Darbas iš casa sassari,
Some courts hold that it is mandatory in any case, while the other reduce the role of the tribunals only darbas iš casa sassari disputes arising from the decision to withdraw life-support.
Praktika „Infomagiovani“, Sasario savivaldybėje (Sardinija, Italija)
Keywords: withdrawal of treatment, passive euthanasia, family law, judicial approval, terminally ill patients. Būtinybė gauti teismo leidimą civilinėse bylose dėl nepagydomai sergančių pacientų gyvybės palaikymo nutraukimo Straipsnyje pateikiama lyginamoji teismų pozicijų analizė dėl būtinybės gauti teismo leidimą nutraukti gyvybės palaikymą.
Kai kurie teismai mano, kad tai yra privaloma bet kuriuo atveju, o kiti sumažina teismų vaidmenį tik ginčuose, kylančiuose dėl sprendimo atsisakyti gyvybės palaikymo. Pagrindiniai žodžiai: gydymo nutraukimas, pasyvi eutanazija, šeimos teisė, teismo leidimas, nepagydomai sergantys pacientai.
Published by Vilnius University Press This is an Open Access article distributed under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Such was the wording of the 14th Arti prekybos galimybės court of the Federal District Brasilia in Brazil in the public civil action to challenge the legitimacy of a resolution by the Darbas iš casa sassari Medical Council allowing an omission of acts by physicians concerning a terminally-ill patient refusing darbas iš casa sassari undergo life-supporting treatment 1.
In fact, the Brazilian federal court has reiterated the main tendency in medical law over the last decades: both the law and the judiciary came to a conclusion that the dignity of the patient concerned and his right to autonomy in decision-making should prevail over the intentions of his close relatives or physicians, regardless of the fact its non-application could result in subsequent forex įmonių sąrašas. The Court of Justice of Rio Grande do Sul an appellate court of a state ruled to reject the appeal, finding that the he cannot be compelled to undergo surgery Ministero Publico c.
Joao Carlos Ferreira Such examples may be observed in various civil law and common law states where either the law or judge-made law recognizes the right to withdraw life-supporting treatment. Various courts recognize that a decision to terminate life-supporting treatment is a highly-personal matter OLG Karlsruhe The problem is complexified by the circumstance that euthanasia-related law either does not exist in some countries at all, and that one or another type of euthanasia is recognized by courts certainly, if it is actually recognizedor the existing law does not specify the role of the courts in decision-making.
Another problem is evoked by the fact that the issue of judicial approval of termination of treatment is still under-investigated in the field of academic literature. Little legacy is devoted to the role of courts concerning the necessity of judicial approval in case of termination of life-supporting treatment.
For instance, Ann Massiein her paper on withdrawal of treatment in respect with minors, mentioned that some US courts found that decision-making should be handled by physicians and families of the respective patient, but mentioned that in the late s, an American hospital in Chicago was reported to be unwilling to dislodge a respirator of a severely darbas iš casa sassari iš casa sassari, six-month-old infant upon request of his father, anticipating civil or criminal liability for acting without a court order Massie, Ethicists occasionally suggested that such decision-making should better be a subject of discussion or an ethical, but not judicial review Doyal, Larcher,p.
Hopefully, some bioethics specialists highly appreciate the role of courts in protecting healthcare service employees from prosecution Larcher, Lask, McCarthy, ; p. These states have been selected by the fact that the given countries provide the largest and the most comprehensive case-law in respect with termination of life-supporting treatment. The states of Latin America, such as Brazil or Argentine, still possess relatively little case-law in respect of the topic. The positions of the courts in various states: pro and contra the judicial intervention in the end-of-life decision-making process 1.
Italy An unfortunate Italian artist, named Piergiorgio Welby, has led a baffling life, combatting fasciocapulohumeral muscular dystrophy for the major part of his being. However, in the mid s Welby collapsed due to a severe respiratory failure and was therafter tube-fed, and was breathing by means of an antomatic respirator.
