P e r s p e c t i v e o f M e d i c a l , I s l a m i c a n d L a w

1. Euthanasia P e r s p e c t i v e o f M e d i c a l , I s l a m i c a n d L a w Ezuwan EzaniMohd Syamirulah RahimAhmad Mahfudz MukriIrfan Mohd Ghazali

2. What is 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.

3. "... we must be wary of those who are too willing to end the lives of the elderly and the ill. If we ever decide that a poor quality of life justifies ending that life, we have taken a step down a slippery slope that places all of us in danger. There is a difference between allowing nature to take its course and actively assisting death. The call for euthanasia surfaces in our society periodically, as it is doing now under the guise of "death with dignity" or assisted suicide. Euthanasia is a concept, it seems to me, that is in direct conflict with a religious and ethical tradition in which the human race is presented with " a blessing and a curse, life and death," and we are instructed '...therefore, to choose life." I believe 'euthanasia' lies outside the commonly held life-centered values of the West and cannot be allowed without incurring great social and personal tragedy. This is not merely an intellectual conundrum. This issue involves actual human beings at risk..." - C. Everett Koop, M.D. * *taken from the book KOOP, The Memoirs of America's Family Doctor by C. Everett Koop, M.D., Random House, 1991.

4. The Definition of Euthanasia • Euthanasia(from Greek: ευθανασία -'ευ "good", θανατος "death") is the practice of ending the life of a person or an animal because they are perceived as living an intolerable life, in a painless or minimally painful way either by lethal injection, drug overdose, or by the withdrawal of life support.

5. The Terminology The Terminology in Euthanasia Active Passive Voluntary Following the broad definition of euthanasia as outlined by James Rachels, euthanasia may employ methods that are active or passive. Non-voluntary Involuntary Terminal Sedation Animal Euthanasia Mercy Killing Continue

6. The Terminology Active Euthanasia Active Passive Voluntary Active euthanasia refers to a physician painlessly putting to death some persons suffering from incurable conditions or diseases. Non-voluntary Involuntary Terminal Sedation Animal Euthanasia Mercy Killing Continue

7. The Terminology Passive Euthanasia Active Passive Voluntary Passive euthanasia refers to any act of allowing the patient to die, which may include failing to provide necessary medication as well as taking a patient off life support. Non-voluntary Involuntary Terminal Sedation Animal Euthanasia Mercy Killing Continue

8. The Terminology Voluntary Euthanasia Active Passive Voluntary Voluntary euthanasia occurs with the fully-informed request of a decisionally-competent adult patient or that of their surrogate (proxy). This should not be confused with death after treatment is stopped on the instructions of the patient himself, either directly or through a do not resuscitate (DNR) order. Enforcing a DNR order has never been considered assisted suicide or suicide of any kind, at least in the eyes of the law. Patients of sound mind have always had a right to refuse treatment. Non-voluntary Involuntary Terminal Sedation Animal Euthanasia Mercy Killing Continue

9. The Terminology Non-voluntary Euthanasia Active Passive Voluntary Nonvoluntary euthanasia occurs without the fully-informed consent and fully-informed request of a decisionally-competent adult patient or that of their surrogate (proxy). An example of this might be if a "patient" has decisional capacity but is not told they will be euthanized; or, if a patient is not conscious or lacks decisional-capacity and their surrogate is not told the patient will be euthanized. Non-voluntary Involuntary Terminal Sedation Animal Euthanasia Mercy Killing Continue

10. The Terminology Involuntary Euthanasia Active Passive Voluntary Involuntary euthanasia occurs over the objection of a patient or their surrogate (proxy). An example of this might be if a patient with decisional capacity (or their surrogate) is told what will happen. The patient (or surrogate) refuses yet the patient is euthanized anyway. This is generally considered murder. If a patient slated for euthanasia changes his or her mind at the last minute, the doctor is categorically required by law to honor that wish. In most other countries removing or denying treatment without the clear instructions of the patient is usually seen as murder. Non-voluntary Involuntary Terminal Sedation Animal Euthanasia Mercy Killing Continue

