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EUTANASIA
1. Repere istorice
In 8.01.1988, JAMA publica un articol anonim ("It's Over, Debbie" vezi anexa 1-)
care a lansat discutiile privitor la E. La putine luni dupa aceea, probabil si ca rezultat al
publicarii unor cazuri dar si al dezbaterilor ce au urmat, Council on Ethical and Juridical
Affairs al American Medical Association, AMA devenita ulterior World Medical Association
WMA (asociatia medicala internationala ce coordoneaza toate colegiile medicilor din toata
lumea), si-a reconfirmat opozitia fata de E.
In 1991 o dezbatere a Parlamentului European asupra eutanasiei a stimulat discutiile in
intreaga Europa. Ele continua si astazi si vor continua inca.
In trecut termenul sugera o moarte usoara, naturala, neindusa de factori externi
(termenul a aparut pentru prima data intr-un text de Suetoniu referindu-se la Augustis Cezar.
Prima persoana care a pus problematica eutanasiei asa cum o stim astazi este F.
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Bacon (1561-1626) care a promovat ideea ca medicul trebuie sa aiba cunostintele necesare
pentru a isi putea ajuta pacientii sa moara usor (euthansia exteriori, numita asa pentru a o
diferentia de moartea care se intampla atunci cand esti impacat cu ideea ei si cu tine insuti
that euthanasia, or sweet calm dying , procured by a due preparation of the soul (Bacon, pp
124-125, Beaty).
Prin urmare termenul nu insemna in acea perioada moarte indusa de medic ci usurarea
mortii naturale de catre medic.
Aceasta conceptie s-a pastrat pentru urmatoarele doua secole si jumatate, pana in
1870 cand notiunea a fost asociata de catre Samuel D. Williams cu moartea usoara,
nedureroasa, indusa de medic.
Eutanasia a fost utilizata pentru ambele notiuni pana in anii 1920, dupa care in uz a
ramas predominant definitia actuala (cea veche fiind inlocuita cu notiunea de euforie si apoi
de grija pentru modul in care o anumita persoana inceteaza din viata.
Sunt inca vii in mintea noastra aspre amintiri ale ideologiei naziste si a legitimizarii
eugeniei din perioada 1939-1943 (Actiunea T4) prin care au fost omorati peste 70.000 oameni
(existente fara valoare vitala ale unor persoane cu probleme psihice, degenerati, diformi,
etc.) vezi Anexa 2-
Alte asocieri alte eutanasiei au fost realizate cu: (1) utilizarea sedativelor pentru a se
asigura o moarte usoara (South Carolina Medical Association); (2) moartea asistata sau
moartea asistata de medic; (3) intreruperea suportului artificial pentru persoane care nu ar mai
fi putut supravietui fara acestea.
E revine in discutie atat in SUA prin Actul Mortii cu Demnitate (Death with Dignity
Act) trecut de legislativul din Oregon in 1994, Actul Alegerii compasionate (Compassionate
Choices Act) respins in California in 2006, Legea Ingrijirii futile (Futile Care Law) trecut in
Texas in 1999.
1
F.Bacon:Obiectulmediciniiesterefacereasanatatiisicalmareadurerilrdarnunumaicandaceastacalmare
poateducelainsanatosirecisiatuncicandpoateserviuneimortiseninesiusoare
In Europa devine legala in Belgia (2002), Olanda -ca E din compasiune mercy killing-
(1993, 2002), Elvetia (lege aprobata privind suicidul asistat (one way tickets to Zurich).
Inntre 2002-2006 se pune in dezbatere publica eutanasia in Regatul Unit, Franta, Cehia fiind
respins.
Numarul E efectuate in Olanda nu este precis cunoscut. Conform Comisiei de cercetare a actului
medical si E (Committee Onderzoeck Medische Praktijk InzKE Euthanasie) in 2000 au fost inregistrate peste
20.000 cereri de E din care au fost indeplinite cel mult 6.000.
