Euthanasia
Euthanasia
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Euthanasia Index:
Sr. No.
1. 2. 3. 4. 5. 6.
Topics
Introduction, Meaning, Types Arguments for Euthanasia Arguments against Euthanasia Current legal position - India List of countries where Euthanasia is legal Articles
Page No.s
05 06 08 11 12 13
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Introduction:
o The word euthanasia is derived from the Greek word ?euthanatos? meaning ?well death? and originally referred to intentional mercy killing. In the modern context euthanasia is limited to the killing of patients by doctors at the request of the patient in order to free him of excruciating pain or from terminal illness. o When medical advances made prolonging of the lives of dying or comatose patients possible, the term euthanasia was also applied to omission to prevent death
Definitions:
o Euthanasia - the intentional killing by act or omission of a dependent human being for his or her alleged benefit. (The key word here is "intentional". If death is not intended, it is not an act of euthanasia)
Types:
Euthanasia may be classified as active and passive or alternatively as voluntary, non-voluntary and involuntary. o Voluntary euthanasia: When the person who is killed has requested to be killed. o Non-voluntary: When the person who is killed made no request and gave no consent. o Involuntary euthanasia: When the person who is killed made an expressed wish to the contrary. o Assisted suicide: Someone provides an individual with the information, guidance, and means to take his or her own life with the intention that they will be used for this purpose. When it is a doctor who helps another person to kill themselves it is called "physician assisted suicide." o Euthanasia by Action or Active Euthanasia: Intentionally causing a person's death by performing an action such as by giving a lethal injection. Active euthanasia involves painlessly putting individuals to death for merciful reasons, as when a doctor administers a lethal dose of medication to a patient.
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o Euthanasia by Omission or Passive Euthanasia: Intentionally causing death by not providing necessary and ordinary (usual and customary) care or food and water. Passive euthanasia involves not doing something to prevent death, as when doctors refrain from using devices necessary to keep alive a terminally ill patient or a patient in a persistent vegetative state.
What Euthanasia is NOT:
o There is no euthanasia unless the death is intentionally caused by what was done or not done. o Thus, some medical actions that are often labeled "passive euthanasia" are no form of euthanasia, since the intention to take life is lacking. These acts include not commencing treatment that would not provide a benefit to the patient, withdrawing treatment that has been shown to be ineffective, too burdensome or is unwanted, and the giving of high doses of pain-killers that may endanger life, when they have been shown to be necessary. o All those are part of good medical practice, endorsed by law, when they are properly carried out.
Arguments for and against Euthanasia:
? Arguments for Euthanasia:
1. o o o o Below are the prime reasons because of which people opt for Euthanasia: It provides a way to relieve extreme pain It provides a way of relief when a person's quality of life is low Frees up medical funds to help other people It is another case of freedom of choice
2. The positive side of Euthanasia is that it ends a person’s suffering in this world. o Many physicians and psychiatrists believe that it may a humane act. From a virtue ethics point of view, it may be appropriate. What we seek in human existence is to be happy, and find happiness. o Suffering from a terminal illness, or affliction, could inhibit one’s happiness in life. If the goal is to be happy, then Euthanasia would be an answer for this person.
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o Euthanasia may even bring about happiness in that it is what the person desires and wants, in order to no longer to be a burden to his/her family. o Also, Euthanasia would stop the pain and not prolong the dying process. 3. Supporters of active euthanasia contend that not allowing euthanasia would come down to forcing people to suffer against their will. o Calling for legalization of active euthanasia, proponents of euthanasia cite circumstances in which a condition has become overwhelmingly burdensome for the patient, pain management is inadequate, and only death seems capable of bringing relief. 4. Reasons why people opt for voluntary euthanasia o Fear of the process of dying rather than the terminal event of death. o Fear the indignity of being hooked on to life support machines and other forms of treatment when all such treatment is futile and death is inevitable. o The desire not to subject the family to emotional and financial distress when all treatment may be futile. 5. Moreover, in the light of the increasing pressure on hospital and medical resources, available facilities ought to be used for the benefit of those patients who stand a better chance of recovery. o Supporters agree that euthanasia may be misused. They point out that almost every individual freedom involves some risk of abuse, but proper legal safeguards could minimize such risks. o Further, the risk of abuse of a right is no reason to deny a person the right. 6. In the utilitarian point of view we all have a duty to our happiness, and a duty to the society. o Euthanizing a person based on the society aspect makes sense. With greater and greater emphasis put on managed care today, many doctors are at a financial risk when they provide treatments to patients who are in the dying process. o These patients may also feel like not becoming a burden to the society at large, and choose to fulfill a duty – Euthanasia. If the person is in a coma or is brain dead, that person is no use to himself or herself, or society anymore.
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o Euthanasia is a viable method to end an otherwise futile attempt at recovery. 7. The family of the person being euthanized may not want their family members in pain – to suffer. It can be a family duty to do the right thing for the person and society. o Depression, family conflict, feelings of abandonment, and hopelessness, are emotional burdens on family members seeing a person suffer. o Committing euthanasia may be the humane act to do for the afflicted family member in this case. 8. The euthanized person may even be of use to society in a utilitarian manner, if his/her bodily organs are to promote the welfare of others, one life saves the lives of others. o This may even be considered a virtuous acts, and possibly even altruistic in it not being of self-interest. o It is the betterment of his/her fellow human kind in helping others in one final gracious act. The benefits are numerous in that the person euthanized would cease suffering, and the families would begin the healing process from grief and/or depression from the situation.
