Background reading material for Year 2 Semester 1 medical students at the Institute of Medicine Universiti Brunei for PPSD session on August 23, 2006 by Professor Omar Hasan Kasule, Sr.


Euthanasia also called mercy killing is defined as causing death to spare a patient from pain and suffering. Euthanasia reverses the customary role of the physician as a preserver into a destroyer of life. Active euthanasia, an act of commission that causes death, is taking some action that leads to death like a fatal injection. Passive euthanasia, an act of omission, is letting a person die by taking no action to maintain life. The Law views all forms of euthanasia, active and passive, as murder. Those who give advice and those who assist in any way with suicide are guilty of homicide. A physician is legally liable for any euthanasia actions performed even if instructed by the patient.



Euthanasia violates the Purpose of the Law to guarantee and protect the right to life. It also makes the physician assume God’s prerogative of causing death. Widespread practice of euthanasia can cheapen human life and make murder and even genocide more acceptable.



According to the principle of intention, there is no distinction between active and passive euthanasia because the end-result is the same. In many cases the distinction between legitimate life support withdrawal and criminal euthanasia in the underlying intention because the actions taken may be the same.



The principle of injury makes euthanasia illegal because it tries to resolve the problems of pain and suffering of terminal illness by causing a bigger injury which is killing. Continuation of pain in terminal illness is a lesser evil than euthanasia. Prohibition of euthanasia closes the door to corrupt relatives killing patients for the sake of inheritance by claiming euthanasia.



The patient cannot legally agree to termination of life because life belongs to the Creator and humans are mere temporary custodians. The determination of lifespan is not in human hands. Patients in terminal illness often lose competence and cannot make valid informed decisions on their treatment or the termination of life. A living will made before the present illness is a non-binding recommendation and can be reversed.



There is no legal basis for euthanasia. Physicians have no right to interfere with the lifespan that was fixed by the Creator. Disease will take its natural course until death. Physicians for each individual patient do not know this course. It is therefore necessary that they concentrate on the quality of the remaining life and not reversal of death. Life support measures should be taken with the intention of quality in mind. Instead of discussing euthanasia, we should undertake research to find out how to make the remaining life of as high a quality as is possible. The most that can be done is not to undertake any heroic measures for a terminally ill patient. However ordinary medical care and nutrition cannot be stopped. This can best be achieved by the hospital having a clear and public policy on life support with clear admission criteria and application to all patients without regard for age, gender, SES, race, or diagnosis.

Professor Omar Hasan Kasule, Sr. August 2006