Ethics of Life and Death: Euthanasia ? Abortionocw.usu.ac.id/course/download/1300000005-etika... · Abortion The dilema, similar with euthansia The fundamental diffference is : Abortion

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Ethics of Life and Death:

Euthanasia ? Abortion

Prof. Amri Amir, Sp.F, DFM, SH

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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

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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

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