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Islam considers medical ethics the same as ethics in other areas of life. Islamic medical ethics
is restating general ethical principles using medical terminology and with medical
applications.
Modern medicine has caused some ethical dilemmas in relation to end-of-life decisions and
what is or is not euthanasia.
Life is sacred
Euthanasia and suicide are not included among the reasons allowed for killing in Islam.
Do not take life, which Allah made sacred, other than in the course of justice.
Qur'an 17:33
Many devout Muslims believe that Do Not Resuscitate (DNR) orders represent a soft form of
euthanasia which is strictly forbidden in Islam. Muslims cannot kill, or be complicit in the
killing of another, except in the interests of justice.
However, the Islamic Code of Medical Ethics states "it is futile to diligently keep the patient
in a vegetative state by heroic means... It is the process of life that the doctor aims to maintain
and not the process of dying". This means doctors can stop trying to prolong life in cases
where there is no hope of a cure.
According to the Islamic Medical Association of America (IMANA
"When death becomes inevitable, as determined by physicians taking care of terminally ill
patients, the patient should be allowed to die without unnecessary procedures."
IMANA say that turning off life support for patients deemed to be in a persistent vegetative
state is permissible. This is because they consider all mechanical life support procedures as
temporary measures.
While turning off a life-support is allowed, hastening death with the use of certain painkilling drugs is not allowed as this would equate to euthanasia.
http://www.bbc.co.uk/religion/religions/islam/islamethics/euthanasia.shtml
birth and death are part of the life processes which God has created, so we should
respect them
therefore no human being has the authority to take the life of any innocent person,
even if that person wants to die
Human beings are valuable because they are made in God's image
human life possesses an intrinsic dignity and value because it is created by God in his
own image for the distinctive destiny of sharing in God's own life
o saying that God created humankind in his own image doesn't mean that people
actually look like God, but that people have a unique capacity for rational
existence that enables them to see what is good and to want what is good
o as people develop these abilities they live a life that is as close as possible to
God's life of love
o this is a good thing, and life should be preserved so that people can go on
doing this
to propose euthanasia for an individual is to judge that the current life of that
individual is not worthwhile
such a judgement is incompatible with recognising the worth and dignity of the
person to be killed
nor should anyone ask for euthanasia for themselves because no-one has the right to
value anyone, even themselves, as worthless
Many churches believe that the period just before death is a profoundly spiritual time
They think it is wrong to interfere with the process of dying, as this would interrupt
the process of the spirit moving towards God
so it would be wrong to treat their lives as worthless and to conclude that they 'would
be better off dead'
patients who are old or sick, and who are near the end of earthly life have the same
value as any other human being
people who have mental or physical handicaps have the same value as any other
human being
If we respect a person we should respect their decisions about the end of their life
We should accept their rational decisions to refuse burdensome and futile treatment
the community should care for people who are dying, and for those who are close to
them
the community should face death and dying with honesty and support
the community should recognise that when people suffer death on earth they entrust
their future to the risen Christ
religious people, both lay and professional, should help the terminally ill to prepare
for death
Euthanasia, also known as assisted suicide, physician-assisted suicide (dying) , doctorassisted dying (suicide) , and more loosely termed mercy killing, basically means to take a
deliberate action with the express intention of ending a life to relieve intractable (persistent,
unstoppable) suffering. Some interpret euthanasia as the practice of ending a life in a painless
manner. Many disagree with this interpretation, because it needs to include a reference to
intractable suffering.
In the majority of countries euthanasia or assisted suicide is against the law. According to the
National Health Service (NHS), UK, it is illegal to help somebody kill themselves, regardless
Active euthanasia - lethal substances or forces are used to end the patient's life.
Active euthanasia includes life-ending actions conducted by the patient or somebody
else.
Active euthanasia is a much more controversial subject than passive euthanasia. Individuals
are torn by religious, moral, ethical and compassionate arguments surrounding the issue.
Euthanasia has been a very controversial and emotive topic for a long time.
The term assisted suicide has several different interpretations. Perhaps the most widely used
and accepted is "the intentional hastening of death by a terminally ill patient with assistance
from a doctor, relative, or another person". Some people will insist that something along the
lines of "in order relieve intractable (persistent, unstoppable) suffering" needs to be added to
the meaning, while others insist that "terminally ill patient" already includes that meaning.
Euthanasia in history
The English medical word "euthanasia" comes from the Greek word eu meaning "good", and
the Greek word thanatos meaning "death".