11. The Terminology Terminal Sedation Active Passive Voluntary Terminal sedation is a combination of medically inducing a deep sleep and stopping other treatment, with the exception of medication for symptom control (such as analgesia). It is considered to be euthanasia by some, but under current law and medical practice it is considered a form of palliative care. Non-voluntary Involuntary TerminalSedation Animal Euthanasia Mercy Killing Continue

12. The Terminology Animal Euthanasia Active Passive Voluntary Animal euthanasia is commonly referred to by the euphemism "put to sleep". Non-voluntary Involuntary Terminal Sedation AnimalEuthanasia Mercy Killing Continue

13. The Terminology Mercy Killing Active Passive Voluntary Mercy Killing is a term used for some cases of euthanasia. Typically it refers to euthanasia by a non-doctor, such as a parent, who perceives the individual to be suffering. In some cases the individual cannot consent. In some cases the individual can consent but is not asked or refuses. Lastly, in some cases the individual consents, and it may even be them who initiates the discussion. Non-voluntary Involuntary Terminal Sedation Animal Euthanasia MercyKilling Continue

14. Legislation and national political movements Australia Nazi Germany Belgium Oregon, USA Canada Netherlands

15. Australia Euthanasia was legalized in Australia's Northern Territory, by the Rights of the Terminally Ill Act 1995. However, this law was soon voided by an amendment by the Commonwealth to the Northern Territory (Self-Government) Act 1978. Three people had already been legally euthanized, however, before the Commonwealth government made this amendment. Although it has for some time been a crime in most Australian states to assist another to commit suicide, prosecutions have been rare. In Queensland recently (2002) a group of relatives and friends who provided moral support to an elderly woman who committed suicide were extensively investigated by police, but no charges were laid. In Tasmania in 2005 a nurse was convicted of assisting her elderly mother and father die as they were both suffering from illness. She was given a two and a half year jail sentence but the judge later suspended the sentence because he believed the community did not want the woman put behind bars. This sparked debate about decriminalizing euthanasia as judges did not seem interested in enforcing the existing law.

16. Belgium After an extensive discussion the Belgian parliament legalized euthanasia in late September 2002. The new legislation, however, institutes a complicated process, which has been criticized as an attempt to establish a bureaucracy of death. Nevertheless, euthanasia is now legal and its proponents in the country hope that it will stop many illegal practices (it is said that several thousand illegal acts of euthanasia have been carried out in Belgium each year).

17. Canada In the early 1990s, 42-year-old Sue Rodriguez, who had amyotrophic lateral sclerosis, fought to overturn the law against assisted suicide. She lost her court battle, but was assisted in her dying with the help of an anonymous doctor. Under Canada's Criminal Code, assisting someone to die is illegal and punishable by up to 14 years in prison. On January 28, 2005, Marcel Tremblay held a press conference to announce plans to kill himself, saying his life with pulmonary fibrosis was unbearable. After attending his own living wake, the 78-year-old man committed suicide at 11:51 pm Eastern time. He had previously said he would be surrounded by his wife and adult children while he placed a bag over his head and filled it with helium. Tremblay said that he publicized his suicide plans to help change laws over assisted suicide. His lawyer said police were satisfied that Tremblay had a sound mind and that authorities would not intervene. Canada decriminalized committing suicide and attempting to commit suicide in 1972.

18. Netherlands In the Netherlands the Termination of Life on Request and Assisted Suicide (Review Procedures) Act took effect on April 1, 2002. It legalizes euthanasia and physician assistance in dying in certain circumstances. The law recognized a practice that had been tolerated for some 20 years. From the time that euthanasia first came to be widely practiced in the Netherlands, it was formally subject to review by boards of doctors in each hospital. The law essentially codified what had already become tolerated practice and unofficial law by judgments in the courts.