? Arguments against Euthanasia:
1. o o o Following are the prime reasons for arguments against Euthanasia: Euthanasia devalues human life Euthanasia can become a means of health care cost containment Physicians and other medical care people should not be involved in directly causing death o There is a "slippery slope" effect that has occurred where euthanasia has been first been legalized for only the terminally ill and later laws are changed to allow it for other people or to be done non-voluntarily. 2. Euthanasia would not only be for people who are "terminally ill" o There are two problems here -- the definition of "terminal" and the changes that have already taken place to extend euthanasia to those who aren't "terminally ill." o There are many definitions for the word "terminal." For example, when he spoke to the National Press Club in 1992, Jack Kevorkian said that a
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terminal illness was "any disease that curtails life even for a day." The co-founder of the Hemlock Society often refers to "terminal old age." Some laws define "terminal" condition as one from which death will occur in a "relatively short time." Others state that "terminal" means that death is expected within six months or less. o Even where a specific life expectancy (like six months) is referred to, medical experts acknowledge that it is virtually impossible to predict the life expectancy of a particular patient. o Some people diagnosed as terminally ill don't die for years, if at all, from the diagnosed condition. Increasingly, however, euthanasia activists have dropped references to terminal illness, replacing them with such phrases as "hopelessly ill," "desperately ill," "incurably ill," "hopeless condition," and "meaningless life." 3. Euthanasia can become a means of health care cost containment o Perhaps one of the most important developments in recent years is the increasing emphasis placed on health care providers to contain costs. In such a climate, euthanasia certainly could become a means of cost containment. o In the United States, thousands of people have no medical insurance; studies have shown that the poor and minorities generally are not given access to available pain control, and managed-care facilities are offering physicians cash bonuses if they don't provide care for patients. o With greater and greater emphasis being placed on managed care, many doctors are at financial risk when they provide treatment for their patients. o Legalized euthanasia raises the potential for a profoundly dangerous situation in which doctors could find themselves far better off financially if a seriously ill or disabled person "chooses" to die rather than receive long-term care. o Savings to the government may also become a consideration. This could take place if governments cut back on paying for treatment and care and replace them with the "treatment" of death. o In Canada, hospital stays are being shortened while, at the same time, funds have not been made available for home care for the sick and elderly. Registered nurses are being replaced with less expensive practical nurses. Patients are forced to endure long waits for many types of needed surgery.
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4. Euthanasia will become non-voluntary o The movement from voluntary to involuntary euthanasia would be like the movement of abortion from "only for the life or health of the mother" as was proclaimed by advocates 30 years ago to today's "abortion on demand even if the baby is half born". o Euthanasia people state that abortion is something people choose - it is not forced on them and that voluntary euthanasia will not be forced on them either. o They are missing the main point - it is not an issue of force - it is an issue of the way laws against an action can be broadened and expanded once something is declared legal. o You don't need to be against abortion to appreciate the way the laws on abortion have changed and to see how it could well happen the same way with euthanasia/assisted suicide as soon as the door is opened to make it legal. 5. Euthanasia is a rejection of the importance and value of human life o People who support euthanasia often say that it is already considered permissible to take human life under some circumstances such as self defense - but they miss the point that when one kills for self defense they are saving innocent life - either their own or someone else's. With euthanasia no one's life is being saved - life is only taken. o History has taught us the dangers of euthanasia and that is why there are only two countries in the world today where it is legal. o That is why almost all societies - even non-religious ones - for thousands of years have made euthanasia a crime. It is remarkable that euthanasia advocates today think they know better than the billions of people throughout history who have outlawed euthanasia - what makes the 50 year old euthanasia supporters in 2005 so wise that they think they can discard the accumulated wisdom of almost all societies of all time and open the door to the killing of innocent people? Have things changed? o If they have, they are changes that should logically reduce the call for euthanasia - pain control medicines and procedure are far better than they have ever been any time in history.
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The current legal position on Euthanasia in India
o In India, euthanasia is undoubtedly and absolutely illegal. Since in cases of euthanasia or mercy killing there is an intention on the part of the doctor to kill the patient, such cases would clearly fall under clause first of Section 300 of the Indian Penal Code, 1860. o However, as in such cases there is the valid consent of the deceased Exception 5 to the said Section would be attracted and the doctor or mercy killer would be punishable under Section 304 for culpable (deserving blame) homicide (murder) not amounting to murder. But it is only cases of voluntary euthanasia (where the patient consents to death) that would attract Exception 5 to Section 300. o Cases of non-voluntary and involuntary euthanasia would be struck by proviso one to Section 92 of the IPC and thus be rendered illegal. o Euthanasia and suicide are different, distinguishing euthanasia from suicide, Lodha J. in Naresh Marotrao Sakhre v. Union of India1, observed: ? "Suicide by its very nature is an act of self-killing or self-destruction, an act of terminating one’s own act and without the aid or assistance of any other human agency. ? Euthanasia or mercy killing on the other hand means and implies the intervention of other human agency to end the life. Mercy killing thus is not suicide and an attempt at mercy killing is not covered by the provisions of Section 309. ? The two concepts are both factually and legally distinct. Euthanasia or mercy killing is nothing but homicide whatever the circumstances in which it is effected."2 (emphasis added) o The law in India is also very clear on the aspect of assisted suicide. Abetment of suicide is an offence expressly punishable under Sections 305 and 306 of the IPC. o Moreover, after the decision of a five judge bench of the Supreme Court in Gian Kaur v. State of Punjab, it is well settled that the "right to life" guaranteed by Article 21 of the Constitution does not include the "right to die". o The Court held that Article 21 is a provision guaranteeing "protection of life and personal liberty" and by no stretch of the imagination can extinction of life be read into it.
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o The criteria laid down by the Courts to determine whether the defence of necessity applies in a given case of euthanasia, have been summarized as follows: 1. The request for euthanasia must come only from the patient and must be entirely free and voluntary. 2. The patient’s request must be well considered, durable and persistent. 3. The patient must be experiencing intolerable (not necessarily physical) suffering, with no prospect of improvement. 4. Euthanasia must be the last resort. Other alternatives to alleviate the patient’s situation must be considered and found wanting 5. Euthanasia must be performed by a physician. 6. The physician must consult with an independent physician colleague who has experience in this field.
