Eutanasia, matar y dejar morir. Desambiguación del concepto de eutanasia y consideraciones bioéticas esenciales / Euthanasia: To Kill or to Let Die. Concept Disambiguation and Essential Bioethical Considerations / Eutanásia, matar e deixar morrer. Desambiguação do conceito de eutanásia e considerações bioéticas essenciais

Resumen El propósito de este artículo es desambiguar el concepto de "eutanasia", describir las conductas que equivocadamente son asociadas a ella, y diferenciar aquellas que no son eutanasia de aquella única que sí lo es. Además, se hacen las consideraciones bioéticas mínimas en relación con los términos de "eutanasia", "matar" y "dejar morir", y se discuten en pacientes conscientes e inconscientes.

Abstract The purpose of this original paper is to clarify the term "euthanasia", describing the varied conducts wrongly associated with it and distinguishing those that are not euthanasia from the only one that certainly is. Additionally, basic bioethical considerations are presented regarding the terms "euthanasia," "killing" and "letting die," and discussed in relation to conscious and unconscious patients.

Resumo O objetivo deste artigo é desambiguar o conceito de eutanásia, descrever as condutas que, de forma equivocada, são associadas a ele e diferenciar as que não são eutanásia daquela única que realmente é. Além disso, são feitas considerações bioéticas mínimas quanto aos termos "eutanásia", "matar" e "deixar morrer", os quais são discutidos com relação a pacientes conscientes e inconscientes.

Eutanasia en Chile: una discusión pendiente / Euthanasia in Chile

Euthanasia is a complex medical procedure. Even though end of life decisions are common situations in health practice, there is a lack of consensus about their terminology. In this manuscript, the main concepts about this issue are defined and delimited; including active and passive euthanasia and limitation of therapeutic effort. Then, a revision is made about the international experience on euthanasia, to then go through the Chile’s history in euthanasia and the population’s opinion. In Chile, euthanasia is an act that has been removed from the social dialogue and legislation. In order to have an open discussion in our population about the issue, the debate has to be opened to the citizens, accompanied by clear medical information about the procedure.

Eutanasia activa, una mirada a la situación internacional / Active euthanasia, a view of international situation

International situation on euthanasia varies among countries. Even though in most of the countries worldwide active euthanasia is forbidden by law, to the date four countries (The Netherlands, Belgium, Luxembourg and Colombia) have approved and regulated by law active euthanasia (defined as “physician’s intentionally administering a treatment -usually medication- to cause the patient’s death, with the patient’s full, informed consent”). For a country like Chile, in which all types of euthanasia are forbidden by law, it is important to look forward to the international situation, in order to enrich public policy debate, based on the international empirical experience.

Demanda por eutanásia e condição de pessoa: reflexões em torno do estatuto das lágrimas / Demanda por eutanasia y condición de persona: reflexiones en torno al estatuto de las lágrimas / Euthanasia court claims and personhood: on the statute of tears

Este artigo enfoca a condição de pessoa contemporânea a partir do exame de notícias recentes sobre demandas por autorização legal de eutanásia. O caso de Christian Rossiter, tetraplégico após um atropelamento, é debatido. Em seu pedido - autorizado pela Suprema Corte do estado da Austrália Ocidental em agosto de 2009 - declarou que "não pode realizar suas funções humanas mais básicas, como secar as lágrimas do rosto". Tal solicitação se diferencia de outras, nas quais o argumento se centra na dor e no sofrimento físico, como ocorreu com Chantal Sébire. O caso aqui examinado evidencia tanto uma formulação da condição de pessoa quanto de gênero, na qual a esfera das emoções - e seu controle - é central. Este artigo discute o estatuto das lágrimas na sociedade ocidental contemporânea no que concerne a diferenças entre os gêneros e a situações radicais de vida/morte, quando é preciso definir os limites de existência da pessoa.