19. Netherlands In the Netherlands the Termination of Life on Request and Assisted Suicide (Review Procedures) Act took effect on April 1, 2002. It legalizes euthanasia and physician assistance in dying in certain circumstances. The law recognized a practice that had been tolerated for some 20 years. From the time that euthanasia first came to be widely practiced in the Netherlands, it was formally subject to review by boards of doctors in each hospital. The law essentially codified what had already become tolerated practice and unofficial law by judgments in the courts.

20. Netherlands • The law permits euthanasia and physician assisted dying when each of the following conditions is fulfilled: • The patient's suffering is unbearable with no prospect of improvement • The patient's request for euthanasia must be voluntary and persist over time (the request can not be granted when under the influence of others, psychological illness or drugs) • The patient must be fully aware of his/her condition, prospects and options • There must be consultation with at least one other independent doctor who needs to confirm the conditions mentioned above • The death must be carried out in a medically appropriate fashion by the doctor or patient, in which case the doctor must be present. • The patient is at least 12 years old (patients between 12 and 16 years of age require the consent of their parents)

21. Netherlands The doctor must also report the cause of death to the municipal coroner in accordance with the relevant provisions of the Burial and Cremation Act. A regional review committee assesses whether a case of termination of life on request or assisted suicide complies with the due care criteria. Depending on its findings, the case will either be closed or brought to the attention of the Public Prosecutor. Finally, the legislation offers an explicit recognition of the validity of a written declaration of will of the patient regarding euthanasia (a "euthanasia directive"). Such declarations can be used when a patient is in a coma or otherwise unable to state whether they want euthanasia or not. The legislation has wide support among the socially libertarian Dutch, who have one of the world's highest life expectancies. There is however persistent opposition, mainly organized by the churches.

22. Netherlands In 1992 a proposal was made known as Drion's Pill. This fictional drug would be a set of 2 pills. The first pill could be taken without any harm, the second pill would have to be taken a couple of days later (and only then would work). This would give the patient the time to think things over. The drug was never developed, the proposal however indirectly started up the discussion of euthanasia in Netherlands.

23. Nazi Germany In Nazi Germany the term euthanasia has been distorted. The word "euthanasia" was used by the Germans to describe the T-4 Euthanasia Program. The German rational for the program was to both lower expenses by systematically killing the institutionalized as well as preserving the genetic quality of the German population by sterilizing people with physical deformities, handicaps, or mental illnesses. Technically, the T-4 Euthanasia Program was actually an eugenics program and not euthanasia, since the goal was not to end suffering but to remove these individuals from the gene pool. The program was "cancelled", at least officially, after public disapproval was expressed. This has tainted the word especially in German-speaking countries; especially as one of the main advocates of euthanasia in Germany after World War II was Werner Catel, a leading Nazi doctor directly involved in T4. The currently accepted German term is the older "Sterbehilfe" (literally "helping to die"), which is used in contemporary German discussions.

24. Oregon, USA Oregon Law, passed by voters in 1994 and reaffirmed by voters in 1997, states an individual must meet the following criteria: 1) 18 years of age or older, unless consent is given by a parent for children under the age of 18 2) a resident of Oregon, 3) informed consent must be given; the patient must be mentally capable of making the consent 4) diagnosed with a terminal illness that will lead to death within six months and is not basing his or her decision to die on depression or another mental disorder. Two physicians assist in verification. Also, it is required by law that this must be verified by two physicians, as well as by two witnesses.

