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VISHNU AMBAREESH


Etymology 
 
Euthanasia (from 
the Greek: εὐθανασία meaning 
"good death": εὖ, eu (well or good) + 
θάνατος, thanatos (de...
 
The first apparent usage of the term 
"euthanasia" belongs to the historian 
Suetonius who described how the 
Emperor ...
 
word "euthanasia" was first used 
in a medical context by Francis 
Bacon in the 17th century, to refer 
to an easy, pa...
Definition 
 
 Definition of EUTHANASIA 
the act or practice of 
killing or permitting the death of 
hopelessly sick or ...
Euthanasia Definitions 
• Voluntary euthanasia: 
The person killed has 
requested to be killed. 
• Non-voluntary: When the...
Euthanasia Definitions 
• Involuntary euthanasia: When the 
person who is killed made an 
expressed wish to the contrary.
Euthanasia Definitions 
• Assisted suicide: Someone provides 
an individual with the information, 
guidance, and means to ...
Euthanasia Definitions 
• Euthanasia By Action: Intentionally 
causing a person's death by 
performing an action such as b...
Euthanasia Definitions 
• Euthanasia By Omission: 
Intentionally causing death by not 
providing necessary and ordinary 
(...
Active Euthanasia 
• Something is done to the patient 
to hasten Death 
• Not legal in the United States 
• Legal in Nethe...
Passive Euthanasia 
• Patient is allowed to die. Only 
medication help ease patient’s 
pain is administered. 
• Examples: ...
Voluntary Euthanasia 
• Patient request 
treatment to be 
stopped. 
• Examples: 
chemotherapy or 
dialysis.
Non- Voluntary 
• Patient cannot 
decide from 
themselves. 
• Someone makes 
the decision for 
them. 
•Examples: children,...
Involuntary 
• Patient is refused a 
life sustaining 
treatment. 
• Examples: Drugs are 
too costly, limited 
supply of or...
 
Voluntary euthanasia is legal in 
some countries and U.S. states. 
Non-voluntary euthanasia is 
illegal in all countr...
Heath Care Surrogate 
 
You can appoint someone, to act as 
your representative in the event you 
are mentally incapacit...
Living Will 
 
A living will is a document 
that states what your wishes in 
the event you need life 
sustaining care.
History 

History 
 
400 B. C. - The earliest recorded 
reference to Euthanasia comes 
from Hippocrates, the father of 
medicine. ...
 
Euthanasia was practised in Ancient Greece 
and Rome: for example, hemlock was 
employed as a means of hastening death...
History Cont. 
 
673 – England prohibits suicide. 
1647 – the Providence Plantations (Rhode 
Island) declared that if a...
History Cont. 
 
1828 – “The earliest American statute 
explicitly to outlaw assisted suicide was 
enacted in New York…....
History Cont. 
 
1920 – “The book "Permitting the Destruction of 
Life not Worthy of Life" was published. 
In this book...
Nazi Germany 
 
 1939 – In “Nazi Germany…Hitler ordered 
widespread ‘mercy killing’ of the sick and disabled.” 
 1935 –...
History Cont. 
 
 1995 – Australia's Northern Territory approved the 
“Rights of the Terminally Ill Act . “ It went into...
Legalized in Oregon 
 
 1994 - the Oregon Death with Dignity Act was 
passed, which legalized assisted suicides. 
Other ...
The Oregon Experience 
Oregon legalized physician-assisted 
suicide in 1997 . . .
History Cont. 
 
 2002 – Euthanasia is legalized in Belgium 
 2005 – “Netherlands set to give the go-ahead to child 
eu...
Various nations 

Japan 
 
In 1995 Japanese legalized "Active 
euthanasia" when four criteria are satisfied: 
unbearable pain, proximate d...
International Laws 
 
Belgium and The Netherlands have legalized 
Euthanasia 
In 1995, with the passage of the "Rights ...
History in Netherlands 
 
Started in 1973 became legal until 2002 
The Dutch situation between 1973 and 
2002 was an ou...
Holland 
legalized euthanasia starting in 
the early 1970s
The Dutch Guidelines 
1. Must be performed by a doctor 
2. Must be requested by patient while competent 
3. Request must b...
Euthanize Children! 
 
The Dutch government has decided to 
endorse guidelines for Nonvoluntary 
euthanasia of infants. ...
Belgium- not to be 
outdone… 
 
The Belgian act legalizing euthanasia was passed 
on May 28, 2002 and went into effect o...
Australia 
 
“Death by Laptop” 
Performed by Dr. Philip Nitschke 
Used the law to assist four people with 
their suici...
Australia (cont.) 
 
