Australien - Max-Planck-Institut für ausländisches und

Australien - Max-Planck-Institut für ausländisches und

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Australien
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Regine Heemann
Staatsanwältin in Stuttgart, ehemalige Mitarbeiterin am Max-PlanckInstitut für ausländisches und internationales Strafrecht, Freiburg i.Br.
unter Mitarbeit von
Gerhard Werner
Rechtsreferendar, ehemaliger Mitarbeiter am Max-Planck-Institut für
ausländisches und internationales Strafrecht, Freiburg i.Br.
Übersicht
Australien ist ein Bundesstaat; die Gesetzgebung auf dem Gebiet des Strafrechts fällt in erster Linie in die Kompetenz der Einzelstaaten.
In den Ländern Queensland (Criminal Code Act von 1899), Western Australia (Criminal Code von 1913), Tasmania (Criminal Code von 1924) und
Northern Territory (Criminal Code von 1983) existieren Kodifikationen des
Strafrechts, in den restlichen Ländern wurden zusammenfassende Gesetze in
Fortführung des Common Law erlassen (in New South Wales - und entsprechend im Australian Capital Territory - der Crimes Act von 1900, in
Victoria der Crimes Act von 1958, in South Australia der Criminal Law Consolidation Act von 1935-1966). Hier muß also ergänzend auf das rezipierte
Common Law Englands abgestellt werden.
Trotz der unterschiedlichen Kodifikationen wird das Problem der Sterbehilfe
jedoch rechtlich weitgehend gleich behandelt.
Folgende Problemkreise müssen jeweils gesondert betrachtet werden:
-
1.
die aktive Sterbehilfe (active euthanasia): das Verabreichen von Mitteln,
die den Tod herbeiführen,
die passive Sterbehilfe (passive euthanasia, letting die): der Verzicht auf
lebensverlängernde Maßnahmen und
das Verabreichen schmerzstillender und gleichzeitig lebensverkürzender
Medikamente.
Gesetzliche Regelung der Sterbehilfe
Spezielle gesetzliche Regelungen zur Sterbehilfe bestehen nur in folgenden
Einzelstaaten (vgl. Dokumente 1.4-1.6):
-
South Australia: Natural Death Act (1983)
Northern Territory: Natural Death Act (1988)
Victoria: Medical Treatment Act (1988)
Diese Vorschriften beschränken sich jedoch darauf, das Recht eines Todkranken auf Verweigerung weiterer medizinischer Behandlung festzuschreiben und als Gegenstück den die Anweisung befolgenden Arzt von seiner
Verantwortung freizustellen. Das Recht zur Verweigerung weiterer Behandlung (refusal of treatment) wird dabei an die Volljährigkeit des Patienten
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(18 Jahre), seine uneingeschränkte Fähigkeit zum Verständnis der Tragweite
seiner Entscheidung und an die Entgegennahme der Erklärung durch zwei
Zeugen geknüpft. Formularmuster für entsprechende Patientenverfügungen
sind als Anhang zum Gesetz (Victoria, Dokument 1.6) bzw. in einer ergänzenden Verordnung (Northern Territory, Dokument 1.5) niedergelegt.
Außerhalb dieser spezialgesetzlichen Regelungen wird auf die allgemeinstrafrechtlichen Bestimmungen zurückgegriffen. Eine dem § 216 dStGB vergleichbare Vorschrift besteht allerdings in keinem der Einzelstaaten.
1.1
Aktive und indirekte Sterbehilfe
Aktive Sterbehilfe wird unter das allgemeine Fremdtötungsverbot subsumiert, so daß jemand, der einen anderen vorsätzlich tötet, wegen Mordes mit
Todesstrafe oder lebenslänglichem Zuchthaus bestraft wird (u.a. ss. 300-303
CC Queensland; ss. 277 ff. CC Western Australia - Dokument 1.2). In
Queensland und Western Australia enthält das Strafgesetzbuch sogar die ausdrückliche Regelung, daß das Motiv des Täters keinen Einfluß auf die Strafbarkeit hat (s. 23 CC Queensland; s. 23 CC Western Australia - Dokument
1.2).
Ausdrücklich geregelt ist außerdem - auch in den anderen Staaten -, daß die
Einwilligung des Opfers für die Strafbarkeit des Täters irrelevant ist
(s. 53 CC Tasmania; s. 284 CC Queensland; s. 261 CC Western Australia Dokument 1.2; s. 26 (3) CC Northern Territory - Dokument 1.1).
Dieser Grundsatz gilt über die Common Law-Rechtsprechung auch in den
anderen Staaten.
In den Fällen, in denen Medikamente zur Schmerzlinderung verabreicht werden, die den Todeseintritt beschleunigen, wird in Anlehnung an den englischen Fall Dr. Adams von 1957 die Kausalität zwischen der Handlung und
dem Tod verneint: nicht das Medikament, sondern die Krankheit wird als
Ursache des Todes angesehen (rule of double effect).