Repere istorice
Juramantul Hippocratic (400 300 BC) Nu voi da curs cererii nimanui si nu voi prescrie un
medicament (drog) si nici nu void a sfat prin care sa-i produca moartea - To please no one will I
prescribe a deadly drug nor give advice which may cause his death-
Legea Comuna din Anglia incepand cu 1930 pana astazi dezaproba suicidal si suicidal asistat
1828 euthanasia este explicit scoasa in afara legii in SUA
1900 (in jurul) euthanasia capata support in unele cercuri intelectuale
1935 apare o societate care promoveaza euthanasia in Anglia
1937 suicidal asistat devine legal in Elvetia
1938 apare o societate care promoveaza euthanasia in USA
1939 Action T4 Germania nazista
1948 procesul de la Nuremberg
1977 living wills in California (ulterior si in alte state ale SUA)
1990 Dr. Jack Kevorkian (Michigan, USA) care a incurajat si asistat personae in comiterea
suicidului este judecat, condamnat in 1999 pentru un omor televizat si eliberat conditionat in 2007
1993 Olanda decriminalizeaza suicidal asistat de medic
1994 statul Oregon (SUA) Death with Dignity Act (US Supreme Court decision 1997, incearca sa
opreasca legea prin amendarea legii utilizarii drogurilor esuat in 2001)
1995 Teritoriile Nordice Australiei: euthanasia bill; respins de legislativul Australian in 1997
1999 Texas (USA) Futile Care Law: aprobat
2002 Legile Eutanasiei in Olanda si Belgia
2005 cazul Terri Schiavo
2005 Protocolul de la Groningen privind eutanasia la copil
EAPC Task Force la nivelul anului 2008 are 41 Asociatii Nationale din care 25 se afla in tot atatea tari
Europene; totalizeaza peste 50.000 de lucratori si voluntari in domeniul ingrijirilor paleative.
3. Clasificare
In relatie cu consimtamantul persoanei, E determina 3 relationari:
o Voluntara (cu consimtamantul direct al persoanei)
o Non-voluntara (fara consimtamantul direct al persoanei dar cu consimtamantul
indirect al apartinatorilor persoane incompetente, etc.-)
o Involuntara (impotriva vointei persoanei si apartinatorilor sau fara exprimarea
acestora-)
4. Argumente
Testamentul Papei Pius XII in anul 1957: Ai dreptul si obligatia ca in caz de boala
grava sa faci pasii necesari pentru a conserva viata si sanatatea. Aceasta datorie revine din
mila ordonata de Creator, din justitia sociala si chiar din lege. Dar doctorul este obligat in
permanenta sa asigure doar masuri de tratament obisnuite...adica masuri care sa nu reprezinte
o povara nici pentru medic si nici pentru pacient.
Daca acordul unuia dintre ei devine obligatoriu, atunci nu ar mai fi nici o diferenta intre
neonaticid si contraceptie. Sigur ca argumentul care afirma ca nou-nascutul nu isi poate
manifesta personalitatea este adevarat, dar nici un pediatru nu poate ucide. Se poate accepta
ca a lasa un copil sa moara poate fi in interesul copilului la un moment dat. Nontratamentul
selectiv al celor plurimalformati nu este discordant cu obligatia medicului de a sprijini viata
de la coneptie si pana la moarte. A lua in mod activ viata unui bolnav inseamna omucidere si
in aceasta definitie varsta nu este importanta.
Argumente care promoveaza existenta diferentei intre a ucide si a lasa sa moara
(Campbell si Downie, Practica pediatrica moderna, 1989).
Este o diferenta uriasa psihologica intre a permite moartea sau a ucide, diferenta care
este foarte importanta pentru personalul unitatilor de terapie intensive. Pentru acestia este o
mare diferenta intre a nu folosi un incubator pentru a tine in viata un copil de 600 gr. si a face
o injectie ucigasa, indiferent ca rezultatul este similar.
Argumente care promoveaza lipsa diferentei intre a ucide si a lasa sa moara, J. Rachel
In the first [instance], Smith stands to gain a large inheritance if anything should
happen to his sixyear-old cousin. One evening, while the child is taking his bath, Smith
sneaks into the bathroomand drowns the child, and then arranges things so that it will look
like an accident.
In the second, Jones also stands to gain if anything should happen to his six-year-old
cousin. Like Smith, Jones sneaks in planning to drown the child in his bath. However, just as
he enters the bathroom Jones sees the child slip and hit his head, and fall face down in the
water, Jones is delighted; he stands by, ready to push the childs head back under if it is
necessary, but it is not necessary. With only a little thrashing about, the child drowns all by
himself, accidentally, as Jones watches anddoes nothing.