List of countries where Euthanasia is legal:
1. Netherlands 2. Belgium 3. Oregon in the U.S. 4. The Northern Territory of Australia 5. Norway 6. Sweden 7. Finland 8. Luxembourg 9 Albania
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Articles on Euthanasia:
Article 1:
Husband pleads for mercy killing of comatose wife! Patna: The echoes of the mercy killing of Terri Shiavo could be heard nearer home in Bihar when Tarkeshwar Chandravanshi, unable to bear the burden of his comatose wife, approached Governor Buta Singh to bring about suitable amendment to the existing law to allow the mercy killing of his wife. Tarkeshwar, living in a slum, behind Shastrinagar police station in the State capital, in a petition to the governor on April six, said his wife Kanchan Devi was in coma ever since she delivered a baby in 2000 at a private nursing home in Patna. Later on, she was admitted to Patna Medical College And Hospital where doctors diagnosed her disease as "incurable" and she was taken back home. Patna High Court had in January 2001 rejected Tarkeshwar's petition seeking permission for mercy killing observing that no order could be passed on such petition as she was "alive and had not herself filed a petition." "Since President's rule has been imposed in Bihar, the Governor being the head of the State has the right to promulgate an ordinance for mercy killing and therefore, we have approached him," Tarkeshwar's lawyer Shruti Singh, who had also filed a petition in the High Court last week for reviewing its earlier order as she was still in coma, said. Shruti Singh in the petition filed on behalf of Tarkeshwar and his son Suraj also cited the latest case of mercy killing of brain-dead Florida resident Terri Shiavo and sought amendments to the existing law. He also pleaded that like the case of a husband or a wife who are free to tie a nuptial bond with any other person after one of them remains traceless for a period of seven years, a law be brought into force to allow mercy killing of a person in coma for over six years. The case was likely to come up for hearing by Patna High Court within a
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week, Shruti Singh said, adding they also expected a favourable response from the governor.
Article 2:
Jobless father wants death for son suffering from sickle cell anaemia Jobless father in Jharkhand and his wife have sought death for their suffering son. Kalidas Munda is a resident of Village Potka, Chakradharpur district of West Singhbhum division in the state. His son, 11-year-old Gulshan, suffers from sickle cell anaemia, an inherited disease that requires complete blood transfusion once every two months. ?We can’t continue… we are left without a penny,? said Munda’s letter addressed to the President of India and submitted to district sub-divisional officer (SDO) JJ Suman. Worse, the daily-wage earner has had no job for the past six months. This, when the boy’s monthly medical bills touched over Rs 5,000. With over a lakh spent on Gulshan's treatment and with no money left, the helpless parent said mercy killing or euthanasia was the only way out of their sufferings and misery. ?I want death for my child. We can't afford his treatment anymore. The child is also suffering,? said Parvati, Gulshan’s mother. The hapless parents approached state Welfare Minister Joba Manjhi but only got assurances from him. On the district administrations’s part SDO Suman said the family was issued Red Cards — to avail free ration under the public distribution scheme. As for Gulshan’s treatment, the official said efforts were being made to get funds from the state government’s kitty. This is not the first time in the state that extreme helplessness pushed people to a death wish. Earlier, Bokaro resident Dilip Machua had written to President Pratibha Patil for mercy killing, after he was paralysed in an accident.
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The 30-year-old former slag picker had an old mother, wife and two infant daughters to feed and no other means of livelihood. In his April 4 letter to the President, he had pleaded that either the government arrange for his treatment or allow him death. He had also sent copies of the letter to the then chief minister of Jharkhand, Madhu Koda and Governor, Syed Sibtey Razi. Mercifully, nature intervened. Dilip died of natural causes some days later.
Article 3:
Euthanasia poses a dilemma for city doctors The city doctors give their opinion about euthanasia while the Indian law continues to call it illegal Euthanasia, and the laws surrounding it, is a legal and moral minefield. And when 13-year-old Hannah Jones was allowed by the UK courts to reject a heart transplant - a decision, which almost certainly will result in her death the debate was renewed. Calls were made from some quarters of society that a patient's right to die is exactly that…a patient's right. But the medical fraternity, in Mumbai, is divided: "Facilitating killing is not an option," says PN Jain, professor of Anaesthesia and Pain, at the Tata Hospital. But Abhijeet S Joshi, general surgeon, Hiranandani Hospital, says, "In my personal opinion, it is the patient's will that should be followed." He, however, admits that it is a controversial subject, as euthanasia is illegal, not only in India, but in many other countries too. But most laws are open to interpretation. "Euthanasia, as we all know is illegal here, but a case of brain death, where the patient is in a vegetative state is a great liability to the family, both financially and emotionally," says
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Ashwin Mehta, director of Cardiology, Jaslok Hospital. "When we see no signs of recovery, and the patient is in excruciating pain, we slow down the treatment, which eventually leads to natural termination, but this is only after consulting the family," he says. Mehta adds that he has witnessed many cases of terminal illness, where patients want to end their life, but cannot, as they fear the law. But in the case of patients who are brain dead, the euthanasia laws cease to apply. And organ donation can then be sought by the hospital. "If a patient is brain dead, and the other organs are functioning properly, and there is no hope of recovery, then we ask the family if they would consider donating the patient's organs as it can save the life of someone else," says Ganesh Kumar, chief of Interventional Cardiology and a member of Hiranandani hospital's Brain Death Committee. But for many city doctors, the act of taking a life is still taboo. As Dr Jain, says, "Throughout our career, we are taught to help people live. Euthanasia, however, is diametrically opposite to that." List of countries where euthanasia is legal 1. Netherlands 2. Belgium 3. Oregon in the U.S. 4. The Northern Teritory of Australia 5. Norway 6. Sweden 7. Finland 8. Luxembourg 9 Albania In India, euthanasia is absolutely illegal. If a doctor tries to kill a patient, the case will surely fall under Section 300 of Indian Penal Code, 1860. but this
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is only so in the case of voluntary euthanasia in which such cases will fall under the exception 5 to section 300 of Indian Penal Code,1860 and thus the doctor will be held liable under Section 304 of Indian Penal Code,1860 for culpable homicide not amounting to murder. Cases of non-voluntary and involuntary euthanasia would be struck by proviso one to Section 92 of the IPC and thus be rendered illegal. There has also been a confusion regarding the difference between suicide and euthanasia. It has been clearly differentiated in the case Naresh Marotrao Sakhre v. Union of India . J. Lodha clearly said in this case. "Suicide by its very nature is an act of self-killing or self-destruction, an act of terminating one's own act and without the aid or assistance of any other human agency. Euthanasia or mercy killing on the other hand means and implies the intervention of other human agency to end the life. Mercy killing thus is not suicide and an attempt at mercy killing is not covered by the provisions of Section 309. The two concepts are both factually and legally distinct. Euthanasia or mercy killing is nothing but homicide whatever the circumstances in which it is effected." The question whether Article 21 includes right to die or not first came into consideration in the case State of Maharashtra v. Maruti Shripathi Dubal . It was held in this case by the Bombay High Court that 'right to life' also includes 'right to die' and Section 309 was struck down.
