Euthanasia is one of the controversial topics in Medical Ethics.

Euthanasia: Merci Killing

We can distinguish 6 types of euthanasia from each other as follows:

1) 2) 3) 4) 5) 6)

Voluntary Active Euthanasia Voluntary Passive Euthanasia Non-Voluntary Active Euthanasia Non-Voluntary Passive Euthanasia Involuntary Active Euthanasia Involuntary Passive Euthanasia

 In Euthanasia, A is killed by B based on As request. There is a distinction between passive and active here. Performing active euthanasia would be actively intervening in the natural life cycle of the patient. However, in passive euthanasia the care-giver does not actively strive to extend the patients life. Moreover, the difference between voluntary and nonvoluntary has to be taken into account.

 According

to some ethicists, the moral permissibility of Non-Voluntary is more than Voluntary and Involuntary Euthanasia.

Moreover,

Passive Euthanasia sounds more plausible in comparison with Active Euthanasia.

 Autonomy,

Human Dignity & Principle of Ends and Neo-Kantian approach: In Defense of Die with Dignity

Deontologistic

In most Islamic countries, in contrast to European ones, such as the Netherland, the laws and regulations with regard to euthanasia are based on Islamic jurisprudence. This jurisprudence has four main sources. Holy Koran is the primary Islamic Source. The second source of Islamic law is the Sunnah, which is what the prophet (and Imams in the Shiite school) said, did, or agreed to. The third source is Ijma, which is consensus of Islamic scholars, and the forth is Aghl, which reason, or the rational mind.

Based on convincing interpretation of the Koran, Islamic jurisprudence does not recognize a persons right to die voluntarily. According to Islamic teachings, life is a divine trust and cannot be terminated by any form of voluntary active intervention. The majority of Islamic scholars regard active voluntary euthanasia as forbidden or haram, and the Sunni and Shiite scholars are in agreement on this matter. There are two instances, however, that could be interpreted as passive assistance in allowing a diagnosed terminally ill patient to die and thus would be permissible under Islamic law: One involves administering analgesic agents to relieve pain and distress but shortening life in the process while the other involves withdrawing seemingly futile treatment.

 What

about switching off life-support for brain-dead patients, in the case of organ and tissue donation, for saving another persons life? This practice is prevalent in Iran and some other Muslim countries.

 The

seven-month medical conflict over Mr. Rasouli's fate ended when Ontario's top court took Mrs. Salasel's side in a ruling that is expected to reignite for Canadians the emotional issue of how to handle endof-life decisions and whether extraordinary medical interventions save lives or merely prolong dying.

think it will reopen the debate Canadawide "about how to effectively and efficiently adjudicate end-of-life disputes," said Mark Handelman, a lawyer for the Euthanasia Prevention Coalition, an intervenor in the appeal. "...The public at large needs to learn a lesson from this. You have to have discussions about endof-life care with your loved ones."

 The

two doctors, Brian Cuthbertson and Gordon Rubenfeld, had argued that although they required consent to provide palliative care to Mr. Rasouli, they did not need it to withdraw life-sustaining measures that are no longer medically useful. The Ontario Court of Appeal upheld a lower court ruling that said that they do need consent, and that if they don't get it, they must refer the case to a tribunal.

 Mrs.

Salasel said she was pleased with the decision, adding: "I have my husband and he is still alive ... He's getting better, absolutely. He is alive and with medication, with modern medicine, he will be better."

 Medical

technology can now keep the sickest patients biologically alive, even though some doctors feel this does more harm than good. Distraught family members, meanwhile, often do not know their family member's wishes, or refuse to give up hope, and choose every intervention available to sustain life.

 "This

is such an important case, dealing with a person's life," Gary Hodder, the lawyer who represented Mr. Rasouli, said in a telephone interview. "It reflects on us as a society, it reflects on us as to our collective mental health on how it is we deal with issues such as life and death."

 Mr.

Rasouli, now 60, came to this health tragedy through a complication. After surgery on Oct.7, 2010, to remove a benign brain tumor, he developed a postoperative complication - bacterial meningitis - causing severe and diffuse brain damage. Since Oct. 16, 2010, he has been on a mechanical ventilator at Sunnybrook, where he receives nutrition and hydration through a tube inserted into his stomach. Doctors say he will never regain consciousness, according to the court decision.

