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2/28/2012 1
Ethics of Life and Death:
Euthanasia ? Abortion
Prof. Amri Amir, Sp.F, DFM, SH
2/28/2012 2
BIRTH OF A NEW HUMAN
BEING
Every human being has to pass through birth and death
Not all birth accepted
Certain reasons for that
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END OF LIFE
Everybody has to die one day
Not every death take place smoothly
Certain death preceded by suffering where hope for survival is imposible
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ADVANCES IN MEDICAL
FIELD Science and tehnology
Treatment more effective
Life of patient prolonged for a certain periode ( respirator)
Birth technology, biological enginering
Seems that death can be prolonged with modern technology
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ETHICS AND LAW
Advances in science and technology not able to solve problem of medical ethics
Dilema of new birth rejected (abortion) and necessary to end the life in a nice way
(euthanasia)
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DEATH
1. Orthothanasia - natural
2. Dysthanasia - unnatural
3. Euthanasia - with or without doctor‟s aid
Moral problems / law / religion
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PROBLEMS
Can the patient / relatives of the patient request ?
Is the doctor eligible to help / perform it ?
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EUTHANASIA
Eu : Good, nice, acceptable
Thanatos : Death
(compare with a patient of heart attack
within minutes)
Not always nice, acceptable (for patient)
Choice for suffering termination --- death
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Sustainable
dispair
Sucide
Ends own
life
suicide
-Broken love etc
-Executed by own self
euthanasia
- painful sickness, not
cured
- wit somebody’s help
(doctors)
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COMPARE
Harakiri (Japan)
Sutee (India)
Eskimo (eaten by bear)
Nomanden (leaving a sick pereson)
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HISTORY
Plato (427 – 347 BC) suicide acceptable due to disease, disability
Aristoteles (384-322 BC) infanticide acceptable
Phytagoras (580-500 BC), killing of weak people, mentally
Hitler
Swiss, Gemany, Soviet union, Cina in the past
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“The Last Wish”, Betty Rollins
Helps the mother commits suicide due to malignant cancer
„The Final Exit”, Dereck Humprey
Ways to end up life
Hemlock Society: force someone to lead life is irrasional
CASES
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Disagree Agree
Attitude toward
Euthanasia
- Hidden killer
- God wish
Accepted by patient
/relatives and doctor
handling the patien
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DOCTOR
Prolife
Respect to human life, dedicated, scientific, integrity
Deklarasi Geneva : I will maintain the utmost respect for human life from the time of conception, even under threat, I will not use my medical knowlegde contrary to the laws of humanity.
Kodeki 29 Oct 69, Kepmenkes RI 23 Okt 69
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A doctor has to remember his obligation to protect human life from conception
Code of Indon Med Ethics
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Euthanasia: Fatwa IDI 1989
1. Dying in peace without suffering, for religious people in the name of Allah
2. When life will end up, suffering relieved by giving transquilizer
3. Ending up life for a sick person perposely on patient demand and family
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TYPES OF EUTHANASIA
Method
1. Passive Euthanasia
2. Active Euthanasia - direct (mercy killing)
- indirect
On demand
1. Voluntary Euthanasia
2. Involuntary Euthanasia
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1. No help in the process without the aim of shortening life
2. Help in the death process without the aim of shortenng life
3. No help in death process with the aim of shortening life
4. Help in the deth process with the aim of shortening life
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LAWS AND REGULATIONS
Act 344 KUHP
Anyone ending up somebody‟s life on his own wih is sentence for 12 years
Act 338 KUHP
Anyone found killing/ taking somebody‟s life is sentence for at least 15 years
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Act 340 KUHP
Anyone found of taking somebody‟s life planed in advance (moord) is sentence for planned murder wit death sentence or life imprisonment or 20 year imprisonment
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Act 359 KUHP
Anyone due to his negligence cause the death of a victim is sentence 5 years imprisonment or one year in jail
Act 338, 340 and 359 KUHP Euthanasia onpatient without demand
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Act 345 KUHP
Anybody instigating someone to kill and help in the act or help in the suicide act is liable to sentence of 4 year
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RELIGION
Life and death are determined by the Almighty
Euthanasiais against God‟s will
Human right
• The right to live
• The right to die
Human right violation ?
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Sciences
In cases where there is no cure or treatment to relieved the suffering -- is
there any right to extent the life of the patient ?
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Abortion
The dilema, similar with euthansia
The fundamental diffference is : Abortion is in the beginning of life,while euthanasia is in the terminal stages of life
Classic dilema which is still controversial till now
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Dilema
Abortion is rejected as illegal and against religion. Done hidingly
Many cases
drugs easily available
many want to do it (doctors, mid-wifes, nurse, self, quack)
Pro-life versus pro-choice
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CASES
Natural, spontaneous abortion 15 %
20 million unsave abortion (WHO)
70.000 maternal death ech year
1 from 8 maternal death, from unsave abortion (12 – 15%)
In some countries : 50%
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INDONESIA
Insidence in Indonesia about 2 million
In the world 40 million (25% of 180 million pregnancy) per-year
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REASONS
Economy
Ilegal pregnancy
Rape
Incest
Old age
Multipara, failure in contraseptive
Still studying
etc
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UNSAVE ABORTION
Law does not support abortion
Unwanted pregnancy looking for incompetent help (mid-wife, nurse, quack)
Maternal mortality rate increase
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RISK FOR MOTHER
Death due to bleeding
Infection
Mammary cancer
Ovarian cancer
Liver cancer
mandul
etc
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LEGALISATION OF
ABORTION ?
Unwanted pregnancy looking for better medical services
No hidden procedure
MMR can be reduce
Hight abortion rate proof that society does not care for abortion law
Legalisation of abortion still chalenged
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CONTROVERSY
Pregnant woman has the right to make the choice of pregnacy beyond her will
Foetus is candidate for humn beeing which has to be respected for the right of survival
Concelling is necessary
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LAW
KUHP prohibit all kinds of termination of pregnancy
Health law no. 23/1992
Act 15. In case of emergency in order to save mother or foetus, specific medical procedure can be executed
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HEALTH LAW 1992
Abortion can be done if;
Medical indication
By medical personnel, well trained and having skill and knowledge and authority, consideration of expert team
consent of the mother, husband or family
special center for abortion
2/28/2012 36
LAW PENALTY
Health Law
pasal 80. Barangsiapa dengan sengaja melakukan tindakan medis tertentu terhadap ibu hamil yang tidak memenuhi ketentuan…….. Dipidana penjara paling lama 15 tahun dan pidan denda sebanyak RP.500.000.000
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KUHP
Pasal 229
1. Barangsiapa dengan sengaja mengobati seorang wanita atau menyuruhnya supaya diobati dengan diberi tahukanatau ditimbulkan harapan bahwa hamilnya dapat digugurkan…….. Penjara 4 tahun, atau denda 3 ribu rupiah
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KUHP
342, 343, 346, 347, 348, 349
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KUHP
Pasal 229
2/28/2012 40
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