Article 4:
Former chess champion K Venkatesh, who was terminally ill, died on December 17 after a futile wait for the courts to accept his plea for euthanasia so that he could donate his organs. His eyes were donated after his death but no other organ could be transplanted as the 25 year old had been on a ventilator for a long period.
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Venkatesh's mother to move SC. Indian laws allow organ donation only if a person is declared brain dead. Euthanasia is the act of ending the life of an individual suffering from a terminal illness or an incurable condition. Quoting Venkatesh's case, experts have said the severe paucity of organ donors is one reason why euthanasia should be legalised. Venkatesh passes away. Venkatesh's mother intends to continue the legal battle to amend the Human Organ Transplant Act and legalise euthanasia.
Article 5: French Woman dies after losing Euthanasia case
PARIS (Reuters) - A French woman suffering from an incurable and disfiguring cancer was found dead on Wednesday, two days after a court rejected her request for medical assistance to help end her life, a source close to the government said. Chantal Sebire, 52, whose face was swollen and distorted by a rare tumour in her sinuses, won heavy media coverage and the compassion of many French people in her bid to set a legal precedent for patients like her seeking to end their suffering. A court in the eastern city of Dijon ruled on Monday that Sebire could not have a doctor help her die because it would breach both the code of medical ethics and the law, under which assisted suicide is a crime. No details were immediately available on the cause of Sebire's death, which was first reported on the Web site of regional daily Le Bien Public. The source said she was found dead at her home near Dijon. Sebire's plight sparked a public debate in mainly Catholic France on euthanasia, and she won the support of several public figures including
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Foreign Minister Bernard Kouchner. President Nicolas Sarkozy met her doctor on Wednesday. The government initially ruled out passing a reform on euthanasia, but Prime Minister Francois Fillon's office said on Wednesday it would consider the issue. One proposal is for an expert panel to allow assisted suicide in exceptional cases. Sebire's doctors had said she would fall into a coma and die if she stopped taking medication to deal with the rare tumour, but she insisted on going to court to try to secure the right to an assisted suicide, which would be less painful. Active euthanasia is legal in the Netherlands, Belgium, Switzerland and Luxembourg, but French courts regularly rule against doctors who administer lethal drugs to end life, although they are usually spared prison. Opponents of euthanasia, including the Roman Catholic Church, say the sanctity of life overrides all other factors. Many also say a right to kill patients could easily be abused. "I want to die partying surrounded by my children, friends and doctors before falling asleep for good at dawn," Sebire had told reporters.
Article 6: Woman's fight to die in peace
LONDON: Debbie Purdy, a multiple sclerosis patient has accused the British Crown Prosecution Service of failing the terminally ill by refusing to be clear about whether their relatives will face criminal charges for helping them to die. Speaking on the first day of the hearing, Purdy's barrister David Pannick QC said that although it was illegal to assist suicide, cases where terminally ill patients were helped to die by their kin were rarely prosecuted making the law "confused and uncertain". The 45-year-old former music journalist said she is not seeking immunity from prosecution for her husband, Omar Puente but more information about when prosecutions are likely.
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The landmark two-day hearing at the High Court which began on Thursday, is again questioning the controversial right to assisted suicide which under British law is treated as a criminal offence punishable by up to 14 years in jail for the relatives. It is claimed that more than 100 Britons have been forced to travel to Dignitas euthanasia clinic in Zurich, Switzerland where assisted suicide is lawful. So far none of their relatives have been prosecuted for helping organise the deaths. The Crown Prosecution Service has said that it will not create a specific policy for assisted suicide but will consider each case individually in deciding whether to prosecute. Purdy's case is just one in a long-running battle being fought for making assisted suicide lawful in the UK. The first to challenge the 1961 Suicide Act was Diane Pretty, a motor neurone disease sufferer, who asked her husband be allowed to kill her. Judges rejected the plea before she died in 2002. Purdy fears more for her husband because he is black and a foreigner. Puente, a Cuban musician has been with Purdy for the last 13 years. She was diagnosed with the terminal disease in 1995, at the age of 31.
Article 7:
'Islam allows passive mercy killing' Scholars say that the Quran has answers about organ transplant, euthanasia and even, contraceptives Can a Muslim donate his/her organs? What does Islam say about euthanasia? When it comes to health and hygiene, the holyQuran has all the answers -it's only a question of right interpretation, said Dr Shoaib Sayyed, a doctor who in his capacity as the manager for Islam and Comparative religions at the Islamic Research Foundation (IRF) has had ample opportunities to research for the answers.
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IRF concluded its peace conference recently at Somaiya grounds where religious scholars and experts from across the world discussed various issues affecting the Muslim community, including the portrayal of the community in mainstream media. "There are three basic things which should be taken into consideration when it comes to organ donation or transplant. One, the person donating his organ should not suffer any health problem as a consequence of his donation. Two, it should be done only if it is life-saving for the recipient. And finally, it should not be done for commercial reasons," said Sayyed. Interestingly, even mercy killing is permitted by Islam. According to religious experts, Islam allows 'passive' mercy killing. If a person is dying and is being kept alive on machines like a ventilator, then it is allowed to offer the person the option of mercy killing. If a person is suffering from cancer or a terminal illness or pain, he cannot be offered a means to kill himself. "This would be active killing, and is haram and forbidden in Islam," said Sayyed. However, sometimes there is no straightforward verse in the Quran on a particular subject, in which case scholars get together and form an opinion. There have been several instances of these opinions, or fatwas, being formed. For instance, when it comes to family planning, Islam does not speak of birth control. Permanent methods like vasectomy and tubectomy are haram. This has been unanimously agreed by all scholars, because it "changes the physiology of the human body." Temporary methods like Copper T are not allowed, as it is actually the 'early abortion of the zygote.' "Abortion is against the teaching of Islam, as the Quran says 'do not kill your children for want of sustenance as Allah provides for all'," said Sayyed. Barrier methods like condoms are open to interpretation. Some scholars say it may be allowed, he added. "As a medical practitioner, I would not advocate contraceptive pills either, as over a period of time, they are detrimental to health," said Sayyed.
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Instead, Islam advocates breast-feeding for two years. "This proves as a natural contraceptive as it results in amenorrhea. This ensures a time gap of two years between children," explained Sayyed. Islam speaks about proper hygiene too like cutting of nails, unwanted hair and even circumcision."How much of this is practiced, however, depends solely on how close to the Quran a person of Muslim faith is," said Sayyed .