El presente artículo aborda la condición contemporánea de persona a partir del examen de noticias acerca de demandas de autorización legal de eutanasia. Se debate el caso de Christian Rossiter, tetraplégico a raíz de un accidente automovilístico, quien en su pedido -concedido por la Suprema Corte de Australia Occidental en agosto de 2009- declaró no poder "realizar sus funciones humanas más básicas, como secarse las lágrimas del rostro". Este reclamo se diferencia de otros cuyos argumentos se centran en el dolor y en el sufrimiento físico. El caso examinado explicita una formulación de la condición de persona en la cual la esfera de las emociones -y su control- es central. El artículo discute el estatuto de las lágrimas en la sociedad occidental contemporánea, enfocando diferencias de género y situaciones radicales de vida/muerte, en las se hace preciso definir límites de la existencia de la persona.

This article focuses on the contemporary notions of personhood, based on the examination of news articles on requests for legal authorization of euthanasia. The case of Christian Rossiter, left quadriplegic after being run over by a car, is discussed. On his claim - authorized by the Western Australia's Supreme Court in August 2009 - he stated that he was "unable to perform even the most basic human functions, such as wiping the tears from his face". Such request differs from others in which the argument focuses on pain and physical suffering, as with Chantal Sébire. The case examined in this study represents a formulation of personhood in which the sphere of emotions - and their control - is central. This article discusses the statute of tears in contemporary Western society, concerning gender differences,, and the extreme situations of life/death, when it is necessary to define the limits of a person's existence.

Matar, dejar morir y eutanasia en el proyecto de ley sobre derechos de las personas y en la doctrina chilena / To kill, let die and euthanasia in the bill of rights of patients and in the Chilean doctrine

The Bill of Rights for Patients provides the patient with autonomy for disposing of his life, enabling him to reject those treatments that unnecessarily prolong his life. However, the bill does not allow an artificial acceleration of death. Therefore, the bill does not permit euthanasia (at least, certain form of it) nor assisted-suicide. However, according to the practice of medicine and also Chilean doctrine, it is permitted to inject morphine to a patient to relieve his pain, even though that could hasten his death. In consequence, it is allowed for the patient to dispose of his life and also to inject in him morphine for pain relief, endangering his life, but neither euthanasia nor assisted-suicide is allowed. Is this coherent? According to Chilean doctrine, it could be coherent under the condition of accepting the distinction between killing and letting die and also the double effect doctrine. The problem is that there is abundant English literature in the realm of moral philosophy to disregard both conditions. Therefore, it is possible to claim that the Bill is not coherent and that the Chilean doctrine is based upon a distinction and a doctrine that are not acceptable.

Bioética de la muerte de Sigmund Freud: ¿Eutanasia o apropiación? / Bioethics of Sigmund Freud´s death: Euthanasia or appropriation?

The death of Freud raises the ethical dilemma about euthanasia. It can be characterized as indirect active euthanasia according to the rule of double effect, or terminal sedation, or palliated death. The primacy of the principle of autonomy over non maleficence, conditioned the physician’s attitude toward his patient Freud. The physician assisted death was and remains punishable in western medicine. Therefore, a fundamental tradition was infringed. In contrast, the present study attempts to characterize the final position of Freud himself to his death and called it appropriation of his finitude; he assumes his being-unto-death, that is, he now projects his being not as a being-at-his-end but as a being-unto-end, indicating thereby that he understood that the end always penetrated his whole existence.