25. Euthanasia I n I s l a m i c P o i n t O f V i e w “Men who celebrate the praises of Allah, standing, sitting, and lying down on their sides, and contemplate the (wonders of) creation in the heavens and the earth, (With the thought): "Our Lord! not for naught Hast Thou created (all) this! Glory to Thee! Give us salvation from the penalty of the Fire. "  Qur'an 3:191   “

26. Euthanasia or Mercy Killing is the act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition, through lethal injection or the suspension of extraordinary medical treatment. This act is Islamically forbidden for it encompasses a positive role on the part of the physician to end the life of the patient and hasten his death via lethal injection, electric shock, a sharp weapon or any other way. This is an act of killing, and, killing is a major sin and thus forbidden in Islam, the religion of pure mercy. Fatwa issued by the prominent Muslim scholar Sheikh Al-Qaradawi ,

27. As for the suspension of medical treatment via preventing the patient from his due medication which is, from a medical perspective, thought to be useless, this is permissible and sometimes it is even recommended. Thus, the physician can do this for the sake of the patient’s comfort and the relief of his family. Nothing is wrong in this, InsyaAllah. It is highly stressed here that medical treatment is deemed non-obligatory by the majority of Muslim scholars and the founders of the famous schools of Islamic Jurisprudence. Rather, to them, it is permissible. Only a few number of Muslim scholars maintain that it is obligatory, as said by some followers of Imam Ahmad and AsyShafie. Also, others maintain that applying medical treatment is commendable and preferable. Fatwa issued by the prominent Muslim scholar Sheikh Al-Qaradawi ,

28. Moreover, some scholars disputed over which is better for the patient: treatment or showing endurance. Some who maintain that showing endurance is far better base their judgment on the narration of Ibn `Abbas in the two Sahihs that: `Ata’ Ibn Abu Rabih said: Ibn `Abbas said to me: “ ‘May I show you a woman of Paradise?’ I said: ‘Yes.’ He said: ‘Here is this dark-complexioned woman. She came to Allah’s Messenger p.b.u.H and said: ‘I am suffering from epilepsy and convulsive seizures make me naked; supplicate Allah for me.” Thereupon, the Prophet, p.b.u.h, said: ‘You can show endurance and win entry to Paradise, but if you like, I’ll pray to Allah for your recovery.’ She said: ‘I am prepared to show endurance but I get naked due to convulsions, so supplicate Allah to spare me getting naked.’ And the Prophet, p.b.u.h, did pray for her.’” (Al-Bukhari and Muslim) Fatwa issued by the prominent Muslim scholar Sheikh Al-Qaradawi ,

29. These are the views of the scholars of the Ummah on treatment and medication; most of them maintain that it is permissible; some maintain that it is recommended; and a few number of them deem it obligatory. I myself agree with those who deem it obligatory in case the pain gets unbearable, and the illness is curable, by Allah’s Grace. This is also compatible with the guidance of Prophet Muhammad, p.b.u.h, who sought treatment for himself and ordered his honorable Companions to seek treatment as well; this is confirmed by Ibn Al-Qayyim in Zad Al-Ma`ad (Provision of the Hereafter). Switching off the life support:If a patient is medically presumed dead through what is known as brain death, in the sense that he no longer has any feelings, switching off the life support may be permissible, with due consultation and care, especially when it’s clear that the life support machine becomes of no use for the already-dead patient. Fatwa issued by the prominent Muslim scholar Sheikh Al-Qaradawi ,

30. But in cases when sickness gets out of hand, and recovery happens to be tied to miracle, in addition to ever-increasing pain, no one can say treatment then is obligatory or even recommended. Thus, the physician’s act of stopping medication, which happens to be of no use, in this case may be justified, as it helps in mitigating some negative effects of medications, and it enhances death. But it’s different from the controversial “Mercy Killing” as it does not imply a positive action on the part of the physician; rather, it is some sort of leaving what is not obligatory or recommended, and thus entails no responsibility. To conclude, the physician can practice this for the sake of the patient’s comfort and the relief of his family. Nothing is wrong in this, InsyaAllah. Fatwa issued by the prominent Muslim scholar Sheikh Al-Qaradawi ,

31. Is there a right to suicide? Not in Islam. Since we did not create ourselves we do not own our bodies. We are entrusted with them for care, nurture and safe keeping. God is the owner and giver of life and His rights in giving and in taking are not to be violated. Attempting to kill oneself is a crime in Islam as well as a grave sin. The Qur'an says: "Do not kill (or destroy) yourselves, for verily Allah has been to you most Merciful" (Qur'an 4:29). To warn against suicide prophet Muhammad p.b.u.h said: "Whoever kills himself with an iron instrument will be carrying it forever in hell. Whoever takes poison and kills himself will forever keep sipping that poison in hell. Whoever jumps off a mountain and kills himself will forever keep falling down in the depths of hell."

