Comment [DZ1]: Use template posted on
Elearning
Mercy killing and the paradox of its legality
Table of contents:
Page number
1. Introduction
…………………………………………………………………..
2. Euthanasia throughout history ……………………………………………….
3. Euthanasia in Islamic perspective …………………………………………….
3-4
4-5
5-7
3.1 Euthanasia in Islamic countries ……………………………………………….
7-8
3.1.1 Euthanasia in Kuwait ……………………………………………………….
8
3.1.2 Euthanasia in Turkey ………………………………………………………
9
3.1.3 Euthanasia in Palestine …………………………………………………….
9-10
3.1.4 Euthanasia in Lebanon ………………………………………………………
10-12
4. The legality of mercy killing in European countries and some states in the US
12- 21
4.1 Legality of euthanasia in Bosnia and Herzegovina ………………………..
13-14
4.2 Legality of euthanasia in Netherlands ……………………………………..
14-16
4.3 Legality of euthanasia in Belgium …………………………………………
17-18
4.4 Legality of euthanasia in Luxembourg ………………………………………
19
4.5 Legality of euthanasia in Switzerland ………………………………………..
19-20
4.6 Legality of euthanasia in the United States …………………………………..
20-21
5. Case studies and opinions …………………………………………………………… 21-26
5.1 case study: case study: Dubai doctor sentenced to life for mercy killing.............. 21-23
5.2 Case study: the cases of de la Rocha and Morrison …………………………… 23-26
6. Conclusion ………………………………………………………………………..
26-27
7. References ………………………………………………………………………..
28-29
1
1. Introduction:
Euthanasia, medical aid in dying, aided suicide, and good death are among the neverending expressions that are used globally to record numerous forms of aided death (Downie
et al., 2022). The multiplicity in terminologies can cause misperceptions in both speculative
discussions and in issuing laws due to the vagueness of who did it, under what conditions,
and the type of activity or passivity that is intended to be recorded (Downie et al., 2022). The
dilemma of Euthanasia has been with us since the medical field has had to deal with terminal
illnesses (Firmansyah et al., 2020). The term “Euthanasia" comes from the Greek words
which stand for eu “good” and Thanatos “death” (Hirsch, 1990). According to the Medical
Dictionary for Lawyers, euthanasia is an act of mercifully killing those who are diagnosed
with terminal illnesses without any pain as a demonstration of compassion is one that many
accept (as cited in Hirsch, 1990). Euthanasia to this day persists as a debatable topic
worldwide (Padubidri et al., 2022). There are countries that welcome and agree to euthanasia
as a part of the belief that it’s the patient’s right to die, and contrastingly there are other
countries that view this act as murder (Padubidri et al., 2022). The dilemma of Euthanasia is
in truth one of the most considerable topics of criminal law in the majority of countries,
especially Islamic countries. In Islam, a human’s body isn’t their own, and they aren’t
allowed to do as they please with it. Life is a gift from god and only god can take it away,
committing suicide or negotiating for someone to do it is a sin. Despite the fact that Islam,
like other religions, prioritizes the quality of life above its quantity, in no way does it allow
the death of a person in order to relieve him of his misery and suffering (Saadery, 2014).
However, in countries where euthanasia is legally penal, sentences fluctuate from merciful to
the death penalty, as is the case in Islamic countries (Banovic & Turanjanin, 2014). Some
countries have also legally and officially permitted “assisted suicide” which is assistance
2
offered to a person to end their own life (Padubidri et al., 2022). These demands for untimely
and early deaths have cast doubts on whether euthanasia is the “right to life” or “right to
death” (Padubidri et al., 2022). In the past, doctors just had to worry about saving lives, but
today they must also consider philosophical and religious questions when debating issues like
mercy killing and euthanasia (Saadery, 2014). In the whirlpool of dilemmas that this topic
opens, legislators worldwide are attempting to reach a useful resolution so as to effectively
sort out the dilemma of euthanasia (Banovic & Turanjanin, 2014). Therefore based on all of
the previous points, this paper aims to tackle the variety of different legalities in some
selected countries both western and eastern.
