in
danger. There is a difference between allowing
nature to take its course and actively assisting
death. The call for euthanasia surfaces in our
society periodically, as it is doing now under
the guise of "death with dignity" or assisted
suicide. Euthanasia is a concept, it seems to
me, that is in direct conflict with a religious
and ethical tradition in which the human race is
presented with " a blessing and a curse, life and
death," and we are instructed '...therefore, to
choose life." I believe 'euthanasia' lies
outside the commonly held life-centered values of
the West and cannot be allowed without incurring
great social and personal tragedy. This is not
merely an intellectual conundrum. This issue
involves actual human beings at risk..."
- C. Everett Koop, M.D. taken from the book
KOOP, The Memoirs of America's Family Doctor by
C. Everett Koop, M.D., Random House, 1991.
4
The Definition of Euthanasia
  • Euthanasia (from Greek e??a?as?a -'e? "good",
    ?a?at?? "death") is the practice of ending the
    life of a person or an animal because they are
    perceived as living an intolerable life, in a
    painless or minimally painful way either by
    lethal injection, drug overdose, or by the
    withdrawal of life support.

5
The Terminology
The Terminology in Euthanasia
Active
Passive
Voluntary
Following the broad definition of euthanasia as
outlined by James Rachels, euthanasia may employ
methods that are active or passive.
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
6
The Terminology
Active Euthanasia
Active
Passive
Voluntary
Active euthanasia refers to a physician
painlessly putting to death some persons
suffering from incurable conditions or diseases.
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
7
The Terminology
Passive Euthanasia
Active
Passive
Voluntary
Passive euthanasia refers to any act of allowing
the patient to die, which may include failing to
provide necessary medication as well as taking a
patient off life support.
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
8
The Terminology
Voluntary Euthanasia
Active
Passive
Voluntary
Voluntary euthanasia occurs with the
fully-informed request of a decisionally-competent
adult patient or that of their surrogate
(proxy). This should not be confused with death
after treatment is stopped on the instructions of
the patient himself, either directly or through a
do not resuscitate (DNR) order. Enforcing a DNR
order has never been considered assisted suicide
or suicide of any kind, at least in the eyes of
the law. Patients of sound mind have always had a
right to refuse treatment.
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
9
The Terminology
Non-voluntary Euthanasia
Active
Passive
Voluntary
Nonvoluntary euthanasia occurs without the
fully-informed consent and fully-informed request
of a decisionally-competent adult patient or that
of their surrogate (proxy). An example of this
might be if a "patient" has decisional capacity
but is not told they will be euthanized or, if a
patient is not conscious or lacks
decisional-capacity and their surrogate is not
told the patient will be euthanized.
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
10
The Terminology
Involuntary Euthanasia
Active
Passive
Voluntary
Involuntary euthanasia occurs over the objection
of a patient or their surrogate (proxy). An
example of this might be if a patient with
decisional capacity (or their surrogate) is told
what will happen. The patient (or surrogate)
refuses yet the patient is euthanized anyway.
This is generally considered murder. If a
patient slated for euthanasia changes his or her
mind at the last minute, the doctor is
categorically required by law to honor that wish.
In most other countries removing or denying
treatment without the clear instructions of the
patient is usually seen as murder.
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
11
The Terminology
Terminal Sedation
Active
Passive
Voluntary
Terminal sedation is a combination of medically
inducing a deep sleep and stopping other
treatment, with the exception of medication for
symptom control (such as analgesia). It is
considered to be euthanasia by some, but under
current law and medical practice it is considered
a form of palliative care.
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
12
The Terminology
Animal Euthanasia
Active
Passive
Voluntary
Animal euthanasia is commonly referred to by the
euphemism "put to sleep".
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
13
The Terminology
Mercy Killing
Active
Passive
Voluntary
Mercy Killing is a term used for some cases of
euthanasia. Typically it refers to euthanasia
by a non-doctor, such as a parent, who perceives
the individual to be suffering. In some cases the
individual cannot consent. In some cases the
individual can consent but is not asked or
refuses. Lastly, in some cases the individual
consents, and it may even be them who initiates
the discussion.