 Dr. Philip Nitschke
Australia (cont.) 
 
 Death by Laptop
Australia (cont.) 
 
Computer asked three questions: 
Are you aware that if you go ahead to the last screen 
and press ...
Canada 
 
Current bill being considered that would legalize 
euthanasia 
Bill C-407 legalizes both euthanasia and assis...
International 
Organizations 
 
Council of Europe has rejected bills that would 
legalize euthanasia 
UN is against eut...
Cases and Controversies 

Euthanasia program 
 
The so-called "Euthanasia" 
program was National Socialist 
Germany's first program of mass 
murde...

Dr. Jack Kevorkian 
• Assisted-suicide advocate, launched 
campaign for “right to die” 
• Tried for murder for his 
assist...
Dr. Jack Kevorkian 
• Believed laws limiting euthanasia, 
as well as limiting smoking, etc. 
were infringement on rights 
...
Karen Ann Quinlan 
 
 In 1975 a 21-year-old woman named Karen Ann 
Quinlan suffered a respiratory arrest that 
resulted ...

Court sided with Family 
 
After a lengthy legal battle, in 1976 the 
Quinlans obtained a court order allowing 
them to ...
Turned off respirator 
 
This decision spawned increased discussion 
of the scope of patients' rights to control their 
...
Katrina Track… 

Louisiana probes 215 
deaths 
 
 A state investigation into whether critically ill 
patients were left to die or were eu...
Tough Decisions at 
Hospital 
 
 Staff doctors in a New Orleans hospital may have 
euthanased critically ill patients wi...
 
Canada: Sue Rodriguez, popularly 
known as 'Victoria woman' and 
diagnosed with Lou Gehrig's disease in 
1991, asked le...
 
 England: Anthony Bland, in March 1993, ended up 
in persistent vegetative state after suffering severe 
brain damage ...
Euthanasia in India 

Aruna Shanbaug case 
 
 Aruna Shanbaug is a former nurse from Haldipur, Uttar 
Kannada, Karnataka in India. In 1973, whi...
 
However in its 
landmark judgment, it 
allowed passive 
euthanasia in India
 
Gautmni Nair will 
played Aruna in 
Malayalam film “ 
maranam peyyumbol”
 
Jeet Narayan of Mirzapur in Uttar 
Pradesh in 2008 pleaded for euthanasia 
for his four sons - Durgesh (22), 
Sarvesh ...
Thalaikoothal 
 
Thalaikoothal (Tamil: தலைக்கூத்தல், lit. 
showering) is the traditional practice of 
senicide (killing ...

 
 Typically, the elderly person is given an extensive 
oil-bath early in the morning and subsequently made 
to drink gl...
Ethics 

 
As of 2006, euthanasia is the 
most active area of research 
in contemporary bioethics
Good consequences of euthanasia 
It would be possible to respect the self-determination 
of competent patients who 
want i...
Potential bad consequences 
Undermine moral center of medicine, “first, 
do no harm” 
Weaken society’s commitment to provi...

Doctors’ attitudes toward 
euthanasia 
20% of physicians who care for the 
seriously ill and terminally ill say they 
have...
Euthanasia - facts and not covering the ethical aspects
Euthanasia - facts and not covering the ethical aspects
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Euthanasia - facts and not covering the ethical aspects

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my presentation during surgery internship..... 2013....

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Euthanasia - facts and not covering the ethical aspects

