The actuality and the historical background of covert Euthanasia in Albania.

Euthanasia is not legal in Albania, yet there is strong evidence that euthanising a terminally ill patient is not an unknown concept for the Albanians. The first mentioned case of euthanasia is found in 7(th) century AD mythology and during the communist regime (1944-1989), allegations of euthanising political prisoners and possible rivals in the struggle for power have widely been formulated. There is a trend among relatives and laymen taking care of terminally ill patients to apply tranquilisers in an abusive dosage, or even against medical advice, aiming at sedating the ailing patient. These actions, the refusal to keep on consistently applying life prolonging treatment, and other data, suggest that covert euthanasia is a practice and legal interventions are needed towards formalising it. This might well improve end-of-life care standards, since the inadequacy of structures, such as hospices and residential asylums, is becoming a major drawback in the struggle for dignity and accessible socio-medical help for third age persons and terminal patients.

[Euthanasia in history and the present - in the spectrum between euthanasia and terminal care]. / Euthanasie in Geschichte und Gegenwart-- im Spektrum zwischen Lebensbeendigung und Sterbebeistand.

Euthanasia signifies in antiquity an easy and happy death and not at all an active termination of life, which was forbidden in the Hippocratic oath, but justified by philosophers. In the Christian middle ages active euthanasia and abortion are explicitly refused. At the beginnings of modern times MORE (1516) and BACON (1623) plead for euthanasia and differentiate for the first time between "euthanasia interior" as a mental preparation and "euthanasia exterior" as a physical and direct termination of life. Around 1900 a change takes place--in medicine as well as in the humanities and arts. The lawyer Karl BINDING and the psychiatrist Alfred HOCHE (1920) support active euthanasia in the case of mental deficiency; similar views are taken by the population. Under the "Third Reich" euthanasia unlawfully is carried out as termination of life without or even against consent. Today oaths, declarations and laws are intended to prevent such a "medicine without humanity" (MITSCHERLICH and MIELKE 1947). Active voluntary euthanasia is under certain conditions allowed by the legislation in some countries (Netherlands, Belgium, Luxembourg). Essential seem the consideration of different types of euthanasia and above all a psychical-mental assistance in the process of dying. The height of culture is measured by dealing with death and dying.

The evolution of euthanasia and its perceptions in Greek culture and civilization.

Death has preoccupied humanity since before the dawn of civilization. As a multidimensional and moral problem, the end of life has concerned different civilizations, and different approaches to euthanasia, or "good death," have been developed in each culture. In Greece, there is a long record of the culture's evolving attitudes toward death and euthanasia.A more widespread knowledge of the views and traditions surrounding the act of euthanasia can contribute to a better understanding of the controversies surrounding modern attitudes and practice.

Ancient euthanasia: 'good death' and the doctor in the graeco-Roman world.

This article maps the concept of 'good death' (euthanasia) in the ancient world and explores the marginal role of the doctor at a 'good dying'. His assistance was not needed when the Homeric warrior died as a hero and was expected to accept death with resignation. Later the city-state regarded as heroes the men fallen for the cause of the community, honouring these model citizens as those who died well. In the more individualistic age of Hellenism and the Roman Empire, a death in luxury or without suffering could be styled euthanasia. The doctor had neither a place in those acts of dying nor in cases of natural death. He shunned death as a failure of his art. Sometimes a doctor was called in to assist in voluntary death, a role that was not forbidden by the Hippocratic oath. An appeal to this oath by opponents of euthanasia in the modern sense of the word therefore is mistaken.

[Euthanasia]. / Eutanazija.

The paper gives a historical overview, and describes psychosociological constellation and tactics of the euthanasia movement. Further, medicosocial experiment and medicolegal engineering which preceded it and followed it are presented on the example of euthanasia in The Netherlands. Legal, ethical, formally logical and psychological arguments against euthanasia are presented. The article concludes with the opinion that it was the duty of the World Medical Association to protect medical profession with the procedure of demedicalization of euthanasia, and to appropriately punish the Royal Dutch Medical Society for breaking professional ethical codex in its essential part, which is the basis of the very identity of medical profession.

Euthanasia.

This article provides a brief review of the history of euthanasia. The problems involved in withholding or withdrawing treatment, physician-assisted suicide, and arguments for or against euthanasia are discussed. Changes in both societal and physician attitudes and practices are presented.

The history of euthanasia debates in the United States and Britain.

Debates about the ethics of euthanasia and physician-assisted suicide date from ancient Greece and Rome. After the development of ether, physicians began advocating the use of anesthetics to relieve the pains of death. In 1870, Samuel Williams first proposed using anesthetics and morphine to intentionally end a patient's life. Over the next 35 years, debates about the ethics of euthanasia raged in the United States and Britain, culminating in 1906 in an Ohio bill to legalize euthanasia, a bill that was ultimately defeated. The arguments propounded for and against euthanasia in the 19th century are identical to contemporary arguments. Such similarities suggest four conclusions: Public interest in euthanasia 1) is not linked with advances in biomedical technology; 2) it flourishes in times of economic recession, in which individualism and social Darwinism are invoked to justify public policy; 3) it arises when physician authority over medical decision making is challenged; and 4) it occurs when terminating life-sustaining medical interventions become standard medical practice and interest develops in extending such practices to include euthanasia.

A good death: is euthanasia the answer?

Euthanasia--particularly active voluntary euthanasia--and assisted suicide are subjects of continuing controversy. Historical attitudes, current concerns, the situation in the Netherlands, and the positions of various medical associations are reviewed. Major arguments for and against active euthanasia are presented, with special consideration to the role that health care providers might be asked to perform should active euthanasia and assisted suicide be given societal sanction. The authors conclude that better pain management and A willingness to provide care within already established ethical and legal guidelines, not the legalization of active euthanasia and assisted suicide, are the appropriate responses to current proposals for assistance in dying.

A probable case of euthanasia amongst prehistoric aborigines at Roonka, South Australia.

Amongst skeletons recovered from an archeological survey at Roonka on the lower Murray River in South Australia was that of a pregnant woman. The position of the full term foetus and evidence of head trauma to the woman suggests that a mercy killing took place following failure of childbirth. The study of this burial provides an insight into Aboriginal society which would not be available from other sources.

Physicians and the dying: a historical sketch.

The tradition fo Western medicine established during the period of classical antiquity and extending through the early modern period encouraged the physician to avoid or to refuse to treat the seriously and/or terminally ill patient. The cultural environment and general attitudes toward death and dying helped to maintain this practice. Since the nineteenth century, however, the physician has increasingly accepted more responsibility, until he has become the central figure in management of the terminally ill patient. This paper examines the evolution of the relationship between the physician and the dying patient with the intention of illuminating various factors which helped to determine that relationship.