2. Euthanasia throughout history:
The concept that death should be compassionate is not revolutionary. When a person
is terribly injured or terminally sick, when death is certain, and when the pain is so
extreme that life no longer provides the individual any pleasure, it is logical that they
would desire to die (Stolberg, 2008). The discovery and widespread usage of morphine in
the 19th century to first cure, and then kill pain led to the assumption that a dying process
that was less painful was attainable (Lopes, 2015). In 1936, a bill was presented to the
House of Lords in the United Kingdom that would make it possible for anybody over the
age of 21 who was mentally competent, suffering from a terminal illness or an incurable
sickness, and experiencing excruciating agony to make a request for voluntary euthanasia
(Hiatt, 2016). According to Cole (2004), In 1957, the Vatican issued a declaration that it
was okay to engage in passive euthanasia. The practise of passive euthanasia involves
making the conscious choice to end a person's life by withdrawing life-sustaining
treatment, such as the use of a ventilator (Brassington, 2020). Four decades later, in 1994,
the state of Oregon was the first in the nation to make medical assistance in dying legal
3
(Hiatt, 2016). The Middle East has a special place in human history. Through years of
contact with many historical periods, cultures, and faiths, people from the area have
collectively established their own unique civilizations (El Houssini, 2013). In the Middle
East, almost all moral judgments are ultimately based on and inextricably linked to a
particular set of religious beliefs. Judaism, Christianity, and Islam, the three major faiths
of the Middle East, all share a belief in the presence of God, an afterlife, and the
immortality of the soul; this is seen in views on euthanasia. There are a few countries,
such as the Netherlands, Belgium, and Luxembourg, which have legalized euthanasia
under certain circumstances, despite the fact that it is prohibited in the majority of
countries (Cohen, 2014). There are also a few states in the United States, such as Oregon,
Washington, Vermont, and Montana, which have legalized the procedure (Rathor, 2014).
3. Euthanasia in Islamic perspective:
Islam holds that morality in medicine is equivalent to morality in other aspects of life.
Islamic medical ethics is a restatement of universal ethical concepts with medical
applications and terminology. In Islamic law, there are four primary sources, and
Muslims throughout look to these sources for guidance when they need solutions to their
many issues. The holy Quran is regarded as the most authoritative source for Islamic legal
doctrine. The second source is known as the Sunnah, and it consists of the sayings,
teachings, and even the way of life that the Prophet of Islam lived. The third source is
known as Ijma', which literally translates to "consensus" or "approval of a topic by a
certain group of people," and the last source is known as Qiyas. Laws and regulations that
are considered to be Islamic are formulated and administered with reference to these
sources. A human being has no power over the timing of death and should make no effort
4
to hurry or postpone this time, since it is entirely within Allah's hands. The prohibition
against taking one's own or another's life also includes acts of murder and genocide. Life
does not belong to the human, therefore the ideals of autonomy, freedom, and individual
choice do not apply here; and killing someone will have negative consequences for their
loved ones and the community as a whole (Narimisa, 2014). Islamic belief concludes that
every life ultimately belongs to Allah. He is the one who decides when life begins and
ends. When it is obvious that the life support machine is no longer of any use to the
patient who has already passed away or in the case of organ and tissue donation for the
purpose of saving the life of another person, which is a common practise in Iran and some
other Muslim countries, it may be permissible to turn off the life support of a patient who
has been medically presumed dead through a process known as brain death (Narimisa,
2014). However, this must be done with the appropriate level of consultation and care. In
Islam, diseases are not seen as only some physical problems but rather as methods for
obtaining spiritual objectives. In this way, one's health and disease may both be tools for
the faithful to use in their pursuit of a greater relationship with God. In an Islamic
environment, a patient is required to receive all of the psychological care and compassion
that is feasible from the patient's family and friends, including the patient's spiritual
resources. Therefore, Islamic teaching discourages the use of fruitless or artificial
techniques to prolong the life of a patient who is terminally ill. It is not just the
responsibility of the physician to alleviate the patients' bodily diseases; in addition, the
physician is obligated to take into account the patients' emotional and spiritual needs. The
connection between a doctor and a patient in Islamic nations is predicated, to a large
extent, on the concept that a doctor should always do what is best for his or her patient
and should always safeguard life (Narimisa, 2014). Indeed, the norms regulating the
practise of medicine state that the physician must perform their profession for the benefit
5
of the individual and the society while also respecting the life, safety, and dignity of his
patients. There has been a rise in debate on controversial ethical problems like euthanasia,
sometimes known as physician assisted suicide or mercy killing, as a result of recent
developments in medicine and biotechnology. Previously, doctors just had to worry about
saving lives, but today they must also consider philosophical and religious questions
when discussing topics like mercy killing and euthanasia. Euthanasia and PAS
(physician-assisted suicide) are legally prohibited in all Middle Eastern countries except
Comment [DZ2]: Also prohibited in Lebanon
for Lebanon (Narimisa, 2014).
3.1
Euthanasia in Islamic countries:
It is widely held that Islamic ethics and Islamic law cannot be divorced from one
another. Both PAS (physician-assisted suicide) and euthanasia are strictly forbidden
by the religion of Islam for all Muslims. This is applicable to each and every Islamic
denomination out there. Because ending a patient's life intentionally constitutes
murder, as defined by the availability of the elements of the crime that result from the
loss of the spirit of a living person and criminal intent that includes assaulting human
beings, all Islamic nations consider these acts to be illegal. This is due to the fact that
murder is defined as the intentional taking of the life of another human being.
