Dr Ruwan M Jayatunge M.D.

You donƒÆ’‚¢ƒ¢-¡‚¬ƒ¢-¾‚¢t need to kill the patient to kill the painƒÆ’-¡ƒ”š‚  –Dr Andre Bourque University of MontrƒÆ’†’ƒ”š‚©al

ƒÆ’-¡ƒ”š‚ Euthanasia or assisted suicide is a controversial topic that is defined as deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering. Today several countries have legalized euthanasia and some view it as a human right. Those who support euthanasia point out that the importance of ƒÆ’-¡ƒ”š‚ ƒÆ’-¡ƒ”š‚ personal autonomy and self-determination, the right of every human being to have his / herƒÆ’-¡ƒ”š‚  ƒÆ’-¡ƒ”š‚ wishes respected in decisions involving his / her own body and the recognition ofƒÆ’-¡ƒ”š‚ ƒÆ’-¡ƒ”š‚  every human being is in principle, master of his/ her own destiny.

In 2002 Holland became the first country in the world to legalize euthanasia and in 2003, 1626 cases were officially reported from Holland.ƒÆ’-¡ƒ”š‚  The Dutch euthanasia law gives doctors immunity from prosecution if they help to kill patients over the age of 12 who are suffering unbearably from incurable conditions and who have repeatedly requested euthanasia.

Euthanasia Guidelines in Holland

The Dutch laid out narrow guidelines for doctors: The patient, who must be suffering unbearably and have no hope of improvement, must ask to die. The patient must clearly understand the condition and prognosis and a second doctor must agree with the decision to help the patient die.

Euthanasia in Belgium

Belgium legalized euthanasia in 2002, but the laws seem to encompass assisted suicide as well. Since its legalization eight years ago, euthanasia now accounts for 2 per cent of deaths in Belgium -ƒÆ’-¡ƒ”š‚  or around 2,000 a year. Two doctors must be involved, as well as a psychologist if the patient’s competency is in doubt. The doctor and patient negotiate whether death is to be by lethal injection or prescribed overdose.

ƒÆ’-¡ƒ”š‚ Oregon Death with Dignity law

In 1994, voters in the state of Oregon approved a ballot measure that would have legalized euthanasia under limited conditions. Under the Death with Dignity law, a person who sought physician-assisted suicide would have to meet certain criteria. In order to qualify for physician-assisted suicide, a person must be an Oregon resident, 18 years of age or older, must have decision-making capacity, and must be suffering from a terminal disease that will lead to death within six months.

ƒÆ’-¡ƒ”š‚ Forced Euthanasia

A number of reports indicate that some medical practitioners have abused the legal privilege of euthanasia and reinforced depressive patients to select euthanasia as an option.

A study found that a high proportion of deaths classed as euthanasia in Belgium involved patients who did not ask for their lives to be ended. ƒÆ’-¡ƒ”š‚ In 1990 government sponsored surveys found that 0.8% of all deaths in the Netherlands were euthanasia deaths that occurred without a request from the patient. In a 1995 study, Dutch doctors reported ending the lives of 948 patients without their request.

ƒÆ’-¡ƒ”š‚ Passive Euthanasia

Although euthanasia is illegal in many countries passive euthanasia (withhold treatment and allow a patient to die) is being practiced.ƒÆ’-¡ƒ”š‚  This is unethical and described as a malpractice. The American Medical Association emphasizes that theƒÆ’-¡ƒ”š‚  ƒÆ’-¡ƒ”š‚ intentional termination of the life of one human being by another is contrary to that for which the medical profession stands. Human life has an absolute value and it is inhuman for a medical practitioner to terminate it.

Mrs. H a resident from North York Ontario Canada witnessed the agonizing death of her grandmother who suffered a stroke. When she was admitted to the hospital the doctors said that she would not recover. After several days the nasal feeding was discontinued. Mrs. H was near her semi conscious grandmother all the time and the grandmother ƒÆ’-¡ƒ”š‚ ƒÆ’-¡ƒ”š‚ responded to her time to time by blinking the eyes. After removal of nasal feeding tube she was starving and I could see tears in my grandmotherƒÆ’‚¢ƒ¢-¡‚¬ƒ¢-¾‚¢s eyes. She was dying but the process was accelerated by discontinuing nasal feeding that led to an agonizing death says Mrs.H

Mrs. V a resident from Colombo Sri Lanka underwent the same experience when her 92 year old mother was admitted to the ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦ hospital. She was diagnosed with a benign ovarian tumor and had numerous age related complications.ƒÆ’-¡ƒ”š‚  During her stay at the hospital she was only given Brufan and Vitamin B. ƒÆ’-¡ƒ”š‚ Doctors and Nurses often said that she had lived her years and taken no significant efforts to improve her condition. She was prematurely discharged and after two weeks she died at home.ƒÆ’-¡ƒ”š‚ 

Mr. T a resident from Negombo met with a road traffic accident and admitted to the ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚¦.. Hospital Intensive Care Unit. He was unconscious throughout and was on a life supporter. By the 8^th day his condition was not improving. The medical staff decided to remove him from the life support system in order to accommodate another patient who was diagnosed with Dengue hemorrhagic fever.ƒÆ’-¡ƒ”š‚  After removing Mr. T from the life support system less than 24 hours he passed away.