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Euthanasia
1
Euthanasia Index:
Sr. No.
1. 2. 3. 4. 5. 6.
Topics
Introduction, Meaning, Types Arguments for Euthanasia Arguments against Euthanasia Current legal position - India List of countries where Euthanasia is legal Articles
Page No.s
05 06 08 11 12 13
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Introduction:
o The word euthanasia is derived from the Greek word ?euthanatos? meaning ?well death? and originally referred to intentional mercy killing. In the modern context euthanasia is limited to the killing of patients by doctors at the request of the patient in order to free him of excruciating pain or from terminal illness. o When medical advances made prolonging of the lives of dying or comatose patients possible, the term euthanasia was also applied to omission to prevent death
Definitions:
o Euthanasia - the intentional killing by act or omission of a dependent human being for his or her alleged benefit. (The key word here is "intentional". If death is not intended, it is not an act of euthanasia)
Types:
Euthanasia may be classified as active and passive or alternatively as voluntary, non-voluntary and involuntary. o Voluntary euthanasia: When the person who is killed has requested to be killed. o Non-voluntary: When the person who is killed made no request and gave no consent. o Involuntary euthanasia: When the person who is killed made an expressed wish to the contrary. o Assisted suicide: Someone provides an individual with the information, guidance, and means to take his or her own life with the intention that they will be used for this purpose. When it is a doctor who helps another person to kill themselves it is called "physician assisted suicide." o Euthanasia by Action or Active Euthanasia: Intentionally causing a person's death by performing an action such as by giving a lethal injection. Active euthanasia involves painlessly putting individuals to death for merciful reasons, as when a doctor administers a lethal dose of medication to a patient.
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o Euthanasia by Omission or Passive Euthanasia: Intentionally causing death by not providing necessary and ordinary (usual and customary) care or food and water. Passive euthanasia involves not doing something to prevent death, as when doctors refrain from using devices necessary to keep alive a terminally ill patient or a patient in a persistent vegetative state.
What Euthanasia is NOT:
o There is no euthanasia unless the death is intentionally caused by what was done or not done. o Thus, some medical actions that are often labeled "passive euthanasia" are no form of euthanasia, since the intention to take life is lacking. These acts include not commencing treatment that would not provide a benefit to the patient, withdrawing treatment that has been shown to be ineffective, too burdensome or is unwanted, and the giving of high doses of pain-killers that may endanger life, when they have been shown to be necessary. o All those are part of good medical practice, endorsed by law, when they are properly carried out.
Arguments for and against Euthanasia:
? Arguments for Euthanasia:
1. o o o o Below are the prime reasons because of which people opt for Euthanasia: It provides a way to relieve extreme pain It provides a way of relief when a person's quality of life is low Frees up medical funds to help other people It is another case of freedom of choice
2. The positive side of Euthanasia is that it ends a person’s suffering in this world. o Many physicians and psychiatrists believe that it may a humane act. From a virtue ethics point of view, it may be appropriate. What we seek in human existence is to be happy, and find happiness. o Suffering from a terminal illness, or affliction, could inhibit one’s happiness in life. If the goal is to be happy, then Euthanasia would be an answer for this person.
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o Euthanasia may even bring about happiness in that it is what the person desires and wants, in order to no longer to be a burden to his/her family. o Also, Euthanasia would stop the pain and not prolong the dying process. 3. Supporters of active euthanasia contend that not allowing euthanasia would come down to forcing people to suffer against their will. o Calling for legalization of active euthanasia, proponents of euthanasia cite circumstances in which a condition has become overwhelmingly burdensome for the patient, pain management is inadequate, and only death seems capable of bringing relief. 4. Reasons why people opt for voluntary euthanasia o Fear of the process of dying rather than the terminal event of death. o Fear the indignity of being hooked on to life support machines and other forms of treatment when all such treatment is futile and death is inevitable. o The desire not to subject the family to emotional and financial distress when all treatment may be futile. 5. Moreover, in the light of the increasing pressure on hospital and medical resources, available facilities ought to be used for the benefit of those patients who stand a better chance of recovery. o Supporters agree that euthanasia may be misused. They point out that almost every individual freedom involves some risk of abuse, but proper legal safeguards could minimize such risks. o Further, the risk of abuse of a right is no reason to deny a person the right. 6. In the utilitarian point of view we all have a duty to our happiness, and a duty to the society. o Euthanizing a person based on the society aspect makes sense. With greater and greater emphasis put on managed care today, many doctors are at a financial risk when they provide treatments to patients who are in the dying process. o These patients may also feel like not becoming a burden to the society at large, and choose to fulfill a duty – Euthanasia. If the person is in a coma or is brain dead, that person is no use to himself or herself, or society anymore.
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o Euthanasia is a viable method to end an otherwise futile attempt at recovery. 7. The family of the person being euthanized may not want their family members in pain – to suffer. It can be a family duty to do the right thing for the person and society. o Depression, family conflict, feelings of abandonment, and hopelessness, are emotional burdens on family members seeing a person suffer. o Committing euthanasia may be the humane act to do for the afflicted family member in this case. 8. The euthanized person may even be of use to society in a utilitarian manner, if his/her bodily organs are to promote the welfare of others, one life saves the lives of others. o This may even be considered a virtuous acts, and possibly even altruistic in it not being of self-interest. o It is the betterment of his/her fellow human kind in helping others in one final gracious act. The benefits are numerous in that the person euthanized would cease suffering, and the families would begin the healing process from grief and/or depression from the situation.