Although Islam, like other religions, places a high priority on the quality of life rather
than the quantity of years lived, it in no way condones the death of a person in order
to relieve them of their physical or mental anguish. Therefore, mercy killing and
euthanasia, both of which have become contentious topics in the medical field, are
subjects that have absolutely no support in almost any Islamic countries. Most Middle
Eastern countries have recently seen modifications to their demographic features,
6
including Turkey and Kuwait. And no person can ever die except by Allah's leave and
at an appointed term (Qur’an, 3:145). Destroy not yourselves. Surely Allah is ever
merciful to you (Qur’an, 4:29).
3.1.1 Euthanasia in Kuwait:
Although Islam is the official religion of Kuwait, the country does not have
any legislation that specifically prohibit euthanasia. However, a legal opinion may
be inferred from Article 149/4 of the Kuwaiti Penal Code, which forbids either the
act of murder or the expediting of a person's passing away (Mohammadpour et al.,
2022). Additionally, euthanasia is against the principles of Islam, just as it is
against the beliefs of Catholicism and conservative Protestantism. A study by
Askar et al., (2000) in Kuwait 2000, found that just 19.9% of physicians were in
favor of the notion of the Department of Health legalizing euthanasia in specific
limited circumstances and with certain restrictions. Another study by Abohaimed
et al., (2019) reported that around forty percent of the medical professionals
surveyed supported the legalization of euthanasia under certain restrictions, which
is the same percentage as the previous survey. In this particular study, just 32
percent of Muslims were in favor of euthanasia when the method was described in
the context of an old patient who was in a vegetative state. This was the lowest
proportion as compared to Christians at 59.1% and other faiths at 61.1%.
According to the findings of this research, university-educated medical
professionals in Europe and North America tended to have more similar opinions
towards euthanasia than their counterparts in Kuwait and other Arab countries.
7
3.1.2 Euthanasia in Turkey:
The Mediterranean, Western Asia, Central Asia, the Middle East, and Eastern
Europe, along with the traditions of the Caucasus, all contributed to the formation
of Turkey's unique culture, which is a synthesis of a diverse range of aspects that
have been derived from the various cultures of those regions (Mohammadpour et
al., 2022). The Islamic beliefs are held by the majority of people in Turkish
society. Article 13 of the Patient's Code of Rights in Turkey categorically
prohibits the practise of euthanasia. According to the information provided in this
piece, a person cannot, under any circumstances, give up the right to life, even
those related to medical issues. It is written that "one cannot give up on a person's
right to life no matter what the cause is or even if it is a medical need" (Ozturk,
2021). This principle applies regardless of the circumstances surrounding the
situation. No life may be stolen, regardless of whether the request comes from the
individual or from another person (Mohammadpour et al., 2022). On the other
hand, the results of a recent survey that was carried out on patients, physicians,
and nurses indicated that more than half of the participants felt that it is essential
for a patient to have the right to make choices about their own life. According to
the results of the latest survey conducted in Turkey, 78% of patients and 63% of
physicians believe that it should be legal to practice at least one method of
euthanasia (Noor, 2014).
3.1.3 Euthanasia in Palestine:
8
The vast majority of people who live in the West Bank and Gaza are devout
Muslims; nonetheless, there are no laws in place that specifically prohibit
euthanasia in this country. Religion is the primary source of inspiration for the
Palestinian set of cultural values. In this particular scenario, a "happy death"
would consist of passing away amongst the company of one's loved ones. It is said
that when someone is diagnosed with a terminal illness, family members often
choose to bring the patient home with them so that they may be with them and
offer them with comfort. Additionally, it is common practice for visitors,
including friends and family, to pay a patient a visit and spend some time with
them while they are hospitalized (Mohammadpour et al., 2022). When it comes to
maintaining one's dignity, important factors among Arabs include the desire to
appear whole, the ability to endure physical pain, the concealment of feelings,
remaining at the head of one's responsibility, performing responsibilities, and
playing roles without admitting the need for assistance or displaying signs of
disability (Abu Seir, 2017). The attitudes of 905 Palestinian Muslim men and girls
between the ages of 13 and 32 on abortion, euthanasia, and the death sentence
were examined in a study that was conducted not too long ago. The participants in
this research had a negative view regarding euthanasia, despite the fact that there
was inevitable pain (Webb & Asa’d, 2019).