Hippocrates (ca. 460 BC - ca. 370 BC) - euthanasia is mentioned in the Hippocratic
Oath. The original oath states "To please no one will I prescribe a deadly drug nor
give advice which may cause his death." Even so, the ancient Greeks and Romans
were not strong advocates of preserving life at any cost, and were tolerant of suicide
when no relief could be offered to the dying.
English Common Law - suicide was a criminal act from the 1300s until the middle
of the last century; this included assisting others to end their lives.
Thomas More (1478-1535) - an English lawyer, scholar, author and statesman; also
recognized as a saint within the Catholic Church, once envisaged a utopian
community as one that would facilitate the death of those whose lives had become
burdensome as a result of torturing and lingering pain.
Since early 1800s - Since the early 1800s euthanasia has been a topic of debates and
activism in the USA, Canada, Western Europe and Australasia. Ezekiel Emanuel
(born 1957, USA), an American National Institutes of Health bioethicist said that the
modern era of euthanasia was ushered in by the availability of anesthesia.
New York 1828 - an anti-euthanasia law was passed in the state of New York in 1828.
It is the first known anti-euthanasia law in the USA. In subsequent years many other
localities and states followed suit with similar laws. Several advocates, including
doctors promoted euthanasia after the American Civil War. At the beginning of the
1900s support for euthanasia peaked in the USA, and then rose up again during the
1930s.
Societies - in 1935 euthanasia societies emerged in England, and in 1938 in the USA.
After WWII - after the Second World War Glanville Williams (1911-1997, Wales. A
legal professor) and Joseph Fletcher (1905-1991, USA. An Episcopal priest, he later
identified himself as an atheist) emerged as proponents of euthanasia.
1960s - During the 1960s advocacy for a right-to-die approach to euthanasia grew.
Australia - Rights of the Terminally Ill Act was passed in 1996 in the Northern
Territory. Under the Act four patients died using a euthanasia device designed by Dr.
Philip Nitschke. One year later the Act was overturned by the Federal Parliament. Dr.
Nitschke responded by founding EXIT International, a pro-euthanasia group. In 2009
a quadriplegic patient, Christian Rossiter (49) was granted the right to refuse
nourishment and be allowed to die; Chief Justice Wayne Martin specified that
Brightwater, his caregiver, would not be held criminally responsible for following his
instructions. A chest infection eventually ended Rossiter's life.
Choice - freedom of choice is the cornerstone of free market systems and liberal
democracies. The patient should be given the option to make their own choice.
Quality of life - only the patient is really aware of what it is like to experience
intractable (persistent, unstoppable) suffering; even with pain relievers. Those who
have not experienced it cannot fully appreciate what effect it has on quality of life.
Apart from physical pain, overcoming the emotional pain of losing independence is
an additional factor that only the patient comprehends fully.
Dignity - every individual should be given the ability to die with dignity.
Witnesses - people who witness the slow death of others are especially convinced that
the law should be altered so that assisted death be allowed.
Drain on resources - in virtually every country there is never enough hospital space.
Channeling the resources of highly-skilled staff, equipment, hospital beds and
medications towards life-saving treatments makes more sense; especially when these
resources are currently spent on terminal patients with intractable suffering who wish
to die.
Public opinion - in nearly all countries a significantly higher proportion of people are
for euthanasia than against it. In a democracy legislation should reflect the will of the
people.
Loved ones - it helps shorten the grief and suffering of the patient's loved ones.
Prolongation of dying - if the dying process is unpleasant, the patient should have
the right to reduce this unpleasantness. In medicine, the prolongation of living may
sometimes turn into the prolongation of dying. Put simply - why should be a patient
be forced to experience a slow death?
The doctor's role - doctors and other health care professionals may have their
professional roles compromised. The Hippocratic Oath, in its ancient form stated "To
please no one will I prescribe a deadly drug nor give advice which may cause his
death."
Moral religious argument - several religions see euthanasia as a form of murder and
morally unacceptable. At best, some see voluntary euthanasia as a form of suicide,
which goes against the teachings of many religions. Euthanasia weakens society's
respect for the sanctity of life.
Guilt - there is a risk patients may feel they are a burden on resources and are
psychologically pressured into consenting. They may feel that the burden - financially,
emotionally, mentally - on their family is overwhelming. Even if the costs of
treatment are provided by the state, there is a risk hospital personnel may have an
economic incentive to encourage euthanasia consent.
Slippery slope - there is a risk things will start with those who are terminally ill and
wish to die because of intractable suffering, and eventally begin to include other
patients.
The patient might recover - the patient might recover against all odds. The diagnosis
might be wrong.