? Arguments against Euthanasia:
1. o o o Following are the prime reasons for arguments against Euthanasia: Euthanasia devalues human life Euthanasia can become a means of health care cost containment Physicians and other medical care people should not be involved in directly causing death o There is a "slippery slope" effect that has occurred where euthanasia has been first been legalized for only the terminally ill and later laws are changed to allow it for other people or to be done non-voluntarily. 2. Euthanasia would not only be for people who are "terminally ill" o There are two problems here -- the definition of "terminal" and the changes that have already taken place to extend euthanasia to those who aren't "terminally ill." o There are many definitions for the word "terminal." For example, when he spoke to the National Press Club in 1992, Jack Kevorkian said that a
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terminal illness was "any disease that curtails life even for a day." The co-founder of the Hemlock Society often refers to "terminal old age." Some laws define "terminal" condition as one from which death will occur in a "relatively short time." Others state that "terminal" means that death is expected within six months or less. o Even where a specific life expectancy (like six months) is referred to, medical experts acknowledge that it is virtually impossible to predict the life expectancy of a particular patient. o Some people diagnosed as terminally ill don't die for years, if at all, from the diagnosed condition. Increasingly, however, euthanasia activists have dropped references to terminal illness, replacing them with such phrases as "hopelessly ill," "desperately ill," "incurably ill," "hopeless condition," and "meaningless life." 3. Euthanasia can become a means of health care cost containment o Perhaps one of the most important developments in recent years is the increasing emphasis placed on health care providers to contain costs. In such a climate, euthanasia certainly could become a means of cost containment. o In the United States, thousands of people have no medical insurance; studies have shown that the poor and minorities generally are not given access to available pain control, and managed-care facilities are offering physicians cash bonuses if they don't provide care for patients. o With greater and greater emphasis being placed on managed care, many doctors are at financial risk when they provide treatment for their patients. o Legalized euthanasia raises the potential for a profoundly dangerous situation in which doctors could find themselves far better off financially if a seriously ill or disabled person "chooses" to die rather than receive long-term care. o Savings to the government may also become a consideration. This could take place if governments cut back on paying for treatment and care and replace them with the "treatment" of death. o In Canada, hospital stays are being shortened while, at the same time, funds have not been made available for home care for the sick and elderly. Registered nurses are being replaced with less expensive practical nurses. Patients are forced to endure long waits for many types of needed surgery.
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4. Euthanasia will become non-voluntary o The movement from voluntary to involuntary euthanasia would be like the movement of abortion from "only for the life or health of the mother" as was proclaimed by advocates 30 years ago to today's "abortion on demand even if the baby is half born". o Euthanasia people state that abortion is something people choose - it is not forced on them and that voluntary euthanasia will not be forced on them either. o They are missing the main point - it is not an issue of force - it is an issue of the way laws against an action can be broadened and expanded once something is declared legal. o You don't need to be against abortion to appreciate the way the laws on abortion have changed and to see how it could well happen the same way with euthanasia/assisted suicide as soon as the door is opened to make it legal. 5. Euthanasia is a rejection of the importance and value of human life o People who support euthanasia often say that it is already considered permissible to take human life under some circumstances such as self defense - but they miss the point that when one kills for self defense they are saving innocent life - either their own or someone else's. With euthanasia no one's life is being saved - life is only taken. o History has taught us the dangers of euthanasia and that is why there are only two countries in the world today where it is legal. o That is why almost all societies - even non-religious ones - for thousands of years have made euthanasia a crime. It is remarkable that euthanasia advocates today think they know better than the billions of people throughout history who have outlawed euthanasia - what makes the 50 year old euthanasia supporters in 2005 so wise that they think they can discard the accumulated wisdom of almost all societies of all time and open the door to the killing of innocent people? Have things changed? o If they have, they are changes that should logically reduce the call for euthanasia - pain control medicines and procedure are far better than they have ever been any time in history.
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The current legal position on Euthanasia in India
o In India, euthanasia is undoubtedly and absolutely illegal. Since in cases of euthanasia or mercy killing there is an intention on the part of the doctor to kill the patient, such cases would clearly fall under clause first of Section 300 of the Indian Penal Code, 1860. o However, as in such cases there is the valid consent of the deceased Exception 5 to the said Section would be attracted and the doctor or mercy killer would be punishable under Section 304 for culpable (deserving blame) homicide (murder) not amounting to murder. But it is only cases of voluntary euthanasia (where the patient consents to death) that would attract Exception 5 to Section 300. o Cases of non-voluntary and involuntary euthanasia would be struck by proviso one to Section 92 of the IPC and thus be rendered illegal. o Euthanasia and suicide are different, distinguishing euthanasia from suicide, Lodha J. in Naresh Marotrao Sakhre v. Union of India1, observed: ? "Suicide by its very nature is an act of self-killing or self-destruction, an act of terminating one’s own act and without the aid or assistance of any other human agency. ? Euthanasia or mercy killing on the other hand means and implies the intervention of other human agency to end the life. Mercy killing thus is not suicide and an attempt at mercy killing is not covered by the provisions of Section 309. ? The two concepts are both factually and legally distinct. Euthanasia or mercy killing is nothing but homicide whatever the circumstances in which it is effected."2 (emphasis added) o The law in India is also very clear on the aspect of assisted suicide. Abetment of suicide is an offence expressly punishable under Sections 305 and 306 of the IPC. o Moreover, after the decision of a five judge bench of the Supreme Court in Gian Kaur v. State of Punjab, it is well settled that the "right to life" guaranteed by Article 21 of the Constitution does not include the "right to die". o The Court held that Article 21 is a provision guaranteeing "protection of life and personal liberty" and by no stretch of the imagination can extinction of life be read into it.
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o The criteria laid down by the Courts to determine whether the defence of necessity applies in a given case of euthanasia, have been summarized as follows: 1. The request for euthanasia must come only from the patient and must be entirely free and voluntary. 2. The patient’s request must be well considered, durable and persistent. 3. The patient must be experiencing intolerable (not necessarily physical) suffering, with no prospect of improvement. 4. Euthanasia must be the last resort. Other alternatives to alleviate the patient’s situation must be considered and found wanting 5. Euthanasia must be performed by a physician. 6. The physician must consult with an independent physician colleague who has experience in this field.