32. Prophet Mohammad p.b.u.h taught: "There was a man in older times who had an infliction that taxed his patience, so he took a knife, cut his wrist and bled to death. Upon this God said: My subject hastened his end, I deny him paradise." During one of the military campaigns one of the Muslims was killed and the companions of the prophet kept praising his gallantry and efficiency in fighting, but, to their surprise, the Prophet commented, "His lot is hell." Upon inquiry, the companions found out that the man had been seriously injured so he supported the handle of his sword on the ground and plunged his chest onto its tip, committing suicide.

33. Euthanasia in a clinical situation, via Islamic point of view, In an Islamic setting the question of euthanasia usually does not arise, and if it does, it is dismissed as religiously unlawful. The patient should receive every possible psychological support and compassion from family and friends, including the patient's spiritual (religious) resources. The doctor also participates in this, as well, and provides the therapeutic measures for the relief of pain. A dilemma arises when the dose of the pain killer necessary to alleviate pain approximates or overlaps with the lethal dose that might bring about the patient's death. Ingenuity on the part of the doctor is called upon to avoid this situation, but from a religious point of view the critical issue is the doctor's intention: is it to kill or to alleviate? Intention is beyond verification by the law but according to Islam it cannot escape the ever watchful eye of God Who according to the Qur'an "knows the treachery of the eyes, and all that hearts conceal" (Quran 40:19). Sins that do not full fill the criteria of a legal crime are beyond the domain of the judge but remain answerable to God.

34. The Islamic Code of Medical Ethics (1981 p.67 ) In his/her defense of life, however, the Doctor is well advised to realize his limit and not transgress it. If it is scientifically certain that life cannot be restored, then it is futile to diligently keep the patient in a vegetative state by heroic means or to preserve the patient by deep freezing or other artificial methods. It is the process of life that the doctor aims to maintain and not the process of dying. In any case, the doctor shall not take a positive measure to terminate the patient's life".

35. The seeking of medical treatment from illness is mandatory in Islam, according to two sayings of the prophet: "Seek treatment, subjects of God, for to every illness God has made a cure", "Your body has a right on you." But when the treatment holds no promise it ceases to be mandatory. This applies both to surgical and/or pharmaceutical measures, and, according to a majority of scholars, to artificial animation equipment. Ordinary life needs which are the right of every living person and which are not categorized as "treatment" are regarded differently. These include food and drink and ordinary nursing care, and they are not to be withheld as long as the patient lives. WallahuA’lam

36. Euthanasia : Case Files #1 Karen Ann Quinlan Karen Ann Quinlan was the first modern icon of the right-to-die debate. The 21-year-old Quinlan collapsed at a party after swallowing alcohol and the tranquilizer Valium on 14 April 1975. Within hours, she entered a coma from which she could never recover. Her parents, staunch Roman Catholics, knew their daughter would not want to be kept alive by extraordinary means. A year later, as Karen lay in a "persistent vegetative state," the courts finally allowed her treatment to be stopped; but artificial feeding was continued and she was maintained as a living corpse until June 1985, when she eventually died of pneumonia. Her case spurred thousands of letters of sympathy and fuelled the "right to die" movement. How many people need to die degrading deaths before society learns a little humanity? Birth 29 March1954 Birthplace Scranton, Pennsylvania Death 11 June1985(pneumonia) Best Known As Controversial coma patient of the 1970s

