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  • Euthanasia*Forensic and Legal Medicine R 135Lecture XVIIJune, 2009

    * This replaces the lecture originally labelled lecture XVII

  • **Euthanasia - DefinitionBelgium menerima the Dutch definition:euthanasia is the intentional taking of someones life by another, on her request. Berikut ini adalah tidak berlaku pada kasus dimana dengan orang yang tidak kompeten; ada usulan penggunaan terminologi dengan penghentian kehidupan pada orang yg tidak kompetenLebih penting lagi, tindakan untuk menghentikan terapi yang sia-sia (futile) ini adalah bukan euthanasia dan pada kasus ini disebut passive euthanasia Apapun yang disebut indirect euthanasia, memaksa untuk menggunakan analgesik dengan efek yang memperpendek kehidupan ini juga secara jelas dibedakan dari euthanasia yang sebenarnya.

  • **Belgian Euthanasia LawOn January 20, 2001 the euthanasia commission of Belgiums upper house, the Senate,memvoting usulan UU euthanasia bahwa euthanasia tidak lagi dihukum oleh undang-undang bila syarat2 tertentu dipenuhi.Sembilan bulan kemudian October 25, 2001 Belgiums Senate menyetujui prpoposal undang2 euthanasia tersebut secara mayoritas

  • *Pembagian (are the part / mean of the debate!)euthanasia (from Greek - good death): killing (terminating the life) of a person (or an animal) in a presumably painless or minimally painful way assisted suicide providing means and/or the help to a person, who want to terminate his/her life-----------------------------------------------------------------------------------------------euthanasia by means[e.g. insulin in a diabetic]activeaggressive using lethal dose of medicaments, or lethal substance/s, or force to killnon-aggressive withdrawing life support

    passive withholding common treatments/giving a medication to relieve pain, knowing that it may also result in death

    euthanasia by consent voluntary with the persons direct consentnon-voluntary without the persons direct consent (e.g. someone not legally competent, or unable to make the decision), decision made by a proxy involuntary against someones will --------------------------------------------------------------------------------------terminal sedationletting die, futile treatments,

  • Places in the World Where Euthanasia or Assisted Suicide are Legal: Netherlands (Green), Belgium (Red), Oregon and Washington (Yellow)

    Accepted:SwitzerlandUSA (state of Oregon)

    Accepted under specific conditions:

    ColumbiaSpainFrance

  • Case StudiesRobert Latimer is a Canadian farmer sentenced to 10 years in prison for the murder of his daughter, Tracy, which occurred on October 24, 1993.

    Latimer says that he killed his daughter because she had severe mental and physical disabilities and ongoing health problems as a result of cerebral palsy and he believed that the next surgery she was to have, to remove a permanently disconnected hip, would only add to her suffering.

    Supporters of Latimer said that this was a mercy killing which should not be punished as harshly as other murders. (10 years is the minimum sentence for murder). The jury that convicted him felt that he should spend 1 year in jail and another under house arrest.

    However, disability rights advocates said that killing a severely disabled child like Tracy should carry the same penalty as killing a non-disabled child. To do otherwise would devalue the lives of disabled people and thereby increase the risk of more "mercy killings" by their caregivers.http://en.wikipedia.org/wiki/Robert_Latimer

  • *WMA Declaration on EuthanasiaEuthanasia, that is the act of deliberately ending the life of a patient, even at the patients own request or at the request of close relatives, is unethical. This does not prevent the physician from respecting the desire of a patient to allow the natural process of death to follow its course in the terminal phase of sickness. WMA, 2002

  • *HistoryHippocratic Oath (400 300 BC) To please no one will I prescribe a deadly drug nor give advice which may cause his death.English Common Law since 1300s until today disapproved suicide and assisted suicide1828 euthanasia explicitly outlawed in the USA1900s growing support in some intellectual circles1935 society to promote euthanasia in England1937 doctor-assisted suicide legal in Switzerland1938 society to promote euthanasia in USA1939 Action T4 Nazi Germany1948 Nuremberg trial 1977 living wills in California (later on in other states of USA)

  • *History1990 Dr. Jack Kevorkian (Michigan, USA) encouraging and assisting people in committing suicide, tried and convicted in 1999 for a murder displayed on television (to be paroled 2007!)1993 Netherlands decriminalization of doctor-assisted suicide 1994 Oregon (USA) Death with Dignity Act (US Supreme Court decision 1997, attempts to stop the law by amendment of the drug law failed 2001)1995 Northern Territory (Australia): euthanasia bill; overturned by Australias legislative branch 19971999 Texas (USA) Futile Care Law passed 2002 euthanasia laws in the Netherlands, in Belgium2005 Terri Schiavo case2005 Groningen Protocol (euthanasia in children) and the history continues nowadays!

