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Dilemmas surrounding passive euthanasia--a Malaysian perspective

Talib N

Med Law, 2005 Sep;24(3):605-13.
PMID: 16229394

In western societies where the principle of autonomy is jealously guarded, perhaps active euthanasia is more often the focus of public concern and debates rather than any other forms of euthanasia. However due to the advance in technology and its corresponding ability in prolonging life, in Malaysia passive euthanasia presents more of a dilemma. For those concerned and involved with end of life decision-making, it is generally agreed that this is an area fraught with not only medical but legal and ethical issues. In Malaysia where the society is not homogenous but is multi-cultural and multi-religious, in addition to medical, legal and ethical issues, religious principles and cultural norms further impact and play significant roles in end of life decision-making. This paper seeks to identify the issues surrounding the practice of passive euthanasia in Malaysia. It will be shown that despite applicable legal provisions, current practice of the medical profession combined with religious and cultural values together affect decision-making which involves the withholding and/or withdrawing of life-saving treatment.

Matched MeSH terms: Euthanasia, Passive/legislation & jurisprudence*; Euthanasia, Passive/ethics
Withdrawal and limitation of life support in paediatric intensive care

Goh AY, Lum LC, Chan PW, Bakar F, Chong BO

Arch Dis Child, 1999 May;80(5):424-8.
PMID: 10208946

OBJECTIVES: To compare the modes of death and factors leading to withdrawal or limitation of life support in a paediatric intensive care unit (PICU) in a developing country.
METHODS: Retrospective analysis of all children (< 12 years) dying in the PICU from January 1995 to December 1995 and January 1997 to June 1998 (n = 148).
RESULTS: The main mode of death was by limitation of treatment in 68 of 148 patients, failure of active treatment including cardiopulmonary resuscitation in 61, brain death in 12, and withdrawal of life support with removal of endotracheal tube in seven. There was no significant variation in the proportion of limitation of treatment, failure of active treatment, and brain death between the two periods; however, there was an increase in withdrawal of life support from 0% in 1995 to 8% in 1997-98. Justification for limitation was based predominantly on expectation of imminent death (71 of 75). Ethnic variability was noted among the 14 of 21 patients who refused withdrawal. Discussions for care restrictions were initiated almost exclusively by paediatricians (70 of 75). Diagnostic uncertainty (36% v 4.6%) and presentation as an acute illness were associated with the use of active treatment.
CONCLUSIONS: Limitation of treatment is the most common mode of death in a developing country's PICU and active withdrawal is still not widely practised. Paediatricians in developing countries are becoming more proactive in managing death and dying but have to consider sociocultural and religious factors when making such decisions.

Matched MeSH terms: Euthanasia, Passive*
THE LEGALITY OF EUTHANASIA FROM THE MALAYSIAN AND ISLAMIC PERSPECTIVES: AN OVERVIEW

Alias F, Muhammad M, Kassim PNJ

Med Law, 2015 Sep;34(1):509-532.
PMID: 30759949

The subject of euthanasia has generated many controversial debates, particularly on its legality. This has been primarily due to the doctrine of sanctity of life which is a predominant principle in many religions and is embedded in moral values. The underlying precept is that human life is sacred and demands respect, as all life comes from God and life can only be taken away intentionally through due process of law. Thus, ending a person's life, even upon his or her request, is considered in many jurisdictions as a criminal offence. Irrespective of humanitarian motives, a doctor who aids a patient in this act will be in breach of his unequivocal duty as a doctor and considered to have committed an unlawful act, which will subject him to legal sanctions. Countries such as the United Kingdom, Australia, New Zealand and Turkey have explicit legal provisions banning, in particular, active euthanasia, while countries such as the Netherlands, Belgium, Switzerland and certain states in the U.S have taken positive steps to legalise euthanasia in certain aspects. The ethical codes and laws in Malaysia have yet to develop to the fullest extent in dealing with these issues. Although Malaysian statutory legislation contains provisions banning active euthanasia, the legal position on passive euthanasia remains implicit. In the absence of indicative legal provisions and judicial precedents governing certain matters arising, it has been the practice of the Malaysian courts to refer to relevant legal principles inherent in English cases. As Islam is proclaimed as the country's official religion, the Islamic perspective is also an important and influential factor in the development of the legal framework in Malaysia as a whole. Thus, there is a need for the existence of a clear and comprehensive regulatory framework governing the legality of euthanasia in Malaysia.

Matched MeSH terms: Euthanasia, Passive

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