Non-voluntary
Involuntary
Terminal Sedation
Animal Euthanasia
Mercy Killing
Continue
14
Legislation and national political movements
Australia
Nazi Germany
Belgium
Oregon, USA
Canada
Netherlands
15
Australia
Euthanasia was legalized in Australia's Northern
Territory, by the Rights of the Terminally Ill
Act 1995. However, this law was soon voided by an
amendment by the Commonwealth to the Northern
Territory (Self-Government) Act 1978. Three
people had already been legally euthanized,
however, before the Commonwealth government made
this amendment. Although it has for some time
been a crime in most Australian states to assist
another to commit suicide, prosecutions have been
rare. In Queensland recently (2002) a group of
relatives and friends who provided moral support
to an elderly woman who committed suicide were
extensively investigated by police, but no
charges were laid. In Tasmania in 2005 a nurse
was convicted of assisting her elderly mother and
father die as they were both suffering from
illness. She was given a two and a half year jail
sentence but the judge later suspended the
sentence because he believed the community did
not want the woman put behind bars. This sparked
debate about decriminalizing euthanasia as judges
did not seem interested in enforcing the existing
law.
16
Belgium
After an extensive discussion the Belgian
parliament legalized euthanasia in late September
2002. The new legislation, however, institutes
a complicated process, which has been criticized
as an attempt to establish a bureaucracy of
death. Nevertheless, euthanasia is now legal and
its proponents in the country hope that it will
stop many illegal practices (it is said that
several thousand illegal acts of euthanasia have
been carried out in Belgium each year).
17
Canada
In the early 1990s, 42-year-old Sue Rodriguez,
who had amyotrophic lateral sclerosis, fought to
overturn the law against assisted suicide. She
lost her court battle, but was assisted in her
dying with the help of an anonymous doctor. Under
Canada's Criminal Code, assisting someone to die
is illegal and punishable by up to 14 years in
prison. On January 28, 2005, Marcel Tremblay
held a press conference to announce plans to kill
himself, saying his life with pulmonary fibrosis
was unbearable. After attending his own living
wake, the 78-year-old man committed suicide at
1151 pm Eastern time. He had previously said he
would be surrounded by his wife and adult
children while he placed a bag over his head and
filled it with helium. Tremblay said that he
publicized his suicide plans to help change laws
over assisted suicide. His lawyer said police
were satisfied that Tremblay had a sound mind and
that authorities would not intervene. Canada
decriminalized committing suicide and attempting
to commit suicide in 1972.
18
Netherlands
In the Netherlands the Termination of Life on
Request and Assisted Suicide (Review Procedures)
Act took effect on April 1, 2002. It legalizes
euthanasia and physician assistance in dying in
certain circumstances. The law recognized a
practice that had been tolerated for some 20
years. From the time that euthanasia first came
to be widely practiced in the Netherlands, it was
formally subject to review by boards of doctors
in each hospital. The law essentially codified
what had already become tolerated practice and
unofficial law by judgments in the courts.
19
Netherlands
In the Netherlands the Termination of Life on
Request and Assisted Suicide (Review Procedures)
Act took effect on April 1, 2002. It legalizes
euthanasia and physician assistance in dying in
certain circumstances. The law recognized a
practice that had been tolerated for some 20
years. From the time that euthanasia first came
to be widely practiced in the Netherlands, it was
formally subject to review by boards of doctors
in each hospital. The law essentially codified
what had already become tolerated practice and
unofficial law by judgments in the courts.
20
Netherlands
  • The law permits euthanasia and physician assisted
    dying when each of the following conditions is
    fulfilled
  • The patient's suffering is unbearable with no
    prospect of improvement
  • The patient's request for euthanasia must be
    voluntary and persist over time (the request can
    not be granted when under the influence of
    others, psychological illness or drugs)
  • The patient must be fully aware of his/her
    condition, prospects and options
  • There must be consultation with at least one
    other independent doctor who needs to confirm the
    conditions mentioned above
  • The death must be carried out in a medically
    appropriate fashion by the doctor or patient, in
    which case the doctor must be present.