37. Euthanasia : Case Files #2 Nancy Cruzan Nancy Cruzan became a public figure after entering a "persistent vegetative state." A 1983 auto accident left Cruzan permanently unconscious and without any higher brain function, kept alive only by a feeding tube and steady medical care. Cruzan's family waged a legal battle to have her feeding tube removed; the case went all the way to the U.S. Supreme Court, which ruled that the Cruzans had not provided "clear and convincing evidence" that Nancy Cruzan did not wish to have her life artificially preserved. The Cruzans later presented such evidence to the Missouri courts, which ruled in their favor in late 1990. The Cruzans stopped feeding Nancy in December of 1990, and she died later the same month. Birth 20 July1957 Birthplace Carterville, Missouri Death 26 December1990(automobile crash) Best Known As The subject of Cruzan v. Missouri

38. Euthanasia : Case Files #3 Theresa Marie Schindler On 25 February 1990, 26-year-old Terri Schiavo suffered severe brain damage when her heart stopped for five minutes. Schiavo spent the following years in rehabilitation centers and nursing homes but never regained higher brain function. In 1998 her husband, Michael Schiavo, filed a legal petition to have Schiavo's feeding tube removed, saying that his wife had told him before her medical crisis that she would not want to be artificially kept alive in such a situation. Terri Schiavo's parents, Bob and Mary Schindler, fought this request. Florida judge George W. Greer ruled in 2000 that Schiavo was "beyond all doubt" in a persistent vegetative state and that her husband could discontinue life support. But as legal appeals in the case continued, the case became widely known as some religious groups and pro-life activists began to insist that Schiavo should be kept alive. Schiavo's feeding tube was removed in 2003, but reinserted six days later when the Florida legislature passed "Terri's Law," which allowed the state's governor to issue a stay in such cases. The law was later ruled invalid by the courts. In March of 2005 Schiavo's feeding tube was again removed, and the case became a greater public sensation when the U.S. Congress was called into special emergency session to pass a bill allowing federal courts to review the case, with President George W. Bush flying from Texas to Washington especially to sign the bill into law. However, federal judges and the U.S. Supreme Court refused to intervene. After two weeks without food and water, Schiavo died of dehydration on 31 March 2005. Birth 3 December1963 Birthplace Pennsylvania Death 31 March2005(dehydration) Best Known As The brain-damaged Florida woman at the center of the Schiavo legal case

39. Euthanasia : Case Files #4 Dr. Cox vs Mrs Boyes In 1992 Dr Cox openly defied the law and assented to 70 year old Mrs Boyes' persistent request for voluntary active euthanasia. Mrs Boyes' was so ill that she "screamed like a dog" if anyone touched her. Conventional medicine did not relieve her agony. In her last days, when she repeatedly requested to die, Dr Cox finally gave her an injection of potassium chloride, bestowing on her the boon of a peaceful death so many of us feel we are entitled to. Dr Cox, although given a suspended sentence, was hauled through the courts like a common criminal. We believe good doctors acting in all conscience like Dr Cox, should be lauded, not vilified, and should have the benefit of legally approved codes of conduct that embody consistent safeguards against abuse. Together we should ensure that medicine and the law serve the patient and the citizen once more. Together, we can stand and be counted. And, from pooled resources, each small contribution will contribute to the powerful tidal wave that Exit can use to bring this about.

40. Arrested in Hospital Deaths After Katrina By CHRISTINE HAUSER Published: July 18, 2006 A doctor and two nurses have been arrested and booked on suspicion of second-degree murder in connection with the deaths of patients at a medical center in New Orleans after Hurricane Katrina struck, a spokeswoman for the Louisiana attorney general’s office said today. The arrests of the three, whose names were not released by the spokeswoman, Kris Wartelle, were part of the culmination of an investigation into accusations that patients might have been euthanized at the Memorial Medical Center in the aftermath of the hurricane. The attorney general, Charles C. Foti Jr., issued subpoenas last October for dozens of hospital employees. “I won’t say it has ended yet,” said Ms. Wartelle, reached by telephone, confirming details of a report on the arrests by The Associated Press. “There could be more things coming down the pike.. … …Officials have confirmed finding 45 bodies at the hospital two weeks after the storm. Officials with Tenet Healthcare have said about 10 of those people died before the storm.After the hurricane struck the city, hospitals and nursing homes struggled to care for their patients. At Memorial, evacuation efforts faltered, emergency generators could not support air conditioning and temperatures inside the building exceeded 100 degrees.