  1. 1. VISHNU AMBAREESH
  2. 2.
  3. 3.
  4. 4. Etymology  Euthanasia (from the Greek: εὐθανασία meaning "good death": εὖ, eu (well or good) + θάνατος, thanatos (death))
  5. 5.  The first apparent usage of the term "euthanasia" belongs to the historian Suetonius who described how the Emperor Augustus, "dying quickly and without suffering in the arms of his wife, Livia, experienced the 'euthanasia' he had wished for."
  6. 6.  word "euthanasia" was first used in a medical context by Francis Bacon in the 17th century, to refer to an easy, painless, happy death, during which it was a "physician's responsibility to alleviate the 'physical sufferings' of the body."
  7. 7. Definition   Definition of EUTHANASIA the act or practice of killing or permitting the death of hopelessly sick or injured individuals (as persons or domestic animals) in a relatively painless way for reasons of mercy.
  8. 8. Euthanasia Definitions • Voluntary euthanasia: The person killed has requested to be killed. • Non-voluntary: When the person who is killed made no request and gave no consent.
  9. 9. Euthanasia Definitions • Involuntary euthanasia: When the person who is killed made an expressed wish to the contrary.
  10. 10. Euthanasia Definitions • Assisted suicide: Someone provides an individual with the information, guidance, and means to take his or her own life.
  11. 11. Euthanasia Definitions • Euthanasia By Action: Intentionally causing a person's death by performing an action such as by giving a lethal injection.
  12. 12. Euthanasia Definitions • Euthanasia By Omission: Intentionally causing death by not providing necessary and ordinary (usual and customary) care or food and water.
  13. 13. Active Euthanasia • Something is done to the patient to hasten Death • Not legal in the United States • Legal in Netherlands and Australia • Examples: drugs are administered at lethal levels.
  14. 14. Passive Euthanasia • Patient is allowed to die. Only medication help ease patient’s pain is administered. • Examples: Turning off respirator, refusing chemotherapy.
  15. 15. Voluntary Euthanasia • Patient request treatment to be stopped. • Examples: chemotherapy or dialysis.
  16. 16. Non- Voluntary • Patient cannot decide from themselves. • Someone makes the decision for them. •Examples: children, comatose patients, or individuals not mentally competent
  17. 17. Involuntary • Patient is refused a life sustaining treatment. • Examples: Drugs are too costly, limited supply of organs. • About 13,000 patients are on waiting list in the US.
  18. 18.  Voluntary euthanasia is legal in some countries and U.S. states. Non-voluntary euthanasia is illegal in all countries. Involuntary euthanasia is usually considered murder
  19. 19. Heath Care Surrogate  You can appoint someone, to act as your representative in the event you are mentally incapacitated. Terri Schiavo did not have a Heath Care Surrogate. If you do not have one, by default it is your spouse. If you are unmarried it is your parents, or next of kin.
  20. 20. Living Will  A living will is a document that states what your wishes in the event you need life sustaining care.
  21. 21. History 
  22. 22. History  400 B. C. - The earliest recorded reference to Euthanasia comes from Hippocrates, the father of medicine. He is quoted as saying “I will give no deadly medicine to any one if asked, nor suggest any such counsel”
  23. 23.  Euthanasia was practised in Ancient Greece and Rome: for example, hemlock was employed as a means of hastening death on the island of Kea, a technique also employed in Marseilles and by Socrates in Athens. Euthanasia, in the sense of the deliberate hastening of a person's death, was supported by Socrates, Plato and Seneca the Elder in the ancient world
  24. 24. History Cont.  673 – England prohibits suicide. 1647 – the Providence Plantations (Rhode Island) declared that if an individual committed suicide his/her possessions would become the property of the King of England. 1800s – Laws of Connecticut essentially states that any person who aids another individual in committing suicide is guilty of murder if the advisee actually goes through with suicide.
  25. 25. History Cont.  1828 – “The earliest American statute explicitly to outlaw assisted suicide was enacted in New York….Between 1857 and 1865, a New York commission drafted a criminal code that prohibited ‘aiding’ suicide and, specifically, ‘furnishing another person with any deadly weapon or poisonous drug, knowing that such person tends to use such weapon or drug in taking his own life.” 1850 – “The California legislature adopted the English common law, under which assisting suicide was… a crime.”
  26. 26. History Cont.  1920 – “The book "Permitting the Destruction of Life not Worthy of Life" was published. In this book, authors Alfred Hoche, M.D., a professor of psychiatry at the University of Freiburg, and Karl Binding, a professor of law from the University of Leipzig, argued that patients who ask for "death assistance" should, under very carefully controlled conditions, be able to obtain it from a physician. This book helped support involuntary euthanasia by Nazi Germany.”
  27. 27. Nazi Germany   1939 – In “Nazi Germany…Hitler ordered widespread ‘mercy killing’ of the sick and disabled.”  1935 – “The Euthanasia Society of England was formed to promote euthanasia.”