  • The patient is at least 12 years old (patients
    between 12 and 16 years of age require the
    consent of their parents)

21
Netherlands
The doctor must also report the cause of death to
the municipal coroner in accordance with the
relevant provisions of the Burial and Cremation
Act. A regional review committee assesses whether
a case of termination of life on request or
assisted suicide complies with the due care
criteria. Depending on its findings, the case
will either be closed or brought to the attention
of the Public Prosecutor. Finally, the
legislation offers an explicit recognition of the
validity of a written declaration of will of the
patient regarding euthanasia (a "euthanasia
directive"). Such declarations can be used when a
patient is in a coma or otherwise unable to state
whether they want euthanasia or not. The
legislation has wide support among the socially
libertarian Dutch, who have one of the world's
highest life expectancies. There is however
persistent opposition, mainly organized by the
churches.
22
Netherlands
In 1992 a proposal was made known as Drion's
Pill. This fictional drug would be a set of 2
pills. The first pill could be taken without any
harm, the second pill would have to be taken a
couple of days later (and only then would work).
This would give the patient the time to think
things over. The drug was never developed, the
proposal however indirectly started up the
discussion of euthanasia in Netherlands.
23
Nazi Germany
In Nazi Germany the term euthanasia has been
distorted. The word "euthanasia" was used by the
Germans to describe the T-4 Euthanasia Program.
The German rational for the program was to both
lower expenses by systematically killing the
institutionalized as well as preserving the
genetic quality of the German population by
sterilizing people with physical deformities,
handicaps, or mental illnesses. Technically, the
T-4 Euthanasia Program was actually an eugenics
program and not euthanasia, since the goal was
not to end suffering but to remove these
individuals from the gene pool. The program was
"cancelled", at least officially, after public
disapproval was expressed. This has tainted the
word especially in German-speaking countries
especially as one of the main advocates of
euthanasia in Germany after World War II was
Werner Catel, a leading Nazi doctor directly
involved in T4. The currently accepted German
term is the older "Sterbehilfe" (literally
"helping to die"), which is used in contemporary
German discussions.
24
Oregon, USA
Oregon Law, passed by voters in 1994 and
reaffirmed by voters in 1997, states an
individual must meet the following criteria 1)
18 years of age or older, unless consent is given
by a parent for children under the age of 18 2) a
resident of Oregon, 3) informed consent must be
given the patient must be mentally capable of
making the consent 4) diagnosed with a terminal
illness that will lead to death within six months
and is not basing his or her decision to die on
depression or another mental disorder. Two
physicians assist in verification. Also, it is
required by law that this must be verified by two
physicians, as well as by two witnesses.
25
Euthanasia
I n I s l a m i c P o i n t O f V i e w
Men who celebrate the praises of Allah,
standing, sitting, and lying down on their sides,
and contemplate the (wonders of) creation in the
heavens and the earth, (With the thought) "Our
Lord! not for naught Hast Thou created (all)
this! Glory to Thee! Give us salvation from the
penalty of the Fire. "  Qur'an 3191  
26
Euthanasia or Mercy Killing is the act or
practice of ending the life of an individual
suffering from a terminal illness or an incurable
condition, through lethal injection or the
suspension of extraordinary medical treatment.
This act is Islamically forbidden for it
encompasses a positive role on the part of the
physician to end the life of the patient and
hasten his death via lethal injection, electric
shock, a sharp weapon or any other way. This is
an act of killing, and, killing is a major sin
and thus forbidden in Islam, the religion of pure
mercy.