41. Will Malaysian doctor euthanized? ATTITUDES OF MEDICAL STUDENTS TOWARDS EUTHANASIA IN A MULTI-CULTURAL SETTING K Adchalingam*, W H Kong*, M A Zakiah*, M Zaini*, Y L Wong**, C C Lang, FRCP***, *Year 2 Medical Students, **Health Research Development Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur*** Department of Medicine, University of Malaya A cross-sectional survey of 400 medical students of multi-cultural backgrounds at the University of Malaya was conducted to understand their attitudes towards euthanasia and factors related to medical decisions and ethical reasoning concerning the prolongation of life, the right to die and euthanasia. The student respondents completed self-administered questionnaires that comprised of twelve questions with multiple stems addressing personal perceptions, knowledge, attitudes and decisions about euthanasia and the relief of suffering. The majority of respondents (52%) were for the withdrawal of active therapy in a patient suffering from a terminal painful disease, while 48% of them were against it. 71% of the students involved in the study were against the idea of active euthanasia, i.e. the administration of a lethal injection. However, 27% of the respondents felt that there was a moral justification to assist patients to die. 32% of the respondents favored the legalization of euthanasia in Malaysia, while 67% of them were strongly against it. The majority (61%) of respondents would not practice euthanasia as a doctor nor would they have performed on themselves if or when it became legal. The main issue surrounding euthanasia that concerned the respondents was the misuse of it by unethical practitioners and they felt that further debate on the matter was essential, both within the local and international communities

42. Euthanasia : From A Malaysian Perspective • Dilemmas surrounding passive euthanasia--a Malaysian perspective.Talib N.Faculty of Law, University of Malaya, Kuala Lumpur, Malaysia. • In western societies where the principle of autonomy is jealously guarded, perhaps active euthanasia is more often the focus of public concern and debates rather than any other forms of euthanasia. However due to the advance in technology and its corresponding ability in prolonging life, in Malaysia passive euthanasia presents more of a dilemma. For those concerned and involved with end of life decision-making, it is generally agreed that this is an area fraught with not only medical but legal and ethical issues. In Malaysia where the society is not homogenous but is multi-cultural and multi-religious, in addition to medical, legal and ethical issues, religious principles and cultural norms further impact and play significant roles in end of life decision-making. This paper seeks to identify the issues surrounding the practice of passive euthanasia in Malaysia. It will be shown that despite applicable legal provisions, current practice of the medical profession combined with religious and cultural values together affect decision-making which involves the withholding and/or withdrawing of life-saving treatment.

43. Research Resources • Wikipedia Online Encyclopedia, http://en.wikipedia.com • National Right To Life Organization, http://www.nrlc.org/euthanasia/index.html • The Memoirs of America’s Family Doctor, C. Everett Koop MD, Random House, 1991 • International Task Force, http://www.internationaltaskforce.com/faqs • He Who Knows Not, Be Silent, Dr. Syed Ali Tawfik Al-Attas, Director General, IKIM • Institusi Kemajuan Islam Malaysia, http://www.ikim.gov.my/bm/cetakmedia.php?key=809 • Malaysian Medical Association, http://www.mma.org.my/mjm/6_original_05.htm • PMID: 16229394 [PubMed - indexed for MEDLINE] • New York Times, http://www.nytimes.com/katrina • The Islamic Code of Medical Ethics