9
3.1.4. Euthanasia in Lebanon
Currently, euthanasia is illegal in Lebanon. Since this is a crime, the
instigator, the accomplice, and the offender will all face consequences if the law is
followed. Article 552 of the Lebanese Penal Code states, "Whoever willfully kills
a human person with a factor of sympathy, depending on his urgency in the
request, will be penalized by imprisonment for 10 years at maximum." This
provision was taken from the French original. In Lebanon, such murders are
considered illegal and are met with severe penalties. Although euthanasia wasn't
specifically mentioned in the same term, it was nonetheless alluded to in another
context. Article 552, Penalties, added the expressive component of compassion,
with the additional requirement expressed by the wish of the patient himself,
despite his haste in the request (‫الموت الرحيم‬, n.d.).
•
Euthanasia needs the following circumstances, drawn from Article 552, Penal Code, to
exist as a necessary element of the crime:
I.
The subject's actions, whether positive or negative, might be either insignificant or
consequential.
II.
Wanting to terminate one's own life is an emergency for the sufferer.
III. The victim tragically dies as a consequence.
IV. correlation between cause and effect.
10
Generally, my opinion on euthanasia is that it should not be legalized
under any circumstances. Euthanasia goes against the religious beliefs of many
countries, and if it were legalized, very religious people would probably be against
it. More specifically, religions talk a lot about death because it is one of the most
important things in life. Death is a big deal in almost every religion. Most
religions say that all human life is holy and should be protected. In the Qur'an,
which is the holy book of Islam, it says, "When their time comes, they cannot
delay it for a single hour and they cannot bring it forward by a single hour." This
means that the length of a person's life is predetermined and we can never change
it. Only God has the power to stop it. In the same way, Christians believe that life
is a gift from God. It is wrong to interfere with the dying process, whether through
murder, suicide, or euthanasia. Only God has the right to decide when someone
dies. The ability to mess with people's lives should not be granted under the
pretext of law or medicine (Hassan, 2008). On the other hand, if euthanasia
becomes legal, we must accept that someone with nefarious intentions,
particularly those close to the sufferer, would be eager to exploit this legal gap.
When it comes to financial reasons, it is very easy for family members to turn to
euthanasia to get rid of the enormous burden-the sick. Finally, the physicians are
given a legitimate explanation to cover up their probable medical errors.
11
Comment [DZ3]: Add your opinion to point 5
4.0 The legality of mercy killing in European countries and some states in
the US
Following the never-ending argument over the legalization of operative
euthanasia, advocates and adversaries have established rigid organizations that
exemplify their ideologies about (un)-righteousness and (un)-viability of
euthanasia. The focal point of this dilemma is the extent to which it is essential to
respect the life of critically sick patients and consequently the firm arguments to
offer on this dilemma. Legislations on this matter differ from country to country.
There are two main diverse types of legislation to be examined in this paper:
euthanasia is treated as murder and the complete opposite of this legislation
(Banović & Turanjanin, 2014).
4.1 Legality of euthanasia in Bosnia and Herzegovina:
According to Berghmans and Lossignol (2012), one of the various reasons that
explicate the divergent approaches to dealing with this matter from one country to
another is that some authors argue that doctors usually have inadequate experience
in this field as they have not previously dealt with this matter (as cited in Banović
& Turanjanin, 2014). This statement is actually true; for example, doctors in
Bosnia and Herzegovina do not have any experience with euthanasia. Bosnia and
Herzegovina is a particular country that consists of Federation Bosnia and
Herzegovina, the Republic of Serbs, and the Brcko District. These three parts have
their own legislation. In the Federation of Bosnia and Herzegovina, stripping
another person’s life is considered a crime punishable by a prison sentence of at
least 5 years. The Criminal Code of Federation Bosnia and Herzegovina (CC
12
FBH) in fact separated between this case, regular murder, first-degree murder
which includes affecting someone’s death using brutal or deceptive ways; by
careless and vicious actions based on multiple various reasons racial, revenge,
religious….etc, and the murder of official military personnel during their
performance of duties (article 166. CC FBH). Just about the same exact provision
is included in the Criminal Code of Brcko District (CC BD) but with the addition
of hate murders (article 163. CC BD). These laws also acknowledge triggered
murder, manslaughter, inducement to suicide and assisted suicide, murder of a
newborn, and illegal finishing of pregnancy all with the previously mentioned
types of murder. Thus, the way they perceive euthanasia, is that any other forms
of stripping of life not mentioned within the particular ones above are forms of
regular murder. Meanwhile, in the region of the country where there are Muslims,
euthanasia is regarded as a murder committed under alleviating conditions.
According to Criminal Code Republic of Serbs (CC RS), anyone who robs
another person of their life will be punished by imprisonment of five years
minimum and maximum of twenty-five years, but if the crime is committed under
alleviating conditions then the person gets a prison sentence of one to eight years
(article 148. CC RS) (Banović & Turanjanin, 2014). Furthermore, according to
Babic and Marković (1997) and Jotanović (2010), in the Republic of Serbs, mercy
killing is distinguished from other forms of murder according to reasons of
enactment, which are supposed to be selfless by default, as their purpose is to
lessen the agony and misery of the patient (as cited in Banović & Turanjanin,
2014). Based on all of the mentioned above, legality of euthanasia in Bosnia and
Herzegovina depends on the specific territory the person is in and the particular
criminal code the territory is regulated by.
