Ethics of Life and Death:

Euthanasia ? Abortion
Dr. Erianto, M.ked (for), Sp.F

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 BIRTH OF A NEW HUMAN
BEING
 Every human being has to pass through
birth and death
 Not all birth accepted
 Certain reasons for that

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 END OF LIFE
 Everybody has to die one day
 Not every death take place smoothly
 Certain death preceded by suffering where
hope for survival is imposible

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 ADVANCES IN MEDICAL
FIELD
 Science and tehnology
 Treatment more effective
 Life of patient prolonged for a certain
periode ( respirator)
 Birth technology, biological enginering
 Seems that death can be prolonged with
modern technology

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 ETHICS AND LAW
 Advances in science and technology not
able to solve problem of medical ethics
 Dilema of new birth rejected (abortion)
and necessary to end the life in a nice way
(euthanasia)

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 DEATH
1. Orthothanasia - natural
2. Dysthanasia - unnatural
3. Euthanasia - with or without
doctor’s aid

 Moral problems / law / religion

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 PROBLEMS
 Can the patient / relatives of the patient
request ?
 Is the doctor eligible to help / perform it ?

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 EUTHANASIA
Eu : Good, nice, acceptable
Thanatos : Death
(compare with a patient of heart attack
within minutes)
Not always nice, acceptable (for patient)
Choice for suffering termination --- death

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 Sustainable
dispair suicide
-Broken love etc
-Executed by own self
euthanasia
Sucide
- painful sickness, not
Ends own cured

life - wit somebody’s help

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 COMPARE
 Harakiri (Japan)
 Sutee (India)
 Eskimo (eaten by bear)
 Nomanden (leaving a sick pereson)

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 HISTORY
 Plato (427 – 347 BC) suicide acceptable
due to disease, disability
 Aristoteles (384-322 BC) infanticide
acceptable
 Phytagoras (580-500 BC), killing of weak
people, mentally
 Hitler
 Swiss, Gemany, Soviet union, Cina in the
past
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 CASES
“The Last Wish”, Betty Rollins
Helps the mother commits suicide due to
malignant cancer
‘The Final Exit”, Dereck Humprey
Ways to end up life
Hemlock Society: force someone to lead life
is irrasional

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 Attitude toward
Euthanasia

Disagree Agree

- Hidden killer Accepted by patient

- God wish /relatives and doctor
handling the patien

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 DOCTOR
 Prolife
 Respect to human life, dedicated,
scientific, integrity
Deklarasi Geneva : I will maintain the
utmost respect for human life from the
time of conception, even under threat, I
will not use my medical knowlegde
contrary to the laws of humanity.
Kodeki 29 Oct 69, Kepmenkes RI 23 Okt 69

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 Code of Indon Med Ethics
 A doctor has to remember his obligation
to protect human life from conception

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 Euthanasia: Fatwa IDI 1989
1. Dying in peace without suffering, for
religious people in the name of Allah
2. When life will end up, suffering relieved
by giving transquilizer
3. Ending up life for a sick person perposely
on patient demand and family

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 TYPES OF EUTHANASIA
Method
1. Passive Euthanasia

2. Active Euthanasia - direct (mercy

killing)
- indirect
On demand
1. Voluntary Euthanasia

2. Involuntary Euthanasia

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1. No help in the process without the aim of
shortening life
2. Help in the death process without the
aim of shortenng life
3. No help in death process with the aim of
shortening life
4. Help in the deth process with the aim of
shortening life

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 LAWS AND REGULATIONS
 Act 344 KUHP
Anyone ending up somebody’s life on his
own wih is sentence for 12 years
 Act 338 KUHP
Anyone found killing/ taking somebody’s
life is sentence for at least 15 years

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 Act 340 KUHP
Anyone found of taking somebody’s life
planed in advance (moord) is sentence for
planned murder wit death sentence or life
imprisonment or 20 year imprisonment

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 Act 359 KUHP
Anyone due to his negligence cause the
death of a victim is sentence 5 years
imprisonment or one year in jail
Act 338, 340 and 359 KUHP Euthanasia
onpatient without demand

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 Act 345 KUHP
Anybody instigating someone to kill and
help in the act or help in the suicide act is
liable to sentence of 4 year

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 RELIGION
 Life and death are determined by the
Almighty
 Euthanasiais against God’s will
 Human right
• The right to live
• The right to die
Human right violation ?

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 Sciences
In cases where there is no cure or
treatment to relieved the suffering -- is
there any right to extent the life of the
patient ?

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 Abortion
 The dilema, similar with euthansia
 The fundamental diffference is : Abortion
is in the beginning of life,while euthanasia
is in the terminal stages of life
 Classic dilema which is still controversial
till now

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 Dilema
 Abortion is rejected as illegal and against
religion. Done hidingly
 Many cases

 drugs easily available

 many want to do it (doctors, mid-wifes,

nurse, self, quack)
 Pro-life versus pro-choice

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 CASES
 Natural, spontaneous abortion  15 %
 20 million unsave abortion (WHO)
 70.000 maternal death ech year
 1 from 8 maternal death, from unsave
abortion (12 – 15%)
 In some countries : 50%

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 INDONESIA

 Insidence in Indonesia about 2 million

 In the world 40 million (25% of 180
million pregnancy) per-year

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 REASONS
 Economy
 Ilegal pregnancy
 Rape
 Incest
 Old age
 Multipara, failure in contraseptive
 Still studying
 etc

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 UNSAVE ABORTION
 Law does not support abortion
 Unwanted pregnancy looking for
incompetent help (mid-wife, nurse, quack)
 Maternal mortality rate increase

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 RISK FOR MOTHER
 Death due to bleeding
 Infection
 Mammary cancer
 Ovarian cancer
 Liver cancer
 mandul
 etc

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 LEGALISATION OF
ABORTION ?
 Unwanted pregnancy looking for better
medical services
 No hidden procedure
 MMR can be reduce
 Hight abortion rate proof that society does
not care for abortion law
 Legalisation of abortion still chalenged

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 CONTROVERSY
 Pregnant woman has the right to make
the choice of pregnacy beyond her will
 Foetus is candidate for humn beeing
which has to be respected for the right of
survival
 Concelling is necessary

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 LAW
 KUHP prohibit all kinds of termination of
pregnancy
 Health law no. 23/1992
Act 15. In case of emergency in order to
save mother or foetus, specific medical
procedure can be executed

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 HEALTH LAW 1992
 Abortion can be done if;
 Medical indication
 By medical personnel, well trained and
having skill and knowledge and authority,
consideration of expert team
 consent of the mother, husband or family

 special center for abortion

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 LAW PENALTY
 Health Law
pasal 80. Barangsiapa dengan sengaja
melakukan tindakan medis tertentu
terhadap ibu hamil yang tidak memenuhi
ketentuan…….. Dipidana penjara paling
lama 15 tahun dan pidan denda sebanyak
RP.500.000.000

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 KUHP

 Pasal 229
1. Barangsiapa dengan sengaja mengobati
seorang wanita atau menyuruhnya supaya
diobati dengan diberi tahukanatau
ditimbulkan harapan bahwa hamilnya
dapat digugurkan…….. Penjara 4 tahun,
atau denda 3 ribu rupiah

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 KUHP
 342, 343, 346, 347, 348, 349

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 KUHP
 Pasal 229

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