The Moral Dilemma of Euthanasia Through the Eyes of the Medical Society in Bulgaria.

INTRODUCTION: With the development of human society, the question of the value and inviolability of human life begins to occupy a central place in the various social strata and social structures. With the adoption of the Universal Declaration of Human Rights after the Second World War, the basic postulates protecting the right to inviolability of human life were laid. The question focused on euthanasia has been discussed in several European countries, such as Germany, Ireland, France, and Italy, leading to considerable interest in the medical community in Bulgaria. MATERIALS AND METHODS: A prospective study was performed using approved sample cards, analyzing the general knowledge of the medical community in the Republic of Bulgaria about euthanasia and assisted suicide over a period of four months, between January 2023 and May 2023. In this process, 623 people were surveyed, and the questionnaire included several targeted questions through electronically generated samples on the Microsoft Forms platform. The target group had doctors with and without a specialty in various fields of hospital and pre-hospital care, dentists, and students from the fields of medicine and dentistry. RESULTS AND DISCUSSION: The results show that the majority of medical professionals clearly state their positive opinion on the adoption of a law to legalize euthanasia in the Republic of Bulgaria, clearly taking into account the fact that the right to life has always been and always will be the most absolute and fundamental human right. Contrary to the above, it is implied that it is inevitably linked to a quality and fulfilling life without suffering. Identically, they also answered that a person should have the right to know exactly when to end his own life. The medical society in Bulgaria clearly shows its positive opinion regarding the idea that the different forms of euthanasia (active euthanasia and assisted suicide) should be defined as morally and legally permissible. Our research confirms the Bulgarian medical community's opinion that the subject of the problems of euthanasia and its legal regulation are already ripe for public discussion, similar to many other European countries. CONCLUSION: The actual issue of euthanasia as a conclusion raises several questions related to the process of acceptance of standard algorithms for action in such cases where the same action is legalized by law. It also includes the process of acceptance of strict regulations by the countries for the so-called negative phenomenon "death tourism" and several other administrative actions related to the mandatory registration of every case of euthanasia, the implementation of mandatory consultations with a psychiatrist and psychologist for patients seeking euthanasia as the only possible option, and providing possible alternatives regarding their illness. This is the unchangeable cornerstone for standardizing the legalization process and acceptance of "good death" in Bulgaria. In its essence, euthanasia creates both a social and an ethical conflict in our modern society, appearing at the same time as a kind of "stress test" for the health system.

Child abuse syndrome - a forensic case of fatal impulsive act of violence.

Child abuse syndrome is a medico-social problem widely spread around the world, which includes a complex of clinically manifested forms of violence against children. This syndrome includes different forms of physical violence, sexual violence, neglect, and emotional violence against children. The main problem with this type of violence continues to be the large number of unregistered "hidden" cases. The consequences of violence against children are serious and have a lasting negative effect on the physical and mental health of the victims. Child abuse is often a result of impulsive violent behavior with minimal provocation and may have a fatal outcome.

The advantage of the virtual forensic autopsy - A new approach which could benefit forensic expertise.

We aimed to assess the accuracy and advantages of postmortem CT examination and three-dimensional (3D) view of the cadaver with the Sectra Visualization Table compared to the full conventional autopsy of a forensic suicidal case. Our survey concerned unusual case of self-strangulation where a body was found in the stage of mummification with a nylon cable tie around the neck and another around the feet. The case was initially determined as a homicide, but later reconsidered a suicide based on objective scene investigation, virtual autopsy and the positions of knots. Unlike the physical autopsy in case of mummification 3D examination does not alter evidence and can revisit the body for additional investigation.

Suicide by unusual manner of hanging. A case report.

We present a case of a 35-year-old man who committed a suicide by unusual manner of hanging. The man positioned his neck between two branches of a cherry tree which were V-shaped. The dead body hung on the tree with the feet 50 cm off the ground. The external examination showed strangulation grooves on both sides of the neck with skin abrasion caused by the compression of the neck between the two tree branches as well as submucosal hemorrhages of both eyelids. Autopsy revealed some of the common signs of asphyxia (hemorrhages under the epicardium and the visceral pleura, acute blood stagnation of the internal organs, liquid blood); hemorrhages in the sternocleidomastoid muscles at their attachment to the sternum; horizontal and parallel ruptures of the intima of the left common carotid artery (Amussat's sign); ruptures of the ligaments and the disc between cervical vertebras 6 and 7 and hemorrhages (Simon's sign). Toxicological blood studies, which were additionally performed, found no evidence of drugs or alcohol.