6. Ingrijiri paliative, IP
Ingrijirile paliative reprezinta in Europa o parte integranata si pe cale de extindere a
ingrijirilor medicale. Pot exista diferente culturale regionale si nationale in ce priveste
organizarea ingrijirilor paliative pentru sanatate care se pot reflecta in practica medicala.
Totusi n 1989 EAPC a reusit definirea ingrijirilor paliative de o maniera recunoscuta de catre
OMS in Cancer Pain Relief and Palliative Care. Recent o noua definitie a OMS a aparut.
Astfel IP reprezinta imbunatatirea calitatii vietii pacientilor si a familiilor acestora in
fata problemlor de sanatate pe care le asociaza boliel letaleprin preventia si usurarea suferintei
prin identificarea precoce si evaluarea impecabila si tratamentul durerii si a altor probleme
fizice, psihologice si spirituale.
IP:
-usureaza durerea si alte simptome suparatoare
-afirma viata si privesc mmoartea ca pe un proces normal
-nu incearca nici sa grabeasca si nici sa amane moartea
-integreaza aspectele psihologice si spirituale ale ingrijirii pacientului
-ofera un suport pentru a ajuta viata pe cat de activ se poate pana la sfarsit
-ofera un sistem pentru a ajuta familia pe timpul bolii apartinatorului si a propriei
suferinte
-foloseste o echipa care sa se adreseze nevoilor pacientilor si familiilor lor
-cresc calitatea vietii si pot dea semenea sa influenteze pozitiv evolutia bolii
-aplicata devreme in evolutia bolii poate impreuna cu alte mijloace terapeutice precum
chemoterapia, radioterapia sa prelungeasca viata si suportabilitatea complicatiilor clinice
Solicitarile pentru eutaanasie si suicid asistat de catre medic sunt adesea alterate de
acordarea unor IP de calitate. Persoanele care solicita E sau suicidul asistat de medic ar trebui
sa aiba acces la expertiza IP.
Realizarea E sau facilitarea suicidului asistat nu au nici o legatura cu IP.
Respectul pentru autonomie este un tel important al IP care incearca sa intareasca
autonomia si nu sa o slabeasca. Accesul la IP de calitate trebuie sa constituie o politica
nationala si internationala.
In eutanasie:
Intentia este de a suprima viata pacientului
Procedura este de a folosi un drog letal
Finalitatea este moartea imediata
9. Aspecte legislative
9.1 Legislatia in Olanda
In ciuda faptului ca E este inca discutata la nivelul public (vezi si art. 293 din Codul
Penal Olandez), guvernul olandez a formulat o legislatie unitara acceptata. Astfel treptat la
nivelul tuturor puterilor judecatoresti incepand cu 1973 a predominat opinia ca daca medicul
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Codul Penal Roman reglementeaza doar omorul (art. 178) si anume: "uciderea unei
persoane se pedepseste cu detentiune severa de la 15 la 25 de ani si interzicerea unor
drepturi".
In aceste conditii, eutanasia si suicidul asistat ar putea fi interpretate ca fiind izvoare
de circumstante atenuante tinand cont de motivatia particulara (omor din mila) si de
participarea victimei.
o Determinarea sau inlesnirea sinuciderii este incriminata de art. 182 care
prevede:
(1) Fapta de a determina sau inlesni sinuciderea unei persoane, daca
sinuciderea sau incercarea de sinucidere a avut loc, se pedepseste cu inchisoare
stricta de la 2 la 7 ani.
(2) Cand fapta prevazuta in alin (1) s-a savarsit fata de un minor sau fata de o
persoana care nu era in stare sa-si dea seama de fapta sa ori nu putea fi stapana
pe actele sale, pedeapsa este inchisoarea stricta de la 3 la 10 ani.
medicul meu stabileste ca este terminala, indic ca masurile de sust inere a vietii care
servesc doar prelungirii agoniei mele sa fie oprite si intrerupte (If I suffer an
incurable, irreversible illness, disease, or condition and my attending physician
determines that my condition is terminal, I direct that life-sustaining measures that
would serve only to prolong my dying be withheld or discontinued.)
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8.3.Jack Kevorkian
nascut in 26 Mai, 1928, patolog american. Declara ca
a asistat cel putin 130 pacienti pentru a muri. A spus
ca a muri nu este o crima (Doctor Death,. A fost
condamnat 8 ani intre 1999-2007 pentru omor grd. II.