  28. 28. History Cont.   1995 – Australia's Northern Territory approved the “Rights of the Terminally Ill Act . “ It went into effect in 1996 and was overturned by the Australian Parliament in 1997.”
  29. 29. Legalized in Oregon   1994 - the Oregon Death with Dignity Act was passed, which legalized assisted suicides. Other states such as California, Michigan, Maine, Hawaii, Arizona, and Vermont have tried to pass similar bills. All attempts have been unsuccessful.
  30. 30. The Oregon Experience Oregon legalized physician-assisted suicide in 1997 . . .
  31. 31. History Cont.   2002 – Euthanasia is legalized in Belgium  2005 – “Netherlands set to give the go-ahead to child euthanasia.”
  32. 32. Various nations 
  33. 33. Japan  In 1995 Japanese legalized "Active euthanasia" when four criteria are satisfied: unbearable pain, proximate death, no other way to relieve pain; and clear consent. Passive euthanasia, without consent, is also allowed if relatives consent.
  34. 34. International Laws  Belgium and The Netherlands have legalized Euthanasia In 1995, with the passage of the "Rights of the Terminally Ill (ROTI) Act," Australia’s Northern Territory became the only jurisdiction in the world with both legalized assisted suicide and euthanasia. The law went into effect in July 1996. It was repealed on March 25, 1997.
  35. 35. History in Netherlands  Started in 1973 became legal until 2002 The Dutch situation between 1973 and 2002 was an outgrowth of a series of court decisions and medical association guidelines, beginning with a 1973 District Court case in which Geertruida Postma, a Dutch physician, was convicted of the crime of euthanasia after she ended the life of her seriously ill mother.
  36. 36. Holland legalized euthanasia starting in the early 1970s
  37. 37. The Dutch Guidelines 1. Must be performed by a doctor 2. Must be requested by patient while competent 3. Request must be free of doubt, well-documented, and repeated 4. A second, independent physician must be consulted. 5. Determination that no one pressured patient 6. “Unbearable pain” or condition that is otherwise intolerable 7. No available means to improve patient’s condition
  38. 38. Euthanize Children!  The Dutch government has decided to endorse guidelines for Nonvoluntary euthanasia of infants. Under the so- called Groningen protocol, euthanasia will be allowed when a child is terminally ill with no hope of recovery and suffering great pain, when two doctors agree that the case is hopeless and when the parents consent.
  39. 39. Belgium- not to be outdone…  The Belgian act legalizing euthanasia was passed on May 28, 2002 and went into effect on September 23, 2002. It limited euthanasia to competent adults and emancipated minors. Just recently, the government announced it intends to extend its euthanasia law to newborns and children Approximately 2,000 people have used the law
  40. 40. Australia  “Death by Laptop” Performed by Dr. Philip Nitschke Used the law to assist four people with their suicides. Hooked up IV to patient which was connected to laptop.
  41. 41. Australia (cont.)   Dr. Philip Nitschke
  42. 42. Australia (cont.)   Death by Laptop
  43. 43. Australia (cont.)  Computer asked three questions: Are you aware that if you go ahead to the last screen and press the ‘yes’ button, you will be given a lethal dose of medicine and die? Yes / No Are you certain you understand that if you proceed and press the ‘yes’ button on the next screen, you will die? Yes / No In 15 seconds you will be given a lethal injection. Yes / No Nitschke still researching ways to help people kill themselves
  44. 44. Canada  Current bill being considered that would legalize euthanasia Bill C-407 legalizes both euthanasia and assisted suicide. For people with chronic suffering and mental pain. Person does not need to try to find other ways of helping ease pain, they may refuse and just choose euthanasia Anyone can help euthanize a person, does not need to be a physician, but need “confirmation”
  45. 45. International Organizations  Council of Europe has rejected bills that would legalize euthanasia UN is against euthanasia However, wording of new draft for rights of people with disabilities seems to leave the door open: The text makes illegal all "medical or related interventions," possibly including life-saving nutrition and hydration, carried out without the "free and informed consent" of the person concerned or his legal representative. Needless to say, Catholic church is strongly opposed to euthanasia
  46. 46. Cases and Controversies 
  47. 47. Euthanasia program  The so-called "Euthanasia" program was National Socialist Germany's first program of mass murder, predating the genocide of European Jewry, which we call the Holocaust, by approximately two years
  48. 48.
  49. 49. Dr. Jack Kevorkian • Assisted-suicide advocate, launched campaign for “right to die” • Tried for murder for his assists, convicted in 1999 • Saw euthanasia as “helping a suffering patient”
  50. 50. Dr. Jack Kevorkian • Believed laws limiting euthanasia, as well as limiting smoking, etc. were infringement on rights • Died in June 2011