13
4.2Legality of euthanasia in Netherlands:
The country that was once known for its fascinating natural scenery,
distinctive architecture, and lavish museums is, according to Turanjanin (2013),
known today for the legitimization of enjoyment and the spreading of light drugs
and lawful euthanasia and assisted suicide (as cited in Banović & Turanjanin,
2014). In the Netherlands, administrative forms and codes frequently use the
expressions “euthanasia”, “assisted suicide”, and “termination of life” (Downie et
al., 2022). Actions related to this matter are controlled at public degrees according
to the Termination of Life on Request and Assisted Suicide (Levensbëëindiging op
verzoek in Dutch) Act (Downie et al., 2022). Cohen-Almagor stated that the first
familiar case of euthanasia in the Netherlands originated in the 1950s when a
doctor executed euthanasia on his own brother who was in a fatal phase of a
disease that created great agony, so he persistently asked his brother to end his life
(as cited in Banović & Turanjanin, 2014). In contrast, the case Postma in 1973
enticed much more public responsiveness when the physician administered a
deadly quantity of morphine to her mother who was in a very terrible health state,
but not terminally diseased which resulted in this physician’s trial (Banović &
Turanjanin, 2014). This case was in fact followed by many others in Amsterdam,
Alkmaar, and Rotterdam. Primarily due to the actions of the Dutch Voluntary
Euthanasia Society (Nederlands Vereniging voor Vrijwillige Euthanasie (NVEE))
and the swift rise in the number of executed euthanasia its decriminalization has
been examined. The Netherlands described the broad circumstances essential for
the performance of euthanasia (Banović & Turanjanin, 2014). In addition,
according to Groenhuijsen (2007), the Law on the Termination of Life does not
mention the term “euthanasia” and instead uses “termination of life on demand”
14
without giving an explanation for the latter, even though the principles in the
1980s used the term “euthanasia” (as cited in Banović & Turanjanin, 2014).
According to Keown (2004), the law states that euthanasia is allowed on the
occasion of fulfilling the following conditions:
I.
II.
It is the patient’s wish and desire and is granted to them willingly and free
The patient endures unbearable aches which cannot be eased
III.
The patient is well-informed about their health state and perspectives
IV.
Euthanasia is the last resort for patients as there are no other options
V.
The physician going to execute euthanasia has already turned to a colleague who has
experience in this matter, and has checked the patient and confirmed that all
requirements are present for euthanasia or assisted suicide
VI.
Euthanasia or assisted suicide is executed with the needed caution and attentiveness
(as cited in Banović & Turanjanin, 2014).
Actually, Turanjanin (2012) argues that following the execution of euthanasia
the physician is responsible for filling out the appropriate procedures and
notifying the community pathologist about the euthanasia, by filling out the
suitable form and attaching all required papers (as cited in Banović & Turanjanin,
2014). Moreover, Sheldon (2011) explains that to attain information on whether
they performed a crime or not, doctors occasionally have to wait a time of eight
months since the euthanasia was executed (as cited in Banović & Turanjanin,
2014). This proves that euthanasia is a matter of control and regulation. Thus
Leenen (2001) points out that, the doctor who executes euthanasia will not be put
15
on trial if they satisfy all the procedural and substantive conditions (as cited in
Banović &Turanjanin, 2014).
4.3 Legality of euthanasia in Belgium:
Belgium decriminalized and permitted euthanasia in 2002 and
described it as the deliberate termination of life by a doctor at a patient’s demand
(Padubidri et al., 2022). The conceptuality of decriminalizing euthanasia surfaced
in the early 1980s as a result of the activities of two organizations for the right to
die with dignity (Banović & Turanjanin, 2014). Unlike the Netherlands, Belgium
did not have a long history of executing euthanasia or putting physicians on trial
and it could not enact adequate principles which in turn led the legislator to make
a quick reaction (Banović & Turanjanin, 2014). In addition, as opposed to the
Netherlands the Belgian Parliament did not amend its criminal code instead it
passed a law particular to euthanasia (Downie et al., 2022). In contrast, Belgium
and the Netherlands have something in common which is that the
decriminalization and permission of euthanasia are confined by conditions. The
conditions concerning the execution of euthanasia do not form a criminal offense
and they are laid out in a way similar to the Dutch legislation (Banović &
Turanjanin, 2014). According to The Belgian Law of May 28, 2002, and
Turanjanin (2013), these conditions are as follows:
I.