1.2
Passive Sterbehilfe
In allen Einzelstaaten ist grundsätzlich derjenige, dem das jeweilige Strafgesetz oder das Common Law eine Rechtspflicht zum Handeln auferlegt, verpflichtet, die erforderliche Sorgfalt (reasonable care) zu beachten bzw. die
Übersicht
223
ihm anvertraute Person mit allem zu versorgen, was notwendig ist, um das
Leben dieser Personen zu schützen und zu erhalten (duty to provide necessaries of life) (ss. 285-288, 290 CC Queensland; ss. 149-152, 183 CC Northern Territory - Dokument 1.1; ss. 262-267 CC Western Australia - Dokument 1.2; ss. 144 (1), 146, 148 CC Tasmania).
Im Northern Territory existiert sogar eine für jedermann bestehende Hilfspflicht in s. 155 CC (Dokument 1.1).
Werden diese Handlungs- und Sorgfaltspflichten nicht eingehalten, so macht
sich die betreffende Person nach den u.a. oben genannten Spezialvorschriften
bzw. zum Teil auch wegen Tötung durch Unterlassen strafbar, wobei manche
Gesetze die Rechtspflichten näher konkretisieren (ss. 285-291, 293, 300-305,
310 CC Queensland; ss. 149-153, 161 CC Northern Territory - Dokument
1.1; ss. 152, 153, 156, 157 CC Tasmania; ss. 3, 5 CA Victoria i.V.m. R. v.
Stone and Dobinson (1977) 2 WLR 169; vgl. die von dem Australian College
of Paediatrics aufgestellten Fallbeispiele - Dokument 2). Auch hier muß einem Kranken aber nur die gewöhnliche Hilfe zukommen (ordinary care), auf
außergewöhnliche Maßnahmen (extraordinary care) kann verzichtet werden.
Als gewöhnlich werden Maßnahmen angesehen, die dem Patienten keine
zusätzlichen Schmerzen bereiten und vernünftigerweise Hoffnung auf Erfolg
versprechen.1 Kodifiziert ist diese Unterscheidung bisher nur in South
Australia im Natural Death Act von 1983 (Dokument 1.4), der jedem das
Recht zugesteht, für den Fall einer unheilbaren Krankheit die Anwendung
von extraordinary measures verbindlich auszuschließen. Nach s. 3 handelt es
sich bei extraordinary measures um lebensverlängernde medizinische Maßnahmen, die die Funktionsfähigkeit von an sich selbständig nicht mehr funktionstüchtigen Körperteilen aufrechterhalten. In s. 7 (2) wird klar unterschieden zwischen Handlungen, die den Tod verursachen bzw. beschleunigen, und
denjenigen, die es erlauben, den Sterbevorgang seinen natürlichen Lauf nehmen zu lassen. S. 4 eröffnet dem einwilligungsfähigen unheilbar Kranken
(Definition in s. 3) die Möglichkeit, in Anwesenheit von zwei Zeugen den
Verzicht auf außergewöhnliche Maßnahmen in einem Patiententestament
schriftlich zu fixieren. Dieses Testament ist nach s. 4 (3) für den Arzt nur
dann nicht bindend, wenn er vernünftige Gründe dafür hat, an der Wirksamkeit der Verfügung zu zweifeln (siehe s. 4 (3) (a) und (b)).
1
O'Sullivan, Law for nurses, S. 243.
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Die Strafgesetze von Queensland (s. 298 CC), Northern Territory (s. 160 CC
- Dokument 1.1) und Western Australia (s. 275 CC - Dokument 1.2) stellen
ausdrücklich fest, daß die Kausalitätskette zwischen der Verletzungshandlung
eines Täters und dem Tod nicht durch eine medizinische Behandlung, die
unter den Umständen angemessen und in gutem Glauben angewandt wurde,
unterbrochen wird.
1.3
Todeszeitpunkt
Die Frage der Definition des Todes und seine Feststellung ist in allen Einzelstaaten - bis auf Western Australia - spezialgesetzlich geregelt (häufig im
Zusammenhang mit Regelungen über die Organtransplantation):
-
South Australia: Death Definition Act (1983), s. 2,
Victoria: Human Tissue Act (1982), s. 41,
Queensland: Transplantation and Anatomy Act (1979), s. 45,
Northern Territory: Human Tissue Transplant Act (1979), s. 23,
Australian Capital Territory: Transplantation and Anatomy Ordinance
(1978), s. 45,
Tasmania: Human Tissue Amendment Act (1987), s. 27a,
New South Wales: Human Tissue Act (1983), s. 33.
In die Dokumentation ist als Beispiel die Regelung des Staates Victoria aufgenommen (Dokument 1.7).
