10/07/2004, 00.00
INDONESIA
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Euthanasia? The government should instead provide medical treatment to the poor, the Church says

by Mathias Hariyadi

Lack of money to pay for treatment pushes man to ask that his wife be euthanised.

Jakarta (AsiaNews) – For the first time in the history of the world's largest Muslim country, people are debating the issue of euthanasia in Indonesia. All because of Panca Satrya Hasan, a Jakarta man, who filed a request with the capital's Bogor Islamic Hospital asking that the plug be pulled on his seriously ailing wife, 33-year-old Agian Isna Nauli Siregar.

The woman, who suffered a permanent stroke and is on a life-support machine, was reacting to external stimuli, this according to the physicians treating her. Her husband claims instead that she has slipped into a coma.

"She won't be able to even recognise me for another 6 to 12 months," Hasan said. "I cannot watch her go through this difficult time like this". The two have been married for ten years.

For the past month Agian has been in the Special Stroke Unit of the Jakarta Central Hospital of Cipto Mangunkusumo. Prior to that, she was in the Bogor Hospital for over a month because of hypertension-induced brain damage. According to the doctors complications from a caesarean section she suffered included a stroke caused by post-natal poisoning.

Her husband Hasan asked that his wife be euthanised because he cannot afford the medical costs which are now running at about one million rupiahs (about US$ 100) per day. "I already owe 60 million rupiahs (US$ 6,000)," Hasan said. "If the government can no longer guarantee her right to live, then it is better to reduce her suffering," he added.

Agian's case is the first known case involving euthanasia in the vast Asian country and has sparked a debate.

According to neurologist Salim Haris, "it would be a different matter if the patient were conscious; for example, a patient suffering from acute cancer". In his view, it is incumbent on the physician to inform the patient's family that the illness is entering its terminal phase or is irreversible, which is the case when permanent brain damage occurs. It would be up to the family, the neurologist believes, to decide whether medical treatment should continue or not.

The neurologist in charge of Agian, Yusuf Misback, claims that Agian had a cerebrovascular incident but "never entered into a coma. She suffered a stroke". Contrary to the husband's claim that she was in a coma, Dr Misback said that she could open her eyes, scream, answer simple questions and follow easy orders. "Coma patients are instead generally unresponsive," he added.

For Fr Franz Magnis-Suseso SJ, professor of ethics at the Jesuit-run Philosophical Institute of Driyarkara in Jakarta, "it is the state's responsibility to take care of any Indonesian citizen who is terminally ill and suffers from lack of money".

Although, he pointed out, the Church has always been against euthanasia the issue in this case is not "whether euthanasia is legal or illegal [. . .] but whether or not the authorities have fulfilled their duty to take care of the needy." According to the Indonesian Constitution, Father Magnis-Suseso insisted, the Social Welfare Department is legally bound to assist the terminally ill who cannot pay for treatment on their own.

In theory at least, active and passive euthanasia are illegal under Indonesian law. However, Indriyanto Seno Adji, Criminal Law expert at the University of Indonesia, is of the opinion that Agian's family could file a request with the district court for the right to euthanise. "If the court approves the request," Seno Adji said, "then euthanasia will be legal."

Iskandar Sitorus, chairman of the Medical Legal Aid Institute, shares this view adding that the Institute plans to provide Hasan with eight lawyers to fight his case.

"Hasan's case has not been regulated by the state. And as long as this matter has not been regulated, his request is theoretically valid," he explained.

Sitorus also rejected the argument that Hasan could be convicted for murder. "Where is the logic behind that? He is asking the state to commit euthanasia because he won't do it himself."

Indonesia's Health Minister Achmad Sujudi declined any comment about the case but said that euthanasia will never be accepted in the country.

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