A fost eliberat in 1 Iunie 2007 conditionat pentru
comportament bun.
Concluzii
Preluand opiniile EAPC opiniem la randul nostru ca legalizarea E poate manifesta un
potential negativ prin:
Presiune asupra persoanelor vulnerabile
Subutilizarea si devaluarea mijloacelor de IP
Conflict intre cerintele legale si valorile profesionale ale medicilor si celorlalte
categorii de personal
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Sistemele medicale moderne nasc meritat temeri asupra unui abuz in ce priveste
dreptul unei persoane devenita incompetenta de a fi solicitat intreruperea masurilor medicale
extraordinare incat pentru unele situatii limita E sau suicidul asistat de catre medic sa para o
optiune acceptabila.
In fata acestor alegeri dificile fie medicul va deveni opozant (pe criterii deontologice,
deon = obligatie) fie isi va incalca normele deontologice prejudiciindu-si pozitia sa
profesionala si sociala. De aceea nu consideram ca aceaste optiuni sunt acceptabile nici atat pe
plan individual si nici social.
O alternativa pentru ca astfel de situatii limita sa nu se repete este folosirea
antedirectivelor de
tratament (living
will) care sa
contribuie la
imbunatatirea
comunicarii intre
pacient si medic
precum si la
planificarea
ingrijirilor
medicale intarind
autonomia
pacientului.
BIBLIOGRAFIE
1 Roy DJ, Rapin C-H, the EAPC Board of Directors.Regarding euthanasia. Eur J Palliat Care 1994; 1: 57 /59.
(Available in full text at: http://www.eapcnet.org/download/Euthanasiastatement94(E).pdf, accessed 24
January 2003)
2 Haverkate I, Onwuteaka-Philipsen BD, van der Heide A,Kostense PJ, van der Wal G, van der Maas PJ.
Refusedand granted requests for euthanasia and assisted suicidein the Netherlands: interview study with
structured questionnaire. BMJ 2000; 321: 865 /66. (Full
text:http://bmj.com/cgi/content/full/321/7265/865, accessed 24 January 2003)
3 Rights of the Terminally Ill Amendment Act 1996. (F ull text of law: ht tp://www.nt.gov.au/lant/parliament/
committees/rotti/rottiamendmentact96.pdf, accessed 24 January 2003)
4 Parliament of Australia. http://www.aph.gov.au/, accessed 24 January 2003.
5 The Oregon Death with Dignity Act. Ballot measure no. 16. Oregon Revised Statute 127.800-127.897. (Full
text of law: http://www.ohd.hr.st ate.or.us/chs/pas/ors.htm, accessed 24 January 2003)
6 The Netherlands Department of Justice. Press Releases.
http://www.minjust.nl:8080/c_actual/persber/index.htm, accessed 24 January 2003.
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14
ANEXE
ANEXA 1
It's Over, Debbie
The call came in the middle of the night. As a gynecology resident rotating through a large,
private hospital, I had come to detest telephone calls, because invariably I would be up for
several hours and would not feel good the next day. However, duty called, so I answered the
phone. A nurse informed me that a patient was having difficulty getting rest, could I please
see her. She was on 3 North. That was the gynecologic-oncology unit, not my usual duty
station. As I trudged along, bumping sleepily against walls and corners and not believing I
was up again, I tried to imagine what I might find at the end of my walk. Maybe an elderly
woman with an anxiety reaction, or perhaps something particularly horrible.
I grabbed the chart from the nurses station on my way to the patient's room, and the nurse
gave me some hurried details: a 20-year-old girl named Debbie was dying of ovarian cancer.
She was having unrelenting vomiting apparently as the result of an alcohol drip administered
for sedation. Hmmm, I thought. Very sad. As I approached the room I could hear loud,
labored breathing. I entered and saw an emaciated, dark-haired woman who appeared much
older than 20. She was receiving nasal oxygen, had an IV, and was sitting in bed suffering
from what was obviously severe air hunger. The chart noted her weight at 80 pounds. A
second woman, also dark-haired but of middle age, stood at her right, holding her hand. Both
looked up as I entered. The room seemed filled with the patient's desperate effort to survive.
