Azernews.Az

By Araz Said, Azernews Staff Writer

What can be better than saving a person from months or even years of unbearable pain? And what can be worse than killing a human being? Probably the main reason for so many disputes around euthanasia is that it draws a thin line between being a merciful savior and a cold-blooded murderer and makes it possible for different people to interpret it in either way. Almost all declarations on human rights around the world state the same basic principle - every human being has the right to life. But do we have the right to death as well?

What is euthanasia?

The term "euthanasia" ("eu" - "good", "thanatos" - "death") was first used by Francis Bacon in 17^th century and is defined differently in various sources, but the basic idea is the same - euthanasia refers to the process of intentionally ending a life in order to relieve suffering (also referred to as "mercy killing").

There are two ways of conducting euthanasia: passive and active. Passive euthanasia is defined as withholding the treatment necessary for the continuance of life while active euthanasia is conducted by using lethal substances or forces.

Modern medicine classifies euthanasia as voluntary, non-voluntary and involuntary. Voluntary euthanasia refers to a mercy killing with the consent of the patient. Active voluntary euthanasia is legal in Belgium, Luxembourg and Netherlands. Another form of active euthanasia is called "assisted suicide" and is conducted by a physician providing the patient with necessary means for suicide (such as lethal drugs), but not taking any action in the process itself.

Throughout the U.S. patients have the right to refuse treatment and receive only an appropriate pain management, even if the refusal leads to their death (passive voluntary euthanasia), but assisted suicide is legal only in states of Oregon, Washington and Montana.

Non-voluntary euthanasia is conducted when the consent of the patient is unavailable. Active non-voluntary euthanasia is illegal in all countries in the world except for Netherlands, where it is practised on infants in accordance with the Groningen Protocol.

Passive non-voluntary euthanasia is legal in India, Albania, and many parts of the U.S. and is also practised in hospitals of the U.K.

The third type - involuntary euthanasia - is in most cases considered murder. This type of a mercy killing is conducted without asking the patient or when they do not choose to give consent. Although judging by the definition it is same as murder, in some specific cases it can be considered a mercy killing. For example, if a soldier is shot so badly that he will definitely die in 10-15 minutes and is experiencing unbearable pain, and no painkillers are available, doctor shoots the soldier dead in order to save him from 15 minutes of suffering.

Legal and ethical issues

Euthanasia has been actively opposed by religious communities all around the world. Seems like the idea that "god gives us our lives and only he can take it away", actively advocated by all religions, gets in the way of objectively assessing the situation. However, apart from religion, there are also legal and ethical issues that cause disputes regarding euthanasia.

Being a very sensitive issue from ethical and legal perspective, euthanasia needs to be regulated by strict laws and concrete procedural standards. Lack of these laws, standards and principles can lead to misuse of the procedure by using experimental drugs on patients or for personal gain (like killing of the elders for getting the heritage).

While some countries like Scotland are in the process of discussing the legalization of euthanasia, in other countries like Australia even the propaganda of it is fraught with criminal prosecution.

Legalization of euthanasia has also led to rise in "medical tourism". Patients living in countries where mercy killings are illegal often travel to countries where it is legal, in order to get assistance to end their lives. One of the most visited countries for assisted suicide is Switzerland, mostly conducted by the assisted dying organization Dignitas, established in 1998 by Ludwig A. Minelli.

According to some sources, thousands of people apply for assisted suicide in Netherlands every year, but since there is a clause demanding a close doctor-patient relationship for conducting mercy killings, euthanasia tourism is not very popular in this country.

Euthanasia in Azerbaijan

Although euthanasia is illegal in Azerbaijan, lately it is on focus of the doctors, bioethicists and lawyers.

Azerbaijan, together with 192 other countries has adopted the UNESCO Bioethics and human rights declaration in 2005.

The new bill on "Patient Rights" prevents conducting euthanasia with consent of the patient, his/her relatives or other individuals representing their interests. In case of establishing the fact of brain death of the patient, medical councils will be authorized to make the decision (in writing) to stop the use of means of keeping the patient alive.

There is a Law "On protection of health of the population of Azerbaijan Republic", adopted June 26, 1997, but it lacks the mechanism for implementation of patient rights.

Prof.Dr., Head of the Azerbaijan Unit of the International Network of the UNESCO Chair in Bioethics, Vugar Mammadov believes that Azerbaijan has a more progressive approach to the issue compared to its neighbors, like Russia, where a doctor who has conducted euthanasia can be sentenced up to 16 years in jail. In Azerbaijan such actions are regulated by the Criminal Code, and a doctor who has conducted a mercy killing will be jailed for up to 3 years.

Mammadov also stated that at this point the legalization of euthanasia contradicts the legal framework, but from the ethical approach it is necessary. "Also, we do not need templates, we must go our own way. If we relieve suffering of our patients, they might not be willing to die."

Since euthanasia is a procedure involving a decision about a person's death, it is vital to be absolutely sure about all the details regarding the issue, including the diagnosis, the legal perspective, etc.

Human rights activist Matanat Azizova says that it is important to organize good trainings for doctors, send them abroad for internships, invite world-class doctors around the world for symposia and trainings. "We have to keep in mind that doctors often come up with wrong diagnoses".

That is why before legalization, doctors' professional skills should be improved, she added.