Euthanasia in cancer patients, Islamic point of view

Euthanasia is an important subject that concerns law and medicine as well as morality and religion in the 21[St] century. Euthanasia has become a challengeable problem in scientific arena. In some countries, legal and medical practitioners are allowed to kill those cancer patients who suffer from excessive pain while incur enormous amount of expenses for their treatments. We used 3 main sources to find Islamic views on euthanasia: First, the Islamic primary source, the Holy Quran, which is the most important and reliable source for finding Islamic perspectives. Second, traditions [hadith] which include Prophet Mohammad's and his relatives's [Imams] advices. Third, religious opinions and decrees [Fatwas] from great Muslim scholars who are called Mofti Al-Aazam in Sunni tradition and Ayatollah Al-Ozma in Shiite tradition. Based on the reasons proposed in the references, it can be concluded that euthanasia is forbidden in Islamic theology; and no types of euthanasia are allowed or accepted in Islam; and any action whether voluntary or involuntary that results in euthanasia of cancer patients is considered suicide and is strongly forbidden in Islam. Euthanasia is purely illegal in Judaism, Christianity, and Islam. In this study, we introduced a religious law based on Islamic point of view and Emamyeh section in Islam. To investigate the sensitive issue of euthanasia in Islam, the Holy Quran as the fundamental reference of Islamic law and Sonnah as the reference of Hadith [Traditions] were studied

Algunas consideraciones médico-legales sobre la eutanasia / Medico-legal considerations related to euthanasia

A systematic approach to medico-legal aspects of euthanasia is presented. Euthanasia can be defined as the intentional putting to death by artificial means of persons with incurable or painful disease. The authors describe the current concepts on the matter and the distinct pathological features

An Analysis of Attitudes on Euthanasia between Residents and Judicial Apprentices

BACKGROUND: Recently, the legal and ethical issues relative to euthanasia are becoming controversial in Korea. This study was designed to verify the differences of the attitudes on euthanasia between judicial apprentices and residents. METHODS: The questionnaire was conducted on the 35th-group of the judicial apprentices on March 24, 2004, and on the residents from April 2 to May 22, 2004. The respondents were 636 in total consisting of 460 judicial apprentices and 176 residents. RESULTS: Of the total 636 subjects, 373 (81.1%) of the judicial apprentices and 149 (84.7%) of residents agreed that allowing euthanasia is moral, without any significant difference (P>0.05). The number of residents was greater (59 people, 33.5%) than that of judicial apprentices (112 people, 24.4%) who agreed with active euthanasia (P0.05). But, among these supporters, the respondents who agreed on active euthanasia were significantly different in number between judicial apprentices (n=93, 23.4%) and residents (n=54, 33.8%) (P<0.05). CONCLUSION: This study did not find any significant differences between the two groups in the necessity of the law for euthanasia, but the rate of agreement on active euthanasia was higher in residents group than in judicial apprentices group.

Bioética: perspectivas históricas e ideológicas sobre eutanasia / Bioethics: historical and ideological perspective on euthanasia

Actualmente la acepción predominante de la eutanasia es “la acción u omisión que permite, acelera o provoca la muerte de un paciente terminal o de un recién nacido con graves malformaciones, para evitar sus sufrimientos”. El concepto implica la intervención de un agente distinto del enfermo y que ella se realice por el bien de éste, movida por la compasión. Eutanasia significa etimológicamente “buen morir”. La muerte entendida como uno de los principales “ritos de paso”, es decir, el cambio incontrovertible de una situación biológica a otra es acompañada de rituales explicativos, los que en último término pretenden asimilarla culturalmente intentando una ayuda al morir, es decir, la obtención de un “ buen morir”, el que se expresará de acuerdo a la significación elaborada frente a este cambio irreversible. El contexto cultural que envuelve a la eutanasia transforma en forma muy diversa su significado moral. Las culturas primitivas se inclinaban a evitar el dolor de los moribundos acelerando de diferentes maneras la aparición de la muerte. “humanizaban” la muerte, ayudando a su aparición. Aplicando esta misma intención, concebían que los niños minusválidos eran potencialmente portadores de discriminación y sufrimiento a lo largo de su vida, y por lo tanto podían ser eliminados, teniendo en cuenta que en la polis todo habitante cumplía con un rol determinado, no sólo para obtener su propia felicidad, sino para mantener el orden social exigido. El aborto, antes de aparecer la “sensación de la vida” (etapas precoces del embarazo), era aceptado por Aristóteles. La aparición de la medicina en Grecia nace junto con el intento de curar la enfermedad, “la institucionalización médica de la eutanasia”.