The unfortunate painter was in a clear mind, being able to communicate by means of a computer and even write a book about his torment 3. By the viršūnių prekybos sistemos wiki, Welby has repeatedly expressed his wish to die, including the statements in his book. However, his treating physician withstood from prekyba pasirinkimo galimybėmis pradedantiesiems the life-support machinery, despite Welby repeatedly asked him to do so.
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Giuseppe Casale Being devasted by the rejection of his application to the court, Welby soon asked a physician named Mario Riccio to dislodge the automatic respirator, who performed his request. As a result, he was soon prosecuted for assisting in a suicide, but was acquitted, as the Court of Rome found that he merely did what Welby asked him Nei confronti di Riccio Mario As we may deduce from the given case and its outcome, the patient practically committed a suicide though, assisted — in fact, such it was classified by the Court of Rome Nei confronti di Riccio Mario Giovanni Nuvoli, the ward in the case of Nuvoli, adjudicated by the Court of Sassari, suffering from ALS, whose wife was appointed as a guardian for limited purposes in February Caso Giovanni Nuvoli However, proceedings on his hypothetical plea to withdraw life-supporting treatment were apparently never commenced.
But does that mean that a firm decision to terminate life-supporting treatment should not require a judicial approval unless some dispute arises Woods v.
New England Sinai Hosp.
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But if we may presuppose that it would be, using the wording of the Supreme Court of the State of Kentucky, United States, in the case of Woods v. Concerning Italian courts and the issue of whether a court approval is necessary to stop life-support, this question is quite tricky.
Italian courts granted orders for appointing a guardian who was to be authorized to terminate life-supporting treatment, either in advance meaning the ward was in relatively good health and is competent, but wishes to appoint a guardian who could authorize to terminate his life-support once he becomes incapacitated 9or at the time where the person concerned was close to death Trib.
Upon such position, the court order seems to be apparently necessary.
Netherlands The Netherlands were arguably the first country where ethical guidelines suggested not to prolong the allegedly pointless medical treatment of dying patients, even regardless of the fact that the law did not tolerate such an approach, which resulted in criminal trials dvejetainis variantas balta etiketė the early s see judgment of the trial court of Leeurwarden: Rechtbank Leeuwarden Though not being practically de-criminalized in law before the law legalizing euthanasia went into force inphysicians who assisted in suicide often received lesser prison sentences than if they would commit an intentional murder under any other circumstances for instance, see Rechtbank Rotterdam Stichting Amphia Ziekenhuis However, it does not mean no-CPR orders may not be impugned in a courtroom: they may be, if plaintiffs introduce sufficient proof of errors of physicians dvejetainiai variantai kas vyksta, e.
At the same time, plaintiffs will not prevail in an action to compel the hospital staff to prolong medical treatment, unless proving that the medical staff is wrong in their inferences, suggesting that further medical treatment of a patient is pointless from a medical point of view 1,2,3, 4 t.
Despite Dutch courts declined approving no-CPR orders for incompetent patients, claiming that it is too darbas iš casa sassari for anybody to draft such a document acting as a surrogate Rechtbank Zeeland-West-Brabant Besides, informing on drugs that could induce death with necessary details does not count as assistance in suicide: in a trial before the first-instance court of Hertogenbosch, a physician was acquitted, being previously prosecuted for informing a woman who claimed she had wished to die concerning drugs that could cause death, their quantity and manner of consumption.
The woman apparently died from toxic shock and the suspect was charged for assisting in suicide. The physician was acquitted Rechtbank Hertogenbosch United States American courts are far from being uniform concerning the role of courts in the process of withdrawal of treatment. The earlier judgments usually indicated that courts would not tolerate unauthorized withdrawal of treatment. In the matter of Springbrought before the Supreme Court of Massachussets, the court had to decide whether to grant an order to terminate the treatment of an elderly dying man who was subjected to hemodyalisis owing to kidney failure.
Therein, the Court held there could be a multitude of circumstances concerning treating incompetent patients that require an approval of the court, and stressed that unauthorized acts could be subject darbas iš casa sassari civil and criminal liability though this approval could not make one immune from liability on other grounds. In this case, the Court held a position darbas iš casa sassari such programinės įrangos testavimo prekybos sistema need an approval of the court in the Matter of Spring However, in case from Washington D.
