Pas Legal Issues

Euthanasia and physician-assisted suicide are illegal under Article 84 of the Turkish Penal Code: “(1) Anyone who incites, encourages or supports a person`s decision to commit suicide or supports the act of suicide in any way shall be punished by imprisonment from two years to five years.” The section provides for harsher penalties for suicide (four to ten years); Encouraging others to commit suicide (three to eight years) and encouraging someone who does not understand the situation to commit suicide (criminal murder punishable by life imprisonment). The ACP States do not support the legalisation of physician-assisted suicide, the practice of which raises ethical, clinical and other concerns. ACP States and their members, including those who could legitimately participate in the practice, should ensure that all patients can count on quality care until the end of their lives, with the longest possible prevention or relief of suffering, a commitment to human dignity and the treatment of pain and other symptoms, and support for families. Physicians and patients must continue to work together to find answers to the challenges of living with serious illnesses before death (9). In particular, the Quinlan case firmly entrenched the right to refuse treatment as an essential element of patient autonomy. Karen Ann Quinlan was a 21-year-old woman who entered a persistent vegetative state after an alleged overdose of alcohol and tranquilizers in 1975. The New Jersey Supreme Court ruled to comply with his father`s request to unplug Quinlan`s ventilator and established the right to deprive adults of life-sustaining therapy in certain circumstances.9 This case, along with Cruzan, not only allowed a patient to refuse life-sustaining treatment, but also allowed a surrogate to make that decision. This principle has been refined to include the right to refuse artificial feeding and hydration, and the establishment of “best interest” standards that allow a surrogate mother to substitute judgment in the best interests of a patient with a disability when the patient`s wishes are unknown. The essence of these cases is summed up in the decision of the court of Natanson v. Kline: “Anglo-American law begins with the premise of complete self-determination. It follows that every person is considered the master of his own body and may, if he is of sound mind, expressly prohibit the performance of surgeries or other medical treatments that save lives. A physician may well believe that surgery or some form of treatment is desirable or necessary, but the law does not allow him to substitute his own judgment for any form of artificiality or deception.

“10 The principles introduced by this legal history have led to increasing public awareness of end-of-life issues and to the development and popularization of living wills such as living wills and DNR directives. Israeli and Jewish law prohibit physician-assisted suicide and active euthanasia. Passive euthanasia (stopping treatment or life-sustaining devices) is prohibited by Jewish law, but was authorized by the Tel Aviv District Court on December 9, 2014. Other bills, called “physician-assisted suicide” or “Sabbath clock,” have been debated in Parliament but have not come into force and would only legalize passive euthanasia. Gradually, end-of-life jurisprudence has developed that focuses on distinguishing between acceptable and unacceptable approaches to palliative care. While a patient`s right to demand deprivation of life support has been consistently upheld by the courts and public consensus, support for the SAP is limited and euthanasia remains illegal in the United States and most other countries. The future of the SAP is uncertain – policy studies are underway abroad and in Oregon, and data after these initiatives are slowly becoming available. Preliminary data have shown that the SAP is relatively free from abuse and bias under controlled circumstances, but it is impossible to predict the applicability of this data to the United States as a whole. The SAP debate has at least led to a renewed appreciation of improving palliative care, clarification of patients` wishes through living wills, and a focus on patient self-determination at the forefront of end-of-life care.

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