Fatwa issued by the prominent Muslim scholar
Sheikh Al-Qaradawi ,
27
As for the suspension of medical treatment via
preventing the patient from his due medication
which is, from a medical perspective, thought to
be useless, this is permissible and sometimes it
is even recommended. Thus, the physician can do
this for the sake of the patients comfort and
the relief of his family. Nothing is wrong in
this, InsyaAllah. It is highly stressed here
that medical treatment is deemed non-obligatory
by the majority of Muslim scholars and the
founders of the famous schools of Islamic
Jurisprudence. Rather, to them, it is
permissible. Only a few number of Muslim scholars
maintain that it is obligatory, as said by some
followers of Imam Ahmad and AsyShafie. Also,
others maintain that applying medical treatment
is commendable and preferable.
Fatwa issued by the prominent Muslim scholar
Sheikh Al-Qaradawi ,
28
Moreover, some scholars disputed over which is
better for the patient treatment or showing
endurance. Some who maintain that showing
endurance is far better base their judgment on
the narration of Ibn Abbas in the two Sahihs
that Ata Ibn Abu Rabih said Ibn Abbas said
to me May I show you a woman of Paradise? I
said Yes. He said Here is this
dark-complexioned woman. She came to Allahs
Messenger p.b.u.H and said I am suffering from
epilepsy and convulsive seizures make me naked
supplicate Allah for me. Thereupon, the Prophet,
p.b.u.h, said You can show endurance and win
entry to Paradise, but if you like, Ill pray to
Allah for your recovery. She said I am
prepared to show endurance but I get naked due to
convulsions, so supplicate Allah to spare me
getting naked. And the Prophet, p.b.u.h, did
pray for her. (Al-Bukhari and Muslim)
Fatwa issued by the prominent Muslim scholar
Sheikh Al-Qaradawi ,
29
These are the views of the scholars of the Ummah
on treatment and medication most of them
maintain that it is permissible some maintain
that it is recommended and a few number of them
deem it obligatory. I myself agree with those
who deem it obligatory in case the pain gets
unbearable, and the illness is curable, by
Allahs Grace.
This is also compatible with the guidance of
Prophet Muhammad, p.b.u.h, who sought treatment
for himself and ordered his honorable Companions
to seek treatment as well this is confirmed by
Ibn Al-Qayyim in Zad Al-Maad (Provision of the
Hereafter).
Switching off the life support If a patient is
medically presumed dead through what is known as
brain death, in the sense that he no longer has
any feelings, switching off the life support may
be permissible, with due consultation and care,
especially when its clear that the life support
machine becomes of no use for the already-dead
patient.
Fatwa issued by the prominent Muslim scholar
Sheikh Al-Qaradawi ,
30
But in cases when sickness gets out of hand, and
recovery happens to be tied to miracle, in
addition to ever-increasing pain, no one can say
treatment then is obligatory or even recommended.
Thus, the physicians act of stopping
medication, which happens to be of no use, in
this case may be justified, as it helps in
mitigating some negative effects of medications,
and it enhances death. But its different from
the controversial Mercy Killing as it does not
imply a positive action on the part of the
physician rather, it is some sort of leaving
what is not obligatory or recommended, and thus
entails no responsibility.
To conclude, the physician can practice this for
the sake of the patients comfort and the relief
of his family. Nothing is wrong in this,
InsyaAllah.
Fatwa issued by the prominent Muslim scholar
Sheikh Al-Qaradawi ,
31
Is there a right to suicide?
Not in Islam. Since we did not create ourselves
we do not own our bodies. We are entrusted with
them for care, nurture and safe keeping. God is
the owner and giver of life and His rights in
giving and in taking are not to be violated.
Attempting to kill oneself is a crime in Islam
as well as a grave sin. The Qur'an says "Do
not kill (or destroy) yourselves, for verily
Allah has been to you most Merciful" (Qur'an
429). To warn against suicide prophet Muhammad
p.b.u.h said "Whoever kills himself with an
iron instrument will be carrying it forever in
hell. Whoever takes poison and kills himself will
forever keep sipping that poison in hell. Whoever
jumps off a mountain and kills himself will
forever keep falling down in the depths of hell."
