Eutanazijos terminų vartojimo bioetikoje bei teisėje problematika Lietuvoje

LTStraipsnyje keliama eutanazijos terminų vartojimo bioetikoje ir teisėje problematika Lietuvoje. Daugelio autorių tiek bioetikos, tiek teisės mokslo darbuose, tyrinėjant eutanazijos temą, gausu eutanazijos termino vartojimo netikslumų. Analizuojant pasaulinę praktiką galima sakyti, kad terminologija nutiesė kelią eutanazijai. Pasitelkiant eufemizmus buvo parenkamos sąvokos, kurių turinys neatitiko tikrovės. Panaši tendencija pastebima ir Lietuvoje. Dažniausiai eutanazija ir savižudybė su gydytojo pagalba sutapatinamos ir nagrinėjamos kartu, nors vienu atveju yra nužudymo, o kitu atveju -- savižudybės veiksmas. Apskritai atsižvelgiama tik į paciento valią, o gydytojo vaidmuo nėra vertinamas. Medicinos etikos specialistai pasyviąja eutanazija vadina gydymo netaikymą leidimo numirti atveju, ir atvirkščiai. Tai matyti ir teisininkų darbuose. Šiame straipsnyje, vadovaujantis universaliais etikos kriterijais, eutanazija atskiriama nuo savižudybės su gydytojo pagalba bei nuo pasinaudojimo paciento teise atsisakyti gydymo (būtų savižudybė, jei gydymas, kurio atsisako pacientas, yra efektyvus ir palaiko gyvybę; būtų etiškai pateisinama, jei terminalinis ligonis atsisako neefektyvaus gydymo). Eutanazijos terminu įvardijamas gydytojo neskausmingas gyvybės atėmimas terminalinės būklės kenčiančiam pacientui, norinčiam mirti: t. y. gydytojo sukelta ar gydytojo pagreitinta (turint tikslą atimti gyvybę) mirtis. Ligonio nužudymas įmanomas atliekant veiksmą, atimantį pacientui gyvybę (aktyvi eutanazija), arba neveikimu, netaikant priemonių, galinčių palaikyti gyvybę (pasyvi eutanazija). Abiem atvejais paciento mirties priežastis yra eutanazija. [Iš leidinio]Reikšminiai žodžiai: Eutanazija; Savižudybė; Teisė atsisakyti gydymo; Euthanasia; Suicide; Refusal of treatment.

ENThe aim of the article is to reveal the problem of euthanasia terminology usage in law and bioethics in Lithuania. To reach the goal the following tasks have been advanced: 1. Present the analysis of scientific works in law and bioethics published in Lithuania on the issue of euthanasia from the point of view of its terminology usage. 2. Study the evolution of the term euthanasia and present the examples of terminology usage of its specific varieties, relying on the universally accepted ethical criteria (distinguish euthanasia from a physician assisted suicide). 3. Distinguish euthanasia from patient's right to refuse the treatment. In the introduction the importance of the topic is emphasized. The article is divided into three parts. The first part presents the analysis of scientific works in law and bioethics published in Lithuania on euthanasia concentrating on the "euthanasia" term usage. The studies in this field revealed the numerous cases of the term being largely misused both in law and bioethics in the scientific works written by different authors. Observing the international practice in the countries where euthanasia has been legalized the role of the terminology becomes absolutely evident. Relying on euphemisms certain definitions have been specified, their content, however, does not reflect reality. The similar tendency is observed also in Lithuania. As a rule, euthanasia and physician assisted suicide are equated and treated similarly, even though the first case deals with killing and the second -- with suicidal action. Generally, only a patient's willingness is taken into consideration while the physician's role remains unevaluated.The experts in medical ethics define it as passive euthanasia, when treatment is stopped in order to allow to die and vice versa. That practice also affects the legal work. In the second part of the article, as the universally accepted ethical criteria suggest the line is drawn between euthanasia and physician assisted suicide. It is strongly emphasized that the word "euthanasia" is formed from two Greek words -- "eu" and "thanatos" which mean "good death" or "happy death". Initially, its primary meaning was as blessed and happy death, but not the premeditated painless killing of a person in order to avoid the ongoing pain due to incurable illness, or to stop the deplorable existence depressed by a grave disease and infirmity. The direct meaning of this word is truly positive and acceptable in compliance with the universal tradition of saving life. However, at the present time the word "euthanasia" is used to denote a doctor's painlessly terminating the life of a suffering, terminally ill patient who wishes to die: physician produced or physician induced death. Advocates of euthanasia often call it a mercy killing. Killing of a patient becomes possible on commitment of a direct action of taking his life (active euthanasia) or non-commitment while refusing to apply means to support his life (passive euthanasia). In both cases the reason of the patient's death is killing. Physician assisted suicide is the case of a suicidal action. The third part of the article considers the right of a patient to refuse the treatment, emphasizing the fact that in such cases the death of the patient cannot be defined as euthanasia. [From the publication]