  51. 51. Karen Ann Quinlan   In 1975 a 21-year-old woman named Karen Ann Quinlan suffered a respiratory arrest that resulted in severe and irreversible brain damage and left her in a coma. Several months later, after doctors informed them that their daughter's recovery was extremely unlikely, Quinlan's parents requested that artificial means of life support be removed. The hospital refused this request.
  52. 52.
  53. 53. Court sided with Family  After a lengthy legal battle, in 1976 the Quinlans obtained a court order allowing them to remove the artificial respirator that was thought to be keeping their daughter alive. The New Jersey Supreme Court ruled that the Quinlans could disconnect the device so that the patient could "die with dignity."
  54. 54. Turned off respirator  This decision spawned increased discussion of the scope of patients' rights to control their death. Although the respirator was removed in 1976, Quinlan began to breathe on her own. She lived until 1985 without ever regaining consciousness.
  55. 55. Katrina Track… 
  56. 56. Louisiana probes 215 deaths   A state investigation into whether critically ill patients were left to die or were euthanized at a New Orleans hospital during the chaotic aftermath of Hurricane Katrina is part of a probe into an estimated 215 deaths at nursing homes and hospitals across the area, according to the Louisiana Department of Health and Hospitals. As Reported 10/17/05
  57. 57. Tough Decisions at Hospital   Staff doctors in a New Orleans hospital may have euthanased critically ill patients with massive doses of morphine in the chaotic aftermath of Hurricane Katrina. According to the London's Mail on Sunday, the doctors say that the patients would have died anyway and some were in great pain. They were unable to care for them properly when the power failed and looters and rapists were roaming the wards.
  58. 58.  Canada: Sue Rodriguez, popularly known as 'Victoria woman' and diagnosed with Lou Gehrig's disease in 1991, asked legislators in 1992 to change the law banning assisted suicide. The Supreme Court rejected her plea, but she committed suicide in 1994 with the help of an anonymous doctor.
  59. 59.   England: Anthony Bland, in March 1993, ended up in persistent vegetative state after suffering severe brain damage in the Hillsborough football stadium stampede. After three years, a court allowed the withdrawal of life-prolonging treatment on him. He was the first patient in British legal history to be allowed to die.
  60. 60. Euthanasia in India 
  61. 61. Aruna Shanbaug case   Aruna Shanbaug is a former nurse from Haldipur, Uttar Kannada, Karnataka in India. In 1973, while working as a junior nurse at King Edward Memorial Hospital, Parel, Mumbai, she was sexually assaulted by a ward boy, Sohanlal Bhartha Walmiki and has been in a vegetative state since the assault. On 24 January 2011, after she had been in this status for 37 years, the Supreme Court of India responded to the plea for euthanasia filed by Aruna's friend journalist Pinki Virani, by setting up a medical panel to examine her. The court turned down the mercy killing petition on 7 March 2011
  62. 62.  However in its landmark judgment, it allowed passive euthanasia in India
  63. 63.  Gautmni Nair will played Aruna in Malayalam film “ maranam peyyumbol”
  64. 64.  Jeet Narayan of Mirzapur in Uttar Pradesh in 2008 pleaded for euthanasia for his four sons - Durgesh (22), Sarvesh (18), Brijesh (13) and Sushil (10) - all crippled and paralysed below the neck. Narayan wrote to the president of India, but his plea was rejected.
  65. 65. Thalaikoothal  Thalaikoothal (Tamil: தலைக்கூத்தல், lit. showering) is the traditional practice of senicide (killing of the elderly) or involuntary euthanasia, by their own family members, observed in some parts of southern districts of Tamil Nadu state of India.
  66. 66.
  67. 67.   Typically, the elderly person is given an extensive oil-bath early in the morning and subsequently made to drink glasses of tender coconut water which results in renal failure, high fever, fits, and death within a day or two. This technique may also involve a head massage with cold water, which may lower body temperature sufficiently to cause heart failure. Alternative methods involve force feeding cow's milk while plugging the nose, causing breathing difficulties (the "milk therapy") or use of poisons.
  68. 68. Ethics 
  69. 69.  As of 2006, euthanasia is the most active area of research in contemporary bioethics
  70. 70. Good consequences of euthanasia It would be possible to respect the self-determination of competent patients who want it. It would reassure the large number of people who want to have the option of euthanasia Some pain and suffering can only be relieved by euthanasia (psychological as well as physical pain).
  71. 71. Potential bad consequences Undermine moral center of medicine, “first, do no harm” Weaken society’s commitment to provide care for dying patients (its easier to kill them) Some patients may feel pressured to accept death because of a felt burden There may be a slip into non-voluntary euthanasia
  72. 72.
  73. 73. Doctors’ attitudes toward euthanasia 20% of physicians who care for the seriously ill and terminally ill say they have been asked for assistance in speeding the dying process. Of those, 3% have written prescriptions to assist suicide and 5% have given lethal injections.

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