Her eyes were hollow, and she had suprasternal and intercostal retractions with her rapid
inspirations. She had not eaten or slept in two days. She had not responded to chemotherapy
and was being given supportive care only. It was a gallows scene, a cruel mockery of her
youth and unfulfilled potential. Her only words to me were, "Let's get this over with."
I retreated with my thoughts to the nurses station. The patient was tired and needed rest. I
could not give her health, but I could give her rest. I asked the nurse to draw 20 mg of
morphine sulfate into a syringe. Enough, I thought, to do the job. I took the syringe into the
room and told the two women I was going to give Debbie something that would let her rest
and to say good-bye. Debbie looked at the syringe, then laid her head on the pillow with her
eyes open, watching what was left of the world. I injected the morphine intravenously and
watched to see if my calculations on its effects would be correct. Within seconds her
breathing slowed to a normal rate, her eyes closed, and her features softened as she seemed
restful at last. The older woman stroked the hair of the now-sleeping patient. I waited for the
inevitable next effect of depressing the respiratory drive. With clocklike certainty, within four
minutes the breathing rate slowed even more, then became irregular, then ceased. The dark-
haired woman stood erect and seemed relieved.
It's over, Debbie.
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ANEXA 2
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ANEXA 3
1. The vocation of the Council of Europe is to protect the dignity of all human beings and the
rights which stem therefrom.
2. Medical progress, which now makes it possible to cure many previously incurable or fatal
diseases, the improvement of medical techniques and the development of resuscitation
techniques, which make it possible to prolong a persons survival, to defer the moment of
death. As a result the quality of life of the dying is often neglected, and their loneliness and
suffering ignored, as is that of their families and care-givers.
3. In 1976, in its Resolution 613, the Assembly declared that it was "convinced that what
dying patients most want is to die in peace and dignity, if possible with the comfort and
support of their family and friends", and added in its Recommendation 779 (1976) that "the
prolongation of life should not in itself constitute the exclusive aim of medical practice, which
must be concerned equally with the relief of suffering".
4. Since then, the Convention for the Protection of Human Rights and Dignity of the Human
Being with regard to the Application of Biology and Medicine has formed important
principles and paved the way without explicitly referring to the specific requirements of the
terminally ill or dying.
5. The obligation to respect and to protect the dignity of a terminally ill or dying person
derives from the inviolability of human dignity in all stages of life. This respect and
protection find their expression in the provision of an appropriate environment, enabling a
human being to die in dignity.
6. This task has to be carried out especially for the benefit of the most vulnerable members of
society, a fact demonstrated by the many experiences of suffering in the past and the present.
Just as a human being begins his or her life in weakness and dependency, he or she needs
protection and support when dying.
7. Fundamental rights deriving from the dignity of the terminally ill or dying person are
threatened today by a variety of factors:
i. insufficient access to palliative care and good pain management;
ii. often lacking treatment of physical suffering and a failure to take into account
psychological, social and spiritual needs;
iii. artificial prolongation of the dying process by either using disproportionate medical
measures or by continuing treatment without a patients consent;
iv. the lack of continuing education and psychological support for health-care
professionals working in palliative medicine;
v. insufficient care and support for relatives and friends of terminally ill or dying
patients, which otherwise could alleviate human suffering in its various dimensions;
vi. patients fear of losing their autonomy and becoming a burden to, and totally
dependent upon, their relatives or institutions;
vii. the lack or inadequacy of a social as well as institutional environment in which
someone may take leave of his or her relatives and friends peacefully;
viii. insufficient allocation of funds and resources for the care and support of the
terminally ill or dying;
ix. the social discrimination inherent in weakness, dying and death.
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8. The Assembly calls upon member states to provide in domestic law the necessary legal and
social protection against these specific dangers and fears which a terminally ill or dying
person may be faced with in domestic law, and in particular against:
i. dying exposed to unbearable symptoms (for example, pain, suffocation, etc.);
ii. prolongation of the dying process of a terminally ill or dying person against his or her
will;
iii. dying alone and neglected;
iv. dying under the fear of being a social burden;
v. limitation of life-sustaining treatment due to economic reasons;
vi. insufficient provision of funds and resources for adequate supportive care of the
terminally ill or dying.