 "These

life-sustaining measures are keeping him alive and he may survive for some months if they are continued," according to the 29-page decision, written by Ontario Court of Appeal judges Michael Moldaver and Janet Simmons. "Without them, it is expected that he will soon stop breathing and die."

 As

for Mr. Rasouli, he was placed on antibiotics earlier after suffering a fever and infection, said his wife, Mrs. Salasel. But she says he's getting better. Some days he will squeeze her hand with his left hand. His left eye is open and looks at her.

 Physician-assisted

suicide? Physicianenabled death? Physician-hastened death? Voluntary euthanasia? Rational suicide? Mercy killing? Death with dignity?...

 The

language we choose tends to reflect where we stand on the underlying question of whether grievously and irremediably ill people should have the right to choose to end their lives rather than let an illness take its course. The fundamental legal and ethical issue is choice: Do individuals have control over their bodies in death as in life?

 The

battle lines in Muslim countries are with libertarians at one end of the spectrum, religious jurists at the other, and most people uncomfortably pragmatic in the middle, meaning they want choice to exist but hope they never have to exercise the choice themselves.

 Those

who are pro-choice use neutral language like consensual physicianassisted dying and describe their quest as ensuring death with dignity. Those who are anti-choice use more loaded terms like assisted suicide and euthanasia.

 Currently,

it is difficult for those who choose to end their lives to do so in a dignified manner. The political and legal climate encourages secrecy, isolation and underground practices. There are many families who harbour painful secrets because they fulfilled the final wish of a loved one.

 The

reality is that there are plenty of physician-assisted deaths already. There is withdrawing of potentially life-sustaining treatment also crudely called unplugging a patient when patients with no hope of recovery are removed from respirators that are keeping them alive artificially.

 Death

is part of the cycle of life. We should not fear it, but plan for it. That includes making our personal wishes explicit, with living wills and in frank discussions with our loved ones..

 One

would conclude that passive assistance in allowing a diagnosed terminally ill patient to die would be permissible both under Islamic law and in accordance with secular ethics( for instance Utilitarianistic ethics).

 It

follows from this that Passive Nonvoluntary Euthanasia would be permissible both from the Islamic and Secular points of view. Other versions of Passive Euthanasia are controversial and disputable. Moreover, there are some religious scholars and jurists who do believe that active Non-Voluntary Euthanasia is permissible as well.

However, both Active Voluntary and Passive Voluntary Euthanasia, are impermissible from the religious point of view, as it is against Gods command and will. According to Islamic jurists, life is the gift of God; we are not entitled to die willingly, as our time of death is entirely dependent on Gods will. The jurist regard it as hormat nafs mohtarameh. According to Koran: Moreover, the underlying principle is that only the One who gives life is the One who can authorise taking life.

There are some contemporary Muslim reformists and thinkers who do believe that Voluntary Euthanasia is permissible, at least in some cases. According to them, there are some contexts in which we are entitled to terminate our lives, and that would not undermine Gods command and will.

For instance, they refer to the very idea of martyrdom and regard it as an example of rational suicide which is moral and acceptable from their perspective. In Shiite tradition, Imam Hossein was martyred in the battle of Karbala. According to these reformists, we do not undermine the moral permissibility of martyrdom and willingly dying. It follows from this that saving life is not ethical, categorically speaking. In fact, saving human dignity, in some contexts, requires us to terminate our lives.

So, they regard martyrdom as an example of rational suicide. According to them, it follows from this that Voluntary Euthanasia and die with dignity can be regarded as a kind of rational suicide which is permissible. However, the majority of jurists do not accept their argument and reject Voluntary Euthanasia, categorically speaking.

According to the majority of secular ethicists, we have to consider the existential concerns of the patient in order to issue a plausible judgment with regard to the moral permissibility of Voluntary Euthanasia. It follows from this that actively and passively engaged in mercy killing wouldnt be wrong and immoral, categorically speaking.

 They

do believe that there are some cases in which we are entitled to regard die with dignity as plausible, morally speaking.