  • Case StudiesRobert Latimer is a Canadian farmer sentenced to 10 years in prison for the murder of his daughter, Tracy, which occurred on October 24, 1993.

    Latimer says that he killed his daughter because she had severe mental and physical disabilities and ongoing health problems as a result of cerebral palsy and he believed that the next surgery she was to have, to remove a permanently disconnected hip, would only add to her suffering.

    Supporters of Latimer said that this was a mercy killing which should not be punished as harshly as other murders. (10 years is the minimum sentence for murder). The jury that convicted him felt that he should spend 1 year in jail and another under house arrest.

    However, disability rights advocates said that killing a severely disabled child like Tracy should carry the same penalty as killing a non-disabled child. To do otherwise would devalue the lives of disabled people and thereby increase the risk of more "mercy killings" by their caregivers.http://en.wikipedia.org/wiki/Robert_Latimer

  • Kapan dilakukan EuthanasiaEuthanasia is mainly taken out when one is terminally ill and wants to die without pain and end their suffering. Tetapi survey membuktikan bahwa kurang dari sepertiga saja yang melakukan euthanasia karena unbearable pain.

  • Hukum mengijinkan review dewan dokter untuk menghentikan penuntutan yang dilakukan dokter yang melakukan euthanasia bila masing-masing kondisi ini dipenuhi:Pasien yang menderita penyakit yg tak tertahankan tanpa prospek dari peningkatan dari penyembuhan penyakitnya itu.Atas permintaan pasien untuk euthanasia harus sukarela dan bersikeras sepanjang waktu (permintaan tersebut tidak dapat diberikan apabila di bawah pengaruh orang lain, atau obat penyakit psikologis) Pasien harus menyadari sepenuhnya tentang kondisi penyakitnya, prospek dan pilihan lainnya

  • Hukum mengijinkan review dewan dokter untuk menghentikan penuntutan yang dilakukan dokter yang melakukan euthanasia bila masing-masing kondisi ini dipenuhi:Harus ada konsultasi dengan setidaknya satu dokter independen lain yang perlu mengkonfirmasi kondisi yang disebutkan di atas Kematian harus dilakukan dalam mode medis sesuai dengan dokter atau pasien, dalam hal ini dokter harus hadir Pasien sekurang-kurangnya 12 tahun (pasien antara 12 dan 16 tahun memerlukan persetujuan dari orang tua mereka)

  • Is Euthanasia Ever Morally OK?

    E.g., Tn B mederita kanker stad terminal dan semua tx telah gagal utk menyembuhkannyaTanpa tx dia akan mati lagi dlm beberapa hariAda penelitian obat yg menjanjikan utk tx kanker spt ini tetapi dengan side efek yg tdk menyenangkanApakah tim medis yang merawat Tn B tdk bermoral bl bila berharap agar Tn B menolak terapi baru tsb.

  • Reasons for EuthanasiaUnbearable PainMajor argument in favour of euthanasia is that the person is in a great deal of pain and can no longer live with it. (orang tersebut menderita sakit yg tak terahankan dan tak lahi mempunyai harapan untuk kesembuhannya). Rasa sakit yang tidak dapat dihilangkan dengan obat-obat penghilang rasa sakitSudah melakukan kosultasi dengan beberapa dokter spesialis yang dapat memberikan support kpd pasien karena emosi dan depressi yang berhubungan dengan sakit fisikBeberapa pasien memerlukan euthanasia walaupun tdk menderita sakit agar dapat mati secara bermartabat

    how do we measure dignity?

  • Reasons for EuthanasiaRight to commit suicide

    Many people think that each person should have the right to control how they die and in what way and by whose hand he or she will die.

    The Suicide Act (1961) made it legal for people to take their own lives, hence there is a right to die but not a right to kill (an assisted suicide cannot be carried out).

    People should not be forced to stay alive

    Keeping a person alive when he or she wants to die would be cruel and inhumane.

    There comes a time when continued attempts to cure are not compassionate or wise and maybe this is where euthanasia comes in play.

  • Arguments against EuthanasiaEuthanasia adalah penolakan terhadap pentingnya dan nilai kehidupan manusia

    Euthanasia biasanya dilihat dari sudut pandang orang yang ingin mati, tetapi efeknya terhadap orang lain juga harus dipertimbangkan, dan hak-hak mereka juga harus dipertimbangkan.

  • Arguments against EuthanasiaEuthanasia memungkinkan dokter dan perawat merusak komitmen mereka menyelamatkan hidup, ini juga menyebabkan mereka tidak mau mencari pengobatan atau perawatan pasien dengan terminal ill

    Mungkin ada c