List of countries where Euthanasia is legal:
1. Netherlands 2. Belgium 3. Oregon in the U.S. 4. The Northern Territory of Australia 5. Norway 6. Sweden 7. Finland 8. Luxembourg 9 Albania
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Articles on Euthanasia:
Article 1:
Husband pleads for mercy killing of comatose wife! Patna: The echoes of the mercy killing of Terri Shiavo could be heard nearer home in Bihar when Tarkeshwar Chandravanshi, unable to bear the burden of his comatose wife, approached Governor Buta Singh to bring about suitable amendment to the existing law to allow the mercy killing of his wife. Tarkeshwar, living in a slum, behind Shastrinagar police station in the State capital, in a petition to the governor on April six, said his wife Kanchan Devi was in coma ever since she delivered a baby in 2000 at a private nursing home in Patna. Later on, she was admitted to Patna Medical College And Hospital where doctors diagnosed her disease as "incurable" and she was taken back home. Patna High Court had in January 2001 rejected Tarkeshwar's petition seeking permission for mercy killing observing that no order could be passed on such petition as she was "alive and had not herself filed a petition." "Since President's rule has been imposed in Bihar, the Governor being the head of the State has the right to promulgate an ordinance for mercy killing and therefore, we have approached him," Tarkeshwar's lawyer Shruti Singh, who had also filed a petition in the High Court last week for reviewing its earlier order as she was still in coma, said. Shruti Singh in the petition filed on behalf of Tarkeshwar and his son Suraj also cited the latest case of mercy killing of brain-dead Florida resident Terri Shiavo and sought amendments to the existing law. He also pleaded that like the case of a husband or a wife who are free to tie a nuptial bond with any other person after one of them remains traceless for a period of seven years, a law be brought into force to allow mercy killing of a person in coma for over six years. The case was likely to come up for hearing by Patna High Court within a
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week, Shruti Singh said, adding they also expected a favourable response from the governor.
Article 2:
Jobless father wants death for son suffering from sickle cell anaemia Jobless father in Jharkhand and his wife have sought death for their suffering son. Kalidas Munda is a resident of Village Potka, Chakradharpur district of West Singhbhum division in the state. His son, 11-year-old Gulshan, suffers from sickle cell anaemia, an inherited disease that requires complete blood transfusion once every two months. ?We can’t continue… we are left without a penny,? said Munda’s letter addressed to the President of India and submitted to district sub-divisional officer (SDO) JJ Suman. Worse, the daily-wage earner has had no job for the past six months. This, when the boy’s monthly medical bills touched over Rs 5,000. With over a lakh spent on Gulshan's treatment and with no money left, the helpless parent said mercy killing or euthanasia was the only way out of their sufferings and misery. ?I want death for my child. We can't afford his treatment anymore. The child is also suffering,? said Parvati, Gulshan’s mother. The hapless parents approached state Welfare Minister Joba Manjhi but only got assurances from him. On the district administrations’s part SDO Suman said the family was issued Red Cards — to avail free ration under the public distribution scheme. As for Gulshan’s treatment, the official said efforts were being made to get funds from the state government’s kitty. This is not the first time in the state that extreme helplessness pushed people to a death wish. Earlier, Bokaro resident Dilip Machua had written to President Pratibha Patil for mercy killing, after he was paralysed in an accident.
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The 30-year-old former slag picker had an old mother, wife and two infant daughters to feed and no other means of livelihood. In his April 4 letter to the President, he had pleaded that either the government arrange for his treatment or allow him death. He had also sent copies of the letter to the then chief minister of Jharkhand, Madhu Koda and Governor, Syed Sibtey Razi. Mercifully, nature intervened. Dilip died of natural causes some days later.
Article 3:
Euthanasia poses a dilemma for city doctors The city doctors give their opinion about euthanasia while the Indian law continues to call it illegal Euthanasia, and the laws surrounding it, is a legal and moral minefield. And when 13-year-old Hannah Jones was allowed by the UK courts to reject a heart transplant - a decision, which almost certainly will result in her death the debate was renewed. Calls were made from some quarters of society that a patient's right to die is exactly that…a patient's right. But the medical fraternity, in Mumbai, is divided: "Facilitating killing is not an option," says PN Jain, professor of Anaesthesia and Pain, at the Tata Hospital. But Abhijeet S Joshi, general surgeon, Hiranandani Hospital, says, "In my personal opinion, it is the patient's will that should be followed." He, however, admits that it is a controversial subject, as euthanasia is illegal, not only in India, but in many other countries too. But most laws are open to interpretation. "Euthanasia, as we all know is illegal here, but a case of brain death, where the patient is in a vegetative state is a great liability to the family, both financially and emotionally," says
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Ashwin Mehta, director of Cardiology, Jaslok Hospital. "When we see no signs of recovery, and the patient is in excruciating pain, we slow down the treatment, which eventually leads to natural termination, but this is only after consulting the family," he says. Mehta adds that he has witnessed many cases of terminal illness, where patients want to end their life, but cannot, as they fear the law. But in the case of patients who are brain dead, the euthanasia laws cease to apply. And organ donation can then be sought by the hospital. "If a patient is brain dead, and the other organs are functioning properly, and there is no hope of recovery, then we ask the family if they would consider donating the patient's organs as it can save the life of someone else," says Ganesh Kumar, chief of Interventional Cardiology and a member of Hiranandani hospital's Brain Death Committee. But for many city doctors, the act of taking a life is still taboo. As Dr Jain, says, "Throughout our career, we are taught to help people live. Euthanasia, however, is diametrically opposite to that." List of countries where euthanasia is legal 1. Netherlands 2. Belgium 3. Oregon in the U.S. 4. The Northern Teritory of Australia 5. Norway 6. Sweden 7. Finland 8. Luxembourg 9 Albania In India, euthanasia is absolutely illegal. If a doctor tries to kill a patient, the case will surely fall under Section 300 of Indian Penal Code, 1860. but this
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is only so in the case of voluntary euthanasia in which such cases will fall under the exception 5 to section 300 of Indian Penal Code,1860 and thus the doctor will be held liable under Section 304 of Indian Penal Code,1860 for culpable homicide not amounting to murder. Cases of non-voluntary and involuntary euthanasia would be struck by proviso one to Section 92 of the IPC and thus be rendered illegal. There has also been a confusion regarding the difference between suicide and euthanasia. It has been clearly differentiated in the case Naresh Marotrao Sakhre v. Union of India . J. Lodha clearly said in this case. "Suicide by its very nature is an act of self-killing or self-destruction, an act of terminating one's own act and without the aid or assistance of any other human agency. Euthanasia or mercy killing on the other hand means and implies the intervention of other human agency to end the life. Mercy killing thus is not suicide and an attempt at mercy killing is not covered by the provisions of Section 309. The two concepts are both factually and legally distinct. Euthanasia or mercy killing is nothing but homicide whatever the circumstances in which it is effected." The question whether Article 21 includes right to die or not first came into consideration in the case State of Maharashtra v. Maruti Shripathi Dubal . It was held in this case by the Bombay High Court that 'right to life' also includes 'right to die' and Section 309 was struck down.