Kennedy Memorial Hospital, Inc. However, a year later this court held that the withdrawal of life-support for a minor does not necessitate a prior court approval, the courts must be open to hear the matter upon the request of the party. In Storarthe Court held that there is no actual requirement to ask a court order to terminate treatment of terminally-ill patients, it anticipated that the legislature could enact such a kind of procedure. In the next decades, a variety of court positions based on legislation and case-law could be found in United States jurisprudence.
In some jurisdictions, the courts are authorized to approve withdrawal of treatment or give consent to no-CPR or do-not-resuscitate orders concerning minors under a statute in re C.
However, if the patients are not terminally ill, courts may refuse to authorize terminating treatment which could save the life of the patient Brophy v. Generally speaking, this dispute arose in the very first cases concerning a right to withdraw life-supporting treatment in the mids: Quinlan and Saikewicz. Such a requirement is distinguishable from the judicial overview traditionally required in other matters such as the adjudication and commitment of mental incompetents.
Rather, such questions of life and death seem to us to require the process of detached but passionate investigation and decision that forms the ideal on which the judicial branch of government was created. Canada Similarly, Canadian courts have also faced the issue of deciding on the role of courts in authorizing withdrawal of treatment, which is also far from uniform.
In the first-ever case on withdrawal of treatment case of Lavalee ina severely injured infant was issued a DNRO by the hospital personnel, which was impugned by the forbearers of the child.
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Because of this, the hospital itself applied to the court to receive an authorization, grounding the claim upon Sec. The Court based its position upon the American case of Shirley Dinnerstein and concluded that neither a court approval, nor the consent of the close relatives is necessary for issuing a do-not-resuscitate order Child and Family Services of Central Manitoba v.
Lavalee et. The said case occurred in Manitoba. Another case, Sawatzkyexpressed a position that the court approval is necessary in case some dispute concerning the decision to withdraw treatment occurs. The patient was issued a do-not-resuscitate order, to which his relatives did not consent, and filed an injunction action to restrain the defendant hospital from doing so.
Considering the role of the court, the judge stated that regardless courts do not have expertise in medical decisions, they definitely have it regarding determining the legality or the illegality of the disputed decision before a patient deceases.
The court granted an interlocutory injunction to restrain the hospital from issuing a do-not-resuscitate order in that case Sawatzky v.
Riverview Health Centre Inc The judgment of Golubchukinvolved a man who sustained a severe head injury, whose condition deteriorated thereafter.
Later, he experienced heart problems and a kidney failure, and soon was totally dependent on artificial feeding and other life-supporting measures. The staff of the hospital suggested withdrawing treatment of the patient, but family members strongly opposed it and filed an injunction action to restrain the defendant hospital from terminating treatment.
The Court also added that a dispute regarding withdrawal of treatment is triable and not frivolous. In respect with the remedies, the Court said that repaying damages will not be an adequate remedy, as no relief would actually compensate the loss of a human life, finding that injunction restraining a healthcare unit from non-consensually terminating life-support is adequate for plaintiffs Golubchuk v.
Salvation Army Grace Hospital Germany German courts have repeatedly approached the question of necessity of a court authorization to withdraw life-supporting treatment.
In the earlier case-law, courts believed that the decision to withdraw life-support does not require a court approval LG Munchen I Of such a position was the land regional court Landsgericht of Duisburg inwhere a plaintiff, the daughter of an immobilized elderly woman that was unable to communicate and react, asked for a court order to terminate life-support. The land regional court of Duisburg said that plaintiff has a right to apply to the court for it, and claimed that it is up to the courts to draw up the criteria upon which withdrawal may be authorized, contemplating a few of them darbas iš casa sassari my comment concerning this case in Lytvynenko,p.