32
Prophet Mohammad p.b.u.h taught "There was a
man in older times who had an infliction that
taxed his patience, so he took a knife, cut his
wrist and bled to death. Upon this God said My
subject hastened his end, I deny him paradise."
During one of the military campaigns one of the
Muslims was killed and the companions of the
prophet kept praising his gallantry and
efficiency in fighting, but, to their surprise,
the Prophet commented, "His lot is hell." Upon
inquiry, the companions found out that the man
had been seriously injured so he supported the
handle of his sword on the ground and plunged his
chest onto its tip, committing suicide.
33
Euthanasia in a clinical situation, via Islamic
point of view,
In an Islamic setting the question of euthanasia
usually does not arise, and if it does, it is
dismissed as religiously unlawful. The patient
should receive every possible psychological
support and compassion from family and friends,
including the patient's spiritual (religious)
resources. The doctor also participates in
this, as well, and provides the therapeutic
measures for the relief of pain. A dilemma arises
when the dose of the pain killer necessary to
alleviate pain approximates or overlaps with the
lethal dose that might bring about the patient's
death.
Ingenuity on the part of the doctor is called
upon to avoid this situation, but from a
religious point of view the critical issue is the
doctor's intention is it to kill or to
alleviate? Intention is beyond verification by
the law but according to Islam it cannot escape
the ever watchful eye of God Who according to the
Qur'an "knows the treachery of the eyes, and all
that hearts conceal" (Quran 4019). Sins that do
not full fill the criteria of a legal crime are
beyond the domain of the judge but remain
answerable to God.
34
The Islamic Code of Medical Ethics (1981 p.67 )
In his/her defense of life, however, the Doctor
is well advised to realize his limit and not
transgress it. If it is scientifically certain
that life cannot be restored, then it is futile
to diligently keep the patient in a vegetative
state by heroic means or to preserve the patient
by deep freezing or other artificial methods.
It is the process of life that the doctor aims
to maintain and not the process of dying. In any
case, the doctor shall not take a positive
measure to terminate the patient's life".
35
The seeking of medical treatment from illness is
mandatory in Islam, according to two sayings of
the prophet "Seek treatment, subjects of God,
for to every illness God has made a cure",
"Your body has a right on you." But when the
treatment holds no promise it ceases to be
mandatory. This applies both to surgical and/or
pharmaceutical measures, and, according to a
majority of scholars, to artificial animation
equipment. Ordinary life needs which are the
right of every living person and which are not
categorized as "treatment" are regarded
differently. These include food and drink and
ordinary nursing care, and they are not to be
withheld as long as the patient lives.
WallahuAlam
36
Euthanasia Case Files
1
Karen Ann Quinlan
Karen Ann Quinlan was the first modern icon of
the right-to-die debate. The 21-year-old Quinlan
collapsed at a party after swallowing alcohol and
the tranquilizer Valium on 14 April 1975. Within
hours, she entered a coma from which she could
never recover. Her parents, staunch Roman
Catholics, knew their daughter would not want to
be kept alive by extraordinary means. A year
later, as Karen lay in a "persistent vegetative
state," the courts finally allowed her treatment
to be stopped but artificial feeding was
continued and she was maintained as a living
corpse until June 1985, when she eventually died
of pneumonia. Her case spurred thousands of
letters of sympathy and fuelled the "right to
die" movement. How many people need to die
degrading deaths before society learns a little
humanity?
Birth 29 March 1954 Birthplace Scranton,
Pennsylvania Death 11 June 1985 (pneumonia)
Best Known As Controversial coma patient of the
1970s
37
Euthanasia Case Files
2
Nancy Cruzan
Nancy Cruzan became a public figure after
entering a "persistent vegetative state." A 1983
auto accident left Cruzan permanently unconscious
and without any higher brain function, kept alive
only by a feeding tube and steady medical care.