Dabei wird auf den Herzstillstand bzw. auf den endgültigen Stillstand der
Gehirnfunktionen abgehoben. Diese Bestimmungen verdienen auch für Fragen der Sterbehilfe Beachtung, da sie die äußerste Grenze der ärztlichen Behandlungspflicht umschreiben.
1.4
Suizid/Beihilfe
Der Suizidversuch ist für den Suizidenten in den Einzelstaaten - bis auf Northern Territory - nicht mehr strafbar.2 Im Northern Territory ist die versuchte
Selbsttötung nach s. 169 CC strafbar und wird mit einem Jahr Freiheitsstrafe
bedroht (Dokument 1.1). Selbst in den Staaten, in denen der Suizidversuch
straflos ist, macht sich jedoch derjenige strafbar, der an der Selbsttötung eines
2
S. 6A CA Victoria; s. 31A CA New South Wales (seit 1983); Aufhebung (1979) von
s. 312 CC Queensland; Aufhebung (1972) von s. 289 CC Western Australia; s. 13a
South Australia (1983 eingefügt) - Dokument 1.3.
Übersicht
225
anderen teilnimmt,3 wobei die Teilnahme durch Unterlassen nicht ausdrücklich erfaßt ist. In New South Wales wird dies auch für den Überlebenden eines fehlgeschlagenen Doppelselbstmordes klargestellt (s. 31B CA). Auch in
Victoria ist dieser Fall besonders geregelt (s. 6B (2) CA), wobei im Vergleich
zur sonstigen Suizidteilnahme eine geringere Freiheitsstrafe - statt bis zu 14
Jahren hier bis zu fünf Jahren - vorgesehen ist.
Der Criminal Law Consolidation Act von South Australia enthält in s. 13a
(Dokument 1.3) eine Vorschrift, die den Suizid und die Beteiligung umfassend regelt und u.a. eine Definition eines "suicide pact" enthält (s. 13a (10)
(a) und auch s. 6B (4) CA Victoria).
Im Northern Territory erstreckt sich die für jedermann bestehende Hilfspflicht nach s. 155 CC (Dokument 1.1, siehe oben unter 1.2) auch auf Suizidfälle.
2.
Rechtsprechung
Nach Auskunft der Law Reform Commissions der jeweiligen Staaten sind
kaum Entscheidungen ersichtlich, die die hier angesprochenen Probleme betreffen. Dies rührt zum Teil daher, daß neben der gesetzlichen Regelung die
Beurteilung durch die Jury, die frei entscheiden kann, eine große Bedeutung
für den Ausgang des Verfahrens hat.4
In Victoria erging 1973 eine Entscheidung, in der ein Mann als Mörder bestraft wurde, der seine Mutter aus Mitleid getötet hatte (R. v. Tait (1973) VR
151). Er wollte ihr ein zukünftiges Leben in einem Pflegeheim ersparen, was
durch Verschlimmerung ihres Krankheitszustandes notwendig geworden war
und gegen das sie sich heftig wehrte. Das Urteil nimmt, soweit veröffentlicht,
nur zu verfahrensrechtlichen Problemen Stellung. Von einer Aufnahme in die
Dokumentation wurde daher abgesehen.
3
4
S. 311 CC Queensland; s. 163 CC Tasmania; s. 288 (3) CC Western Australia - Dokument 1.2; s. 31C CA New South Wales; s. 6B (2) CA Victoria; s. 168 CC Northern
Territory - Dokument 1.1; s. 13a (5) CLCA South Australia - Dokument 1.3.
Siehe Human Rights Commission of Australia, Legal and Ethical Aspects of the Management of Newborns with Severe Disabilities, S. 8.
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Australien
In dem englischen Fall R. v. Malcherek und R. v. Steel (1981) 1 WCR 690
wurde festgestellt, daß die Kausalkette zwischen der Verletzungshandlung
des Täters und dem Tod nicht dadurch unterbrochen wurde, daß lebenserhaltende Apparate abgestellt wurden.
In Queensland erging im Fall R. v. Kinash am 5.11.1981 eine entsprechende
(unveröffentlichte) Entscheidung.
3.
Literaturstimmen
3.1
Sterbehilfe
In einem unveröffentlichten Arbeitspapier für die Law Reform Commission
of Tasmania wird in Anlehnung an einen Gesetzesvorschlag, der in Kalifornien eingebracht wurde (California Senate Bill No. 762: Durable Power of
Attorney for Health Care), die Frage untersucht, ob und unter welchen Umständen die Möglichkeit bestehen soll, einem Vertreter für solche Fälle Vollmacht zu übertragen, in denen medizinische Entscheidungen getroffen werden müssen und der Vollmachtgeber dazu nicht mehr in der Lage ist.5
3.2
Neugeborenen-