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In that case, the court authorized to withdraw treatment LG Duisburg Another firm support of the position of the strict necessity of a court order to withdraw the life-support was demonstrated by the higher regional land court of Karlsruhe OLG, Oberlandesgericht Karlsruhe in According to the facts of the case, an elderly man suffered a pulmonary embolism with a cardiovascular arrest rendering him comatose. The spouse, the plaintiff, being his legal guardian sinceand applied to the court to authorize her to terminate treatment see the full description darbas iš casa sassari the case in Lytvynenko,p.
Concerning the necessity of a court order, the court said that neither the court, nor the guardian decides — it is a decision [previously] actually made by the patient himself. The court augmented that a court approval is necessary to avoid any suspicion in manslaughter OLG Karlsruhe As the case-law of Germany developed especially after the decision of the Federal Supreme Court inwhich concluded in its judgment that courts have cognizance over claims to withdraw treatment and the absense of legal basis in the Civil Code is no actual obstacle for applying for a court authorization to terminate treatment Bundesgerichthof In the s case-law of the Federal Supreme Court Bundergerichthof the position concerning the necessity of a court order was clarified, leaving little room to perform it without commencing civil proceedings.
The decisions of the Federal Supreme Court of Bundesgerichthof In other situations, e. Apparently, if the caregiver has to determine treatment requests of the ward himself or deduce the presumed will of the patient, and decides to consent to terminate life support, court approval is also necessary Bundesgerichthof Conclusions As it may be deduced from the paper, there is no uniform position concerning the role of tribunals in decision-making regarding the withdrawal of life-supporting treatment.
The said problem is aggravated by the fact that issues of euthanasia are quite novel for most countries of the world and the legal systems frequently do not possess any legislation regarding it. Against such background, some courts may be eager to determine the issue in the field of case-law, while the others may be quite reluctant to authorize termination of treatment without appropriate legislation.
The courts have also no uniform position in respect of their role in decision-making. Some courts, however, did emphasize that the right to refuse medical treatment involves a conflict between the constitutional or the common-law-based rights, namely the right to life and the right to self-determination D.
I contend this position to be the most appropriate. The current position of the German courts is more strict, as the contemporary case-law indicates that the only situation when a court approval is not necessary is when a person has drafted a will Patientenverfugung which corresponds the standards set out in the Civil Code and their health darbas iš casa sassari corresponds to the contents of the will and apparently, no disputes regarding this issue exist, as all darbas iš casa sassari disputes darbas iš casa sassari respect to this will be resolved in a court.
The position of Canadian courts is not uniform, as some of the provincial courts find that the role of courts could be potentially broader than in solving disputes concerning decision-making.
Darbas iš casa sassari position of Italian courts seems to confirm the position of necessity of a court order.
As we may behold from numerous disputes regarding euthanasia-related decision-making, a judicial review of the issue is essential to abort fraud and conspiracy, though it really may be cumbersome. But matters of life and death are always controversial darbas iš casa sassari be decided upon, and it seems that there is no ideal solution of the question, as on the one hand, proceedings in regard with termination of life-supporting treatment may be lengthy, but on the other, it is impossible to exclude the malicious intents of the persons, immediate to the patient concerned.
At the same time, the length of proceedings darbas iš casa sassari patients in a permanent vegetative state does not seem to be decisive in such case. References Academic literature Massie, A. MacLean Doyal, L. F60 Larcher, V.
Paediatrics at the cutting edge: do we need clinical ethics committees? Medical Law, 25, pp. Ministero Publico c. Nº N° CNJ: Reggio Emilia, Giudice Tutelare, decreto 24 luglio Reg. Caso Giovanni Nuvoli, Trib. Piergiorgio Welby c.
Giuseppe Casale, Trib. Woods v.
Commonwealth, S. DeGrella By and Through Parrent v. Elston, S. Child and Family Services of Central Manitoba v. Matter of Shirley Dinnerstein, 6 Mass.
Brophy v. OLG Karlsruhe, X, Trib.
Trieste, decreto del 3 lugliono. Caso Englaro, Corte di Cassazione, Sentenza n. Rechtbank Leeuwarden Rechtbank Rotterdam, Rechtbank Utrecht, Hof Amsterdam, Rechtbank Zeeland-West-Brabant,