Article 4:
Former chess champion K Venkatesh, who was terminally ill, died on December 17 after a futile wait for the courts to accept his plea for euthanasia so that he could donate his organs. His eyes were donated after his death but no other organ could be transplanted as the 25 year old had been on a ventilator for a long period.
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Venkatesh's mother to move SC. Indian laws allow organ donation only if a person is declared brain dead. Euthanasia is the act of ending the life of an individual suffering from a terminal illness or an incurable condition. Quoting Venkatesh's case, experts have said the severe paucity of organ donors is one reason why euthanasia should be legalised. Venkatesh passes away. Venkatesh's mother intends to continue the legal battle to amend the Human Organ Transplant Act and legalise euthanasia.
Article 5: French Woman dies after losing Euthanasia case
PARIS (Reuters) - A French woman suffering from an incurable and disfiguring cancer was found dead on Wednesday, two days after a court rejected her request for medical assistance to help end her life, a source close to the government said. Chantal Sebire, 52, whose face was swollen and distorted by a rare tumour in her sinuses, won heavy media coverage and the compassion of many French people in her bid to set a legal precedent for patients like her seeking to end their suffering. A court in the eastern city of Dijon ruled on Monday that Sebire could not have a doctor help her die because it would breach both the code of medical ethics and the law, under which assisted suicide is a crime. No details were immediately available on the cause of Sebire's death, which was first reported on the Web site of regional daily Le Bien Public. The source said she was found dead at her home near Dijon. Sebire's plight sparked a public debate in mainly Catholic France on euthanasia, and she won the support of several public figures including
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Foreign Minister Bernard Kouchner. President Nicolas Sarkozy met her doctor on Wednesday. The government initially ruled out passing a reform on euthanasia, but Prime Minister Francois Fillon's office said on Wednesday it would consider the issue. One proposal is for an expert panel to allow assisted suicide in exceptional cases. Sebire's doctors had said she would fall into a coma and die if she stopped taking medication to deal with the rare tumour, but she insisted on going to court to try to secure the right to an assisted suicide, which would be less painful. Active euthanasia is legal in the Netherlands, Belgium, Switzerland and Luxembourg, but French courts regularly rule against doctors who administer lethal drugs to end life, although they are usually spared prison. Opponents of euthanasia, including the Roman Catholic Church, say the sanctity of life overrides all other factors. Many also say a right to kill patients could easily be abused. "I want to die partying surrounded by my children, friends and doctors before falling asleep for good at dawn," Sebire had told reporters.
Article 6: Woman's fight to die in peace
LONDON: Debbie Purdy, a multiple sclerosis patient has accused the British Crown Prosecution Service of failing the terminally ill by refusing to be clear about whether their relatives will face criminal charges for helping them to die. Speaking on the first day of the hearing, Purdy's barrister David Pannick QC said that although it was illegal to assist suicide, cases where terminally ill patients were helped to die by their kin were rarely prosecuted making the law "confused and uncertain". The 45-year-old former music journalist said she is not seeking immunity from prosecution for her husband, Omar Puente but more information about when prosecutions are likely.
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The landmark two-day hearing at the High Court which began on Thursday, is again questioning the controversial right to assisted suicide which under British law is treated as a criminal offence punishable by up to 14 years in jail for the relatives. It is claimed that more than 100 Britons have been forced to travel to Dignitas euthanasia clinic in Zurich, Switzerland where assisted suicide is lawful. So far none of their relatives have been prosecuted for helping organise the deaths. The Crown Prosecution Service has said that it will not create a specific policy for assisted suicide but will consider each case individually in deciding whether to prosecute. Purdy's case is just one in a long-running battle being fought for making assisted suicide lawful in the UK. The first to challenge the 1961 Suicide Act was Diane Pretty, a motor neurone disease sufferer, who asked her husband be allowed to kill her. Judges rejected the plea before she died in 2002. Purdy fears more for her husband because he is black and a foreigner. Puente, a Cuban musician has been with Purdy for the last 13 years. She was diagnosed with the terminal disease in 1995, at the age of 31.
Article 7:
'Islam allows passive mercy killing' Scholars say that the Quran has answers about organ transplant, euthanasia and even, contraceptives Can a Muslim donate his/her organs? What does Islam say about euthanasia? When it comes to health and hygiene, the holyQuran has all the answers -it's only a question of right interpretation, said Dr Shoaib Sayyed, a doctor who in his capacity as the manager for Islam and Comparative religions at the Islamic Research Foundation (IRF) has had ample opportunities to research for the answers.
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IRF concluded its peace conference recently at Somaiya grounds where religious scholars and experts from across the world discussed various issues affecting the Muslim community, including the portrayal of the community in mainstream media. "There are three basic things which should be taken into consideration when it comes to organ donation or transplant. One, the person donating his organ should not suffer any health problem as a consequence of his donation. Two, it should be done only if it is life-saving for the recipient. And finally, it should not be done for commercial reasons," said Sayyed. Interestingly, even mercy killing is permitted by Islam. According to religious experts, Islam allows 'passive' mercy killing. If a person is dying and is being kept alive on machines like a ventilator, then it is allowed to offer the person the option of mercy killing. If a person is suffering from cancer or a terminal illness or pain, he cannot be offered a means to kill himself. "This would be active killing, and is haram and forbidden in Islam," said Sayyed. However, sometimes there is no straightforward verse in the Quran on a particular subject, in which case scholars get together and form an opinion. There have been several instances of these opinions, or fatwas, being formed. For instance, when it comes to family planning, Islam does not speak of birth control. Permanent methods like vasectomy and tubectomy are haram. This has been unanimously agreed by all scholars, because it "changes the physiology of the human body." Temporary methods like Copper T are not allowed, as it is actually the 'early abortion of the zygote.' "Abortion is against the teaching of Islam, as the Quran says 'do not kill your children for want of sustenance as Allah provides for all'," said Sayyed. Barrier methods like condoms are open to interpretation. Some scholars say it may be allowed, he added. "As a medical practitioner, I would not advocate contraceptive pills either, as over a period of time, they are detrimental to health," said Sayyed.
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Instead, Islam advocates breast-feeding for two years. "This proves as a natural contraceptive as it results in amenorrhea. This ensures a time gap of two years between children," explained Sayyed. Islam speaks about proper hygiene too like cutting of nails, unwanted hair and even circumcision."How much of this is practiced, however, depends solely on how close to the Quran a person of Muslim faith is," said Sayyed .
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