Before stripping the patient of his life, doctors should notify the patient about his
medical state and life assumptions, talk with him about his demand for euthanasia
and the possibility of alleviating care, and the outcomes of such a decision
II.
The patient’s demand should be out of his pure will, and both he and the doctor
should deduce that there are no other appropriate options for his condition
16
III.
The physician must be believing to the patient’s persistent mental and(or)
physical agony and aching and to the fact that the demand is irreversible
IV.
Multiple meetings with the patient and turning to another doctor about the state of
the patient to notify the doctor about the demand for euthanasia and to be certain
of the conclusions made about the patient is essential
V.
The other doctor that the physician turned to has to be absolutely unrelated to the
patient and the executing physician and this doctor must be competent to provide
opinions on the medical state in question
VI.
The physician also needs to talk about the patient’s demand for mercy killing to
people who had continuous contact with him especially if the worry about him
emerges (as cited in Banović & Turanjanin, 2014).
Thus according to the above, upon not meeting the lawful conditions and
measures assisted suicide is treated as a poisoning crime while euthanasia is
legally viewed as a form of homicide (Downie et al., 2022). In addition, the
Belgian Law on euthanasia confirms that a person who reacts in harmony with the
law is executing an allowable form of homicide, while no deductions can be made
regarding assisted suicide whether it is viewed in the eyes of law as a kind of
suicide as suicide was not brought up in the Criminal Code (Downie et al., 2022).
4.4 Legality of euthanasia in Luxembourg:
According to Luxembourg (2009), an enormous legislative framework
consisting of a law on sedative care is the origin of The Law of 16 March 2009 on
euthanasia and assisted suicide where the latter was ratified as a section of this
framework (as cited in Downie et al., 2022). This act utilizes the terms
17
“euthanasia” and “assisted suicide” and confirms that they should be executed by
a doctor and must be in harmony with the legislation’s bases and satisfy specific
procedural requirements so as not to be punishable doings (Downie et al., 2022).
As a part of the subject of permitting euthanasia and assisted suicide, the
Luxembourgian law constructs an exemption for countless Criminal Code crimes
such as poisoning, patricide, homicide, infanticide, and murder. Moreover, the
Luxembourgian law distinctly and clearly acknowledges assisted suicide as a
practice of suicide and utilizes the term “suicide” (Downie et al., 2022).
4.5 Legality of euthanasia in Switzerland:
Switzerland which is known for its beautiful natural scenery and calm
neighborhoods is also known for a distinctive expression “suicide tourism”.
Switzerland is a federal republic consisting of 26 cantons or states (Downie et al.,
2022). Unlike Swiss health law which originates from both federal and cantonal,
criminal law and guidelines for pharmaceuticals come from federal jurisdictions.
Moreover, criminal law is the origin of the specific conditions and situations in
which assistance in dying is legal (Downie et al., 2022). According to article 115
of Código Penal, 1918, assisted suicide is permitted and lawfully allowed in
Switzerland when executed by non-doctors (as cited in Padubidri et al., 2022).
Although according to Switzerland (2020b), the fatal matter used typically has to
be recommended by a doctor according to the Federal Act on Medicinal Products
and Medical Devices (as cited in Downie et al., 2022). In addition, only four out
of the six organizations that perform assisted suicide permit assisted suicide for
foreigners and as a result, the notorious expression “suicide tourism” was created
(Padubidri et al., 2022).
18
4.6 Legality of euthanasia in the United States:
Assistance in dying in the United States is contained inside the area of
criminal law; moreover, criminal law originates from the commands of the state
(Downie et al., 2022). While euthanasia is generally prohibited in the United
States, assisted death is lawfully permitted in some states and the District of
Columbia by mixed legal tools where the legislations in (California, Washington,
Oregon, and Colorado) were ratified based on pure democracy appearing as
resident initiatives through ballot suggestions and (or) actions, legislative figures
were the origin of legality in (Hawaii, Vermont, Maine, District of Columbia, and
New Jersey), and in (Montana) it was an outcome of judicial decisions (Downie et
al., 2022). The first state to decriminalize euthanasia was Oregon in 1997 through
the “Death with Dignity Act” where permission was granted to qualified adults
who are inhabitants of Oregon, suffer from fatal diseases, and are assumed to live
a maximum of 6 months to obtain deadly doses of drugs recommended by a
physician for this aim through chosen self-aid. Moreover, in March 2009
Washington State ratified a matching act called the “Death with Dignity Act” and
the State of Montana followed shortly after in the exact year. In May 2013,
Vermont decriminalized euthanasia by stating that patients have authority and
decisions at their life finale (Padubidri et al., 2022). Castro et al. (2016) also
explained that California’s governor validated the “End of Life Option Act” in
2015 (as cited in Padubidri et al., 2022). Furthermore, according to the Death with
Dignity Acts (2021) in the following years Colorado, Maine, New Jersey, Hawaii,
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and the District of Columbia all endorsed the “Death with Dignity Act” (as cited
in Padubidri et al., 2022).