Eutanasia / Euthanasia

Technological progress in medicine regarding the application of life-sustaining treatment in the critical patient and the cultural changes that have taken place in contemporary society with respect to the patients' right to decide over the end of their lives, demand the existence of a definition of euthanasia that will acknowledge this new scenario. The concept of euthanasia would be very specifically limited by the exclusion of so-called passive forms of euthanasia and of omission as a possible procedure to cause death and the need for the explicit request of the patient involved. Likewise, the definition of euthanasia should include a specific reference to the means through which death is to be achieved. Euthanasia would thus be defined basically as causing the death of a patient suffering from a mortal disease, upon his or her request and for his or her own benefit, by administering a toxic or poisonous substance in mortal doses. This restrictive definition would differentiate euthanasia from cases of refusal to receive treatment, even if death is the consequence of such refusal, and also from cases in which life-sustaining treatment is withheld or withdrawn to enable the occurrence of death

Attitudes of medical students and housestaff toward euthanasia

BACKGROUND: Medical decisions concerning the prolongation of life, the right to die and euthanasia are among the most extensively discussed issues within medicine and law today. The purpose of this study was to evaluate the attitudes of medical students and housestaff toward euthanasia. METHODS: From July 15 to September 15 of the 1998, the responses of 180 medical students and 132 housestaff to a self-administered questionnaire were analyzed to identify attitudes toward euthanasia. Over 312 respondents about attitudes toward euthanasia, the analysis of differences between proportions was made by the Chi-square test. RESULTS: About 69.9% of the respondents thought euthanasia should be legalized. The findings suggest that Buddhists (77.5%) and non-religious groups (88.1%) tend to support euthanasia more than Christians. Futhermore, medical students (74.4%) support euthanasia more than housestaffs(63.6%), male(75.1%) more often than female(57.9%). About 73.1% of the respondents said that active euthanasia is not justifiable, and 79.2% said that they do not like performing active euthanasia. In respect to passive euthanasia, 69.0% said that it is not ethically justifiable, but 63.0% would perform this as if it were legal. Housestaffs of internal medicine (76.9%) were more willing to do euthanasia than pediatrics (70.0%), surgery (63.6%), family practice (53.8%) and Ob/Gyn (33.3%). CONCLUSION: Respondents have positive attitudes toward legalization of euthanasia.. Most considered that passive euthanasia is not morally justifiable. But if it were legalized, they would be willing to do euthanasia, while they would still be disturbed by active euthanasia. The opinions of physician and medical students directly affect patient care and their attitudes must be considered if clear policies are to be developed concerning euthanasia.

Consideraciones juridicas en torno al concepto de eutanasia / Legal considerations around the concept of euthanasia

Dada la confusión conceptual que existe en relación con la expresión eutanasia, el objetivo de la presente monografia consiste, precisamente, en dilucidar el sentido y alcance de esta expresión desde una perspectiva juridico-penal, para asi poder determinar qué conductas son penalmente relevantes y cuáles deben ser necesariamente excluidas del ámbito del ius puniendi. Como paso siguiente, el autor analiza los elementos determinantes de las conductas eutanásicas, consideradas siempre desde la perspectiva penal. Una vez precisado el alcance de la expresi¢n, es posible analizar dichas conductas desde el punto de vista de su tipificación objetiva, para revisar, posteriormente, algunas legislaciones latinoamericanas que tipifican expresamente dichas prácticas. Finalmente, se analizará la factibilidad ética y jur¡dica de una legislaci¢n propiamente eutanásica, a la luz del principiode la dignidad de la persona humana, reconocido explicita o impl¡citamente porlos principales instrumentos internacionales y por todas los c¢digos politicos de los Estados sociales y democráticos de derecho.