9. The Assembly therefore recommends that the Committee of Ministers encourage the
member states of the Council of Europe to respect and protect the dignity of terminally ill or
dying persons in all respects:
a. by recognising and protecting a terminally ill or dying persons right to comprehensive
palliative care, while taking the necessary measures:
i. to ensure that palliative care is recognised as a legal entitlement of the individual in all
member states;
ii. to provide equitable access to appropriate palliative care for all terminally ill or dying
persons;
iii. to ensure that relatives and friends are encouraged to accompany the terminally ill or
dying and are professionally supported in their endeavours. If family and/or
private networks prove to be either insufficient or overstretched, alternative or
supplementary forms of professional medical care are to be provided;
iv. to provide for ambulant hospice teams and networks, to ensure that palliative care is
available at home, wherever ambulant care for the terminally ill or dying may be
feasible;
v. to ensure co-operation between all those involved in the care of a terminally ill or
dying person;
vi. to ensure the development and implementation of quality standards for the care of
the terminally ill or dying;
vii. to ensure that, unless the patient chooses otherwise, a terminally ill or dying person
will receive adequate pain relief and palliative care, even if this treatment as a
side-effect may contribute to the shortening of the individuals life;
viii. to ensure that health professionals are trained and guided to provide medical,
nursing and psychological care for any terminally ill or dying person in co-
ordinated teamwork, according to the highest standards possible;
ix. to set up and further develop centres of research, teaching and training in the fields
of palliative medicine and care as well as in interdisciplinary thanatology;
x. to ensure that specialised palliative care units as well as hospices are established at
least in larger hospitals, from which palliative medicine and care can evolve as an
integral part of any medical treatment;
xi. to ensure that palliative medicine and care are firmly established in public awareness
as an important goal of medicine;
b. by protecting the terminally ill or dying persons right to self-determination, while taking
the necessary measures:
i. to give effect to a terminally ill or dying persons right to truthful and comprehensive,
yet compassionately delivered information on his or her health condition while
respecting an individuals wish not to be informed;
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ii. to enable any terminally ill or dying person to consult doctors other than his or her
usual doctor;
iii. to ensure that no terminally ill or dying person is treated against his or her will while
ensuring that he or she is neither influenced nor pressured by another person.
Furthermore, safeguards are to be envisaged to ensure that their wishes are not
formed under economic pressure;
iv. to ensure that a currently incapacitated terminally ill or dying persons advance
directive or living will refusing specific medical treatments is observed.
Furthermore, to ensure that criteria of validity as to the scope of instructions given
in advance, as well as the nomination of proxies and the extent of their authority
are defined; and to ensure that surrogate decisions by proxies based on advance
personal statements of will or assumptions of will are only to be taken if the will
of the person concerned has not been expressed directly in the situation or if there
is no recognisable will. In this context, there must always be a clear connection to
statements that were made by the person in question close in time to the decision-
making situation, more precisely at the time when he or she is dying, and in an
appropriate situation without exertion of pressure or mental disability. To ensure
that surrogate decisions that rely on general value judgements present in society
should not be admissible and that, in case of doubt, the decision must always be
for life and the prolongation of life;
v. to ensure that notwithstanding the physicians ultimate therapeutic responsibility
the expressed wishes of a terminally ill or dying person with regard to particular
forms of treatment are taken into account, provided they do not violate human
dignity;
vi. to ensure that in situations where an advance directive or living will does not exist,
the patients right to life is not infringed upon. A catalogue of treatments which
under no condition may be withheld or withdrawn is to be defined;
c. by upholding the prohibition against intentionally taking the life of terminally ill or dying
persons, while:
i. recognising that the right to life, especially with regard to a terminally ill or dying
person, is guaranteed by the member states, in accordance with Article 2 of the
European Convention on Human Rights which states that "no one shall be
deprived of his life intentionally";
ii. recognising that a terminally ill or dying persons wish to die never constitutes any
legal claim to die at the hand of another person;
iii. recognising that a terminally ill or dying persons wish to die cannot of itself
constitute a legal justification to carry out actions intended to bring about death.
______
1. Assembly debate on 25 June 1999 (24th Sitting) (see Doc. 8421, report of the Social, Health and Family
Affairs Committee, rapporteur: Mrs Gatterer; and Doc. 8454, opinion of the Committee on Legal Affairs and
Human Rights, rapporteur: Mr McNamara).
Text adopted by the Assembly on 25 June 1999 (24th Sitting).
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