5.0 case studies & opinions:
5.1 case study: Dubai doctor sentenced to life for mercy killing:
On October 20, 2012, the former chief of the intensive care unit at Rashid
Hospital was sentenced to life in prison for the euthanasia of a quadriplegic
patient at the age of 50. Ghulam Mohammed’s life-support machine was turned
off by Eugen Adelsmayr. Abdelsmary increased Ghulam’s morphine dose.
Furthermore, Adelsmayr ordered his medical staff not to revive the laborer, who
was immobilized in an accident. Adelsmayr was not at Dubai criminal court to
hear the verdict, he was in Austria for the funeral of his wife. In October 20, 2012,
he objected his guiltlessness. Moreover, Adelsmayr claimed that the verdict was
based on inaccurate conveyance of the medical report. According to The National
(2012), Adelsmayr said “The verdict was shocking and not understandable “.
However, the court came to the conclusion that he gave the ICU staff verbal
orders to "do not resuscitate," then wrote those instructions down and personally
oversaw the carrying out of those instructions. Correspondingly, In February,
2009, the Intensive Care Unit attending physician was cleared of declining to
resuscitate the victim on orders from Adelsmayr. The victim ( M.A ) was from
India and aged 49 in February 2009. Two days after giving the order to not
attempt resuscitation, Adelsmayr turned off the man's life-support equipment and
raised the amount of morphine he was receiving from 5 mg to almost 12 mg,
which ultimately led to the man having a fatal heart attack, which exactly what
happened in the case of Ghulam Mohammed’s. After the incident, a medical
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committee at the hospital conducted an investigation into it and determined that
the two doctors were to blame for it. The committee determined that their
activities were unlawful and in breach of the norms set out by the Dubai Health
Authority. After then, a referral to the Public Prosecutor of Dubai was made so
that a criminal inquiry could be conducted. They refuted the allegations against
them. Prosecutors were informed by the chairman of the committee, an Egyptian
medical expert named Ashraf Mahmood Al Houthy. He said that Adelsmayr had
broken the rule of medical practice. The patient was aware and not clinically dead
when the instructions were given, hence they were in violation of the medical
practice code in Dubai. The directives were given verbally and subsequently
backed up in writing. According to federal legislation, euthanasia is prohibited,
and medical professionals are compelled to attempt to revive patients regardless of
whether or not the patients want to be revived. During the course of the trial, the
defense attorney for M.A. stated in front of the court that the nurse who was
caring for the patient falsified an electronic report by changing the time of death to
30 minutes after the actual time. This was done to ensure that M.A. had arrived to
take responsibility for the death. The defense attorney presented a report from
Rashid Hospital to the court as evidence that the document had been forged. The
hospital did not want to comment on the matter. According to the DHA
investigation, some of his acts were "clinically incorrect" but did not lead directly
(substantially) to the patient suffering any injury (Al Amir, 2012).
5.2 Case study: the cases of de la Rocha and Morrison:
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Active euthanasia is actions taken that precisely lead to the passing of a
patient, while passive euthanasia is permitting a patient to pass away through the
action of holding back therapy (Gorman, 1999). The following two cases to be
discussed not only illustrate the dissimilarity between active and passive
euthanasia but also pose the question of whether or not active euthanasia should
be permitted. Firstly, the case of Dr. Claudio de la Rocha, which had a patient
who came in in October of 1991 suffering from lung cancer and had been
previously placed on an inhalator at a hospital in Timmins, Ontario. She had
notified her family that she wanted her agony to end by getting rid of her ET tube
(artificial airway) to which they backed up her decision and passed it on to Dr. de
la Rocha. He detached the tube and provided 40mg of morphine in 3 portions to
make sure that she did not undergo a sensation of choking, according to
conventional exercise. He then violated conventional exercise by providing
potassium chloride which led to a pause in her heart. He was sentenced in April
1993 in criminal court due to providing a deadly matter. According to the College
of Physicians and Surgeons of Ontario (1995), he received a 3-year probation
period although his verdict was postponed, and in a hearing in April 1995 in front
of the Discipline Committee of the College Of Physicians and Surgeons of
Ontario, he was accused of professional wrongdoing as a result of the sentence in
court, in addition to being accused of inadequacy to sustain conventional exercise
(as cited in Gorman, 1999). He actually accepted blame and responsibility for the
first accusation and the college did not progress with the other one. Moreover, the
College of Physicians and Surgeons of Ontario (1995) stated that he got a 90-day
holdup of his license as his punishment which would be raised if he inscribed an
instruction on removing life support from patients with fatal diseases (as cited in
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Gorman, 1999). Secondly, the case of Dr. Nancy Morrison who had a patient
come in with esophageal cancer and had done already six operations and in
November 1996 was being cured of serious infections in a hospital in Halifax (QE