Cruzan's family waged a legal battle to have her
feeding tube removed the case went all the way
to the U.S. Supreme Court, which ruled that the
Cruzans had not provided "clear and convincing
evidence" that Nancy Cruzan did not wish to have
her life artificially preserved. The Cruzans
later presented such evidence to the Missouri
courts, which ruled in their favor in late 1990.
The Cruzans stopped feeding Nancy in December of
1990, and she died later the same month.
Birth 20 July 1957 Birthplace Carterville,
Missouri Death 26 December 1990 (automobile
crash) Best Known As The subject of Cruzan v.
Missouri
38
Euthanasia Case Files
3
Theresa Marie Schindler
On 25 February 1990, 26-year-old Terri Schiavo
suffered severe brain damage when her heart
stopped for five minutes. Schiavo spent the
following years in rehabilitation centers and
nursing homes but never regained higher brain
function. In 1998 her husband, Michael Schiavo,
filed a legal petition to have Schiavo's feeding
tube removed, saying that his wife had told him
before her medical crisis that she would not want
to be artificially kept alive in such a
situation. Terri Schiavo's parents, Bob and Mary
Schindler, fought this request. Florida judge
George W. Greer ruled in 2000 that Schiavo was
"beyond all doubt" in a persistent vegetative
state and that her husband could discontinue life
support. But as legal appeals in the case
continued, the case became widely known as some
religious groups and pro-life activists began to
insist that Schiavo should be kept alive.
Schiavo's feeding tube was removed in 2003, but
reinserted six days later when the Florida
legislature passed "Terri's Law," which allowed
the state's governor to issue a stay in such
cases. The law was later ruled invalid by the
courts. In March of 2005 Schiavo's feeding tube
was again removed, and the case became a greater
public sensation when the U.S. Congress was
called into special emergency session to pass a
bill allowing federal courts to review the case,
with President George W. Bush flying from Texas
to Washington especially to sign the bill into
law. However, federal judges and the U.S. Supreme
Court refused to intervene. After two weeks
without food and water, Schiavo died of
dehydration on 31 March 2005.
Birth 3 December 1963 Birthplace Pennsylvania Deat
h 31 March 2005 (dehydration) Best Known As The
brain-damaged Florida woman at the center of the
Schiavo legal case
39
Euthanasia Case Files
4
Dr. Cox vs Mrs Boyes
In 1992 Dr Cox openly defied the law and assented
to 70 year old Mrs Boyes' persistent request for
voluntary active euthanasia. Mrs Boyes' was so
ill that she "screamed like a dog" if anyone
touched her. Conventional medicine did not
relieve her agony. In her last days, when she
repeatedly requested to die, Dr Cox finally gave
her an injection of potassium chloride, bestowing
on her the boon of a peaceful death so many of us
feel we are entitled to. Dr Cox, although given a
suspended sentence, was hauled through the courts
like a common criminal. We believe good doctors
acting in all conscience like Dr Cox, should be
lauded, not vilified, and should have the benefit
of legally approved codes of conduct that embody
consistent safeguards against abuse. Together we
should ensure that medicine and the law serve the
patient and the citizen once more. Together, we
can stand and be counted. And, from pooled
resources, each small contribution will
contribute to the powerful tidal wave that Exit
can use to bring this about.
40
Arrested in Hospital Deaths After Katrina By
CHRISTINE HAUSER Published July 18, 2006 A
doctor and two nurses have been arrested and
booked on suspicion of second-degree murder in
connection with the deaths of patients at a
medical center in New Orleans after Hurricane
Katrina struck, a spokeswoman for the Louisiana
attorney generals office said today. The
arrests of the three, whose names were not
released by the spokeswoman, Kris Wartelle, were
part of the culmination of an investigation into
accusations that patients might have been
euthanized at the Memorial Medical Center in the
aftermath of the hurricane. The attorney general,
Charles C. Foti Jr., issued subpoenas last
October for dozens of hospital employees. I
wont say it has ended yet, said Ms. Wartelle,
reached by telephone, confirming details of a
report on the arrests by The Associated Press.