ƒÆ’-¡ƒ”š‚ Euthanasia Declines in the quality of care

Euthanasia devalues human life; in the long run euthanasia can become a means of health care cost containment. In Holland legalized euthanasia has led to a severe decline in the quality of care for terminally-ill patients. ƒÆ’-¡ƒ”š‚ Dr Els Borst, the former Health Minister and Deputy Prime Minister who guided the euthanasia law through the Dutch parliament recently admitted that medical care for the terminally-ill had declined since the law came into effect.

ƒÆ’-¡ƒ”š‚ Euthanasia and Murder

According to the Criminal CodeƒÆ’-¡ƒ”š‚ ƒÆ’-¡ƒ”š‚  aƒÆ’-¡ƒ”š‚ ƒÆ’-¡ƒ”š‚  person commits homicide when, directly or indirectly by any means, he causes the death of a human being. In this context euthanasia is mealy a murder. The main aim of the medical practitioners should be focused on improving and enhancing the care of the patient. Under the Hippocratic Oath, medical practitioner cannot engage in euthanasia.ƒÆ’-¡ƒ”š‚ 

ƒÆ’-¡ƒ”š‚ Dr Jack Kevorkian alias Dr Death

Dr Jack Kevorkian is a pathologist who actively support of voluntary euthanasia. He designed a so called death machine (thanatron) ƒÆ’-¡ƒ”š‚ that was used by several terminally ill patients to commit suicide. He had helped more than 130 terminally ill people end their own lives. In 1994, he faced murder charges in the death of Thomas Hyde, who suffered from a terminal nerve illness.ƒÆ’-¡ƒ”š‚ ƒÆ’-¡ƒ”š‚  He was convicted ofƒÆ’-¡ƒ”š‚ ƒÆ’-¡ƒ”š‚  second-degree murder.ƒÆ’-¡ƒ”š‚  Some experts consider Dr Jack Kevorkian is highly obsessed with mercy killings and gradually lost the human touch. ƒÆ’-¡ƒ”š‚ Instead of promoting health as a doctor Dr Jack Kevorkian promoted death.ƒÆ’-¡ƒ”š‚ 

ƒÆ’-¡ƒ”š‚ Harold Shipman

British doctor Harold Shipman murdered 215 of his patients using the drug Diamorphine over a period of 20 years. He killed an average of one patient a month during his medical career. Young Shipman observed the painful death of his mother who suffered from a terminal cancer. In the later years he killed mainly elderly womenƒÆ’-¡ƒ”š‚ who were suffering from various illnesses. He was an addictive serial killer who may have believed that he was helping the patients to end their suffering. Shipman hanged himself in January 2004 while in the custody.

ƒÆ’-¡ƒ”š‚ NAZI Movement and Euthanasia

Those who support euthanasia should study what the NAZI s did in Germany and in their occupied countries. The NAZI s widely used euthanasia as a social cleansing method. First, they exterminated the mentally ill and disabled Germans. Subsequently they extended euthanasia as a political tool. ƒÆ’-¡ƒ”š‚ NAZI s used the medical practice to propagate racial supremacy. Dr Josef Mengele alias the angel of death used to do horrible experiments euthanizing men women and children. NAZI genocide machine started from euthanasia and it ended up with the Final Solution. During the HitlerƒÆ’‚¢ƒ¢-¡‚¬ƒ¢-¾‚¢s regime, 6 million Jews were terminated.

ƒÆ’-¡ƒ”š‚ Conclusion

Before the advances in medical science diseases like leprosy, syphilis etc were considered as incurable and relatives often performed mercy killings to end the suffering of the patients. Today the doctors are struggling with terminal cancer and sometimes suggest euthanasia as a temporary answer. Good palliative care is the primary answer to pain and suffering. Euthanasia is a dangerous and uncontrollable phenomenon. The future advancements in medical science would bring viable solutions to many incurable diseases and euthanasia would be considered as an outdated, inhuman and unprofessional form of practice.