II). His tube was removed and he was given huge portions of morphine and
hydromorphone as a result of his family’s demand that he be removed from life
support. He was in great suffering after 2 hours and Morrison is claimed to have
provided nitroglycerin although his blood pressure was already really low. She is
claimed to have provided potassium chloride after another 10 minutes had passed
which resulted in his passing in only a few seconds. According to Cox (1998),
Morrison got 3 months holdup from the (QE II) in February 1997. She was seen in
court after being detained in May 1997 and she was accused of first-degree
murder (as cited in Gorman, 1999). Cox (1998) also explained that she claimed
innocent and was let go with a 10,000$ bail; however, the Court said in November
that it would pursue judgments of manslaughter. Furthermore, cox confirmed that
in February 1998, an initial hearing was done and Judge Hughes Randall
commanded that she would not be placed on trial due to the lack of sufficient
evidence to hold her accountable for any crime. The primary moral issue in these
two cases is not about if euthanasia is a correct action or not but it’s about whether
the differentiation between both passive and active euthanasia is ethically proper
or not. A lot of people presume that what the doctors did when they provided
potassium chloride leading to the patients’ passing was a wrong act. Thus,
according to the aforementioned, we should not neglect the fact that even if we
attempted to offer the best alleviating care as much as we can there’s no doubt that
there will be times when our exertions are in vain. Accordingly, the toll of
criminalizing active euthanasia is that patients suffering from fatal diseases are
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going to be permitted to be in agony for a period longer than needed (Gorman,
1999).
Generally, my opinion on euthanasia is that it shouldn’t be legalized especially
in cases where there are existing cures for the diseases. This is based on the fact
that article 3 of the declaration of human rights states that everyone has the
entitlement to life, freedom, and being safe (UN, n.d) and also the according to the
Equality and Human Rights Commission in the UK article 2 of the human rights
act everyone has the entitlement to life and this entitlement should be sheltered by
law and this article also does not mean that the person has the right to terminate
their life meaning that a right to life does not equal a right to die (Equality and
Human Rights Commission, n.d); moreover, all religions and holy books consider
the human life and soul sacred as it is a gift from god and they do not condone or
allow that a person takes their own life or asks to die and severely punishes a
person who does so in the afterlife. Furthermore, my opinion on these two cases is
that they were based on patients’ requests and families’ approval of such requests,
and the administration of lethal matters was just to end the patients’ suffering and
agony immediately without any pain, thus I do not see that these doctors have
committed any wrong doings and that although it was considered a violation of
law to administer potassium chloride then but the courts should have considered
the fact that both the patients and their families had willingly requested this and
approved of such an action.
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6.0 Conclusion:
According to Banović and Turanjanin (2014), for ages stripping a person’s life
has been seen as a dilemma that captured everyone’s attentiveness regardless
of their field of work medical, legal, or even social. Padubidri et al (2022)
explain that euthanasia constantly lies at the center of disputes as a result of its
various righteous and social problems. Moreover, Euthanasia is an irreversible
procedure, medical professionals must address any potential psychological
stresses such as depression before granting terminally ill patients’ wishes to
terminate their lives. Furthermore, Euthanasia is abhorred in accordance with
the holy precepts of Islam, Christianity, and Judaism. There is a value seen in
suffering in each of these faiths. As long as it does not purposefully result in
death, alleviating someone's suffering is praiseworthy, according to both
Christianity and Islam. Different perspectives on life and death may be found
in eastern religions. They hold the view that everyone has many lifetimes, and
that each life's quality is determined by the manner the individual lived the
preceding one. Doctors in Shiite communities are often exceedingly orthodox
and vehemently opposed to assisted suicide and euthanasia. Given this, there
is a critical need for comprehensive programs operated by multidisciplinary
teams to diagnose and treat depression in terminally ill patients as well as to
provide social support to patients and their families. On the contrasting side, in
European countries especially Belgium, the Netherlands, and Luxembourg if
an action of ending a person’s life was executed consistently with the explicit
lawful regulations and health processes then it’s not considered an offense or a
violation of the law (Banović & Turanjanin, 2014). Many diverse phenomena
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such as suicide tourism have emerged as a result of the absence of unison
among parliamentary findings in some American and European countries
(Banović & Turanjanin, 2014). Thus, it is essential to place suitable
boundaries and restrictions in laws that decriminalize euthanasia and also
execute laws and regulations in a somewhat united way so as to avoid future
conflicts (Banović & Turanjanin, 2014).
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