1. Right to Die
PRO: "The right of a competent, terminally
ill person to avoid excruciating pain and
embrace a timely and dignified death bears
the sanction of history and is implicit in the
concept of ordered liberty. The exercise of
this right is as central to personal autonomy
and bodily integrity as rights safeguarded by
this Court's decisions relating to marriage,
family relationships, procreation,
contraception, child rearing and the refusal or
termination of life-saving medical treatment.
In particular, this Court's recent decisions
concerning the right to refuse medical
treatment and the right to abortion instruct
that a mentally competent, terminally ill
person has a protected liberty interest in
choosing to end intolerable suffering by
bringing about his or her own death.
care."
-- Gerrit Kimsma, MD, MPh
Associate Professor in Medical Philosophy
Evert van Leeuwen, PhD
Professor in Philosophy and Medical Ethics
Center for Ethics and Philosophy at Free
University in Amsterdam (Amsterdam,
Netherlands)
"Assisted Death in the Netherlands:
Physician at the Bedside When Help Is
Requested"
Physician-Assisted Dying: The Case for
Palliative Care & Patient Choice
2004
7. Healthcare Spending Implications
PRO: "Even though the various elements
that make up the American healthcare system
are becoming more circumspect in ensuring
that money is not wasted, the cap that marks
a zero-sum healthcare system is largely
absent in the United States... Considering the
way we finance healthcare in the United
States, it would be hard to make a case that
there is a financial imperative compelling us
to adopt physician-assisted suicide in an
effort to save money so that others could
benefit..."
9. Religious Concerns
PRO: "Guided by our belief as Unitarian
Universalists that human life has inherent
dignity, which may be compromised when
life is extended beyond the will or ability of a
person to sustain that dignity; and believing
that it is every person's inviolable right to
determine in advance the course of action to
be taken in the event that there is no
reasonable expectation of recovery from
extreme physical or mental disability...
Federal law restricts this drug to use by or on the order of a licensed veterinarian.
Description
A non-sterile solution containing pentobarbital sodium and phenytoin sodium as the active
ingredients. Rhodamine B, a bluish-red fluorescent dye, is included in the formulation to help
distinguish it from parenteral drugs intended for therapeutic use. Although the solution is not
sterile, benzyl alcohol, a bacteriostat, is included to retard the growth of microorganisms.
Each mL contains: active ingredients: 390 mg pentobarbital sodium (barbituric acid
derivative), 50 mg phenytoin sodium; inactive ingredients: 10% ethyl alcohol, 18%
propylene glycol, 0.003688 mg rhodamine B, 2% benzyl alcohol (preservative), water for
injection q.s. Sodium hydroxide and/or hydrochloric acid may be added to adjust pH.
ACTIONS: EUTHASOL (pentobarbital sodium and phenytoin sodium) contains two active
ingredients which are chemically compatible but pharmacologically different. Each
ingredient acts in such a manner so as to cause humane, painless, and rapid euthanasia.
Euthanasia is due to cerebral death in conjunction with respiratory arrest and circulatory
collapse. Cerebral death occurs prior to the cessation of cardiac activity.
When administered intravenously, pentobarbital sodium produces rapid anesthetic action.
There is a smooth and rapid onset of unconsciousness. At the lethal dose, there is depression
of vital medullary respiratory and vasomotor centers.
When administered intravenously, phenytoin sodium produces toxic signs of cardiovascular
collapse and/or central nervous system depression. Hypotension occurs when the drug is
administered rapidly.
Pharmacodynamic Activity: The sequence of events leading to humane, painless, and rapid
euthanasia following the intravenous injection of EUTHASOL is similar to that following
intravenous injection of pentobarbital sodium, or other barbituric acid derivatives. Within
seconds, unconsciousness is induced with simultaneous collapse of the dog. This stage
rapidly progresses to deep anesthesia with concomitant reduction in the blood pressure. A few
seconds later, breathing stops, due to depression of the medullary respiratory center;
encephalographic activity becomes isoelectric, indicating cerebral death; and then cardiac
activity ceases.
Phenytoin sodium exerts its effect during the deep anesthesia stage caused by the
pentobarbital sodium. This ingredient, due to its cardiotoxic properties, hastens the stoppage
of electrical activity in the heart.
Euthasol Euthanasia Solution Indications
When restraint may cause the dog pain, injury, or anxiety, or danger to the person making the
injection, prior use of tranquilizing or immobilizing drugs may be necessary.
http://www.drugs.com/vet/euthasol-euthanasia-solution.html