There could be more things coming down the
pike.. Officials have confirmed finding 45
bodies at the hospital two weeks after the storm.
Officials with Tenet Healthcare have said about
10 of those people died before the storm.After
the hurricane struck the city, hospitals and
nursing homes struggled to care for their
patients. At Memorial, evacuation efforts
faltered, emergency generators could not support
air conditioning and temperatures inside the
building exceeded 100 degrees.
41
Will Malaysian doctor euthanized?
ATTITUDES OF MEDICAL STUDENTS TOWARDS EUTHANASIA
IN A MULTI-CULTURAL SETTING K Adchalingam, W H
Kong, M A Zakiah, M Zaini, Y L Wong, C C
Lang, FRCP, Year 2 Medical Students,
Health Research Development Unit, Faculty of
Medicine, University of Malaya, 50603 Kuala
Lumpur Department of Medicine, University of
Malaya A cross-sectional survey of 400 medical
students of multi-cultural backgrounds at the
University of Malaya was conducted to understand
their attitudes towards euthanasia and factors
related to medical decisions and ethical
reasoning concerning the prolongation of life,
the right to die and euthanasia. The student
respondents completed self-administered
questionnaires that comprised of twelve questions
with multiple stems addressing personal
perceptions, knowledge, attitudes and decisions
about euthanasia and the relief of suffering.
The majority of respondents (52) were for the
withdrawal of active therapy in a patient
suffering from a terminal painful disease, while
48 of them were against it. 71 of the
students involved in the study were against the
idea of active euthanasia, i.e. the
administration of a lethal injection. However,
27 of the respondents felt that there was a
moral justification to assist patients to die.
32 of the respondents favored the legalization
of euthanasia in Malaysia, while 67 of them were
strongly against it. The majority (61) of
respondents would not practice euthanasia as a
doctor nor would they have performed on
themselves if or when it became legal. The main
issue surrounding euthanasia that concerned the
respondents was the misuse of it by unethical
practitioners and they felt that further debate
on the matter was essential, both within the
local and international communities
42
Euthanasia From A Malaysian Perspective
Dilemmas surrounding passive euthanasia--a
Malaysian perspective.Talib N.Faculty of Law,
University of Malaya, Kuala Lumpur, Malaysia. In
western societies where the principle of autonomy
is jealously guarded, perhaps active euthanasia
is more often the focus of public concern and
debates rather than any other forms of
euthanasia. However due to the advance in
technology and its corresponding ability in
prolonging life, in Malaysia passive euthanasia
presents more of a dilemma. For those concerned
and involved with end of life decision-making, it
is generally agreed that this is an area fraught
with not only medical but legal and ethical
issues. In Malaysia where the society is not
homogenous but is multi-cultural and
multi-religious, in addition to medical, legal
and ethical issues, religious principles and
cultural norms further impact and play
significant roles in end of life decision-making.
This paper seeks to identify the issues
surrounding the practice of passive euthanasia in
Malaysia. It will be shown that despite
applicable legal provisions, current practice of
the medical profession combined with religious
and cultural values together affect
decision-making which involves the withholding
and/or withdrawing of life-saving treatment.
43
Research Resources
  • Wikipedia Online Encyclopedia,
    http//en.wikipedia.com
  • National Right To Life Organization,
    http//www.nrlc.org/euthanasia/index.html
  • The Memoirs of Americas Family Doctor, C.
    Everett Koop MD, Random House, 1991
  • International Task Force, http//www.internationa
    ltaskforce.com/faqs
  • He Who Knows Not, Be Silent, Dr. Syed Ali Tawfik
    Al-Attas, Director General, IKIM
  • Institusi Kemajuan Islam Malaysia,
    http//www.ikim.gov.my/bm/cetakmedia.php?key809
  • Malaysian Medical Association,
    http//www.mma.org.my/mjm/6_original_05.htm
  • PMID 16229394 PubMed - indexed for MEDLINE
  • New York Times, http//www.nytimes.com/katrina
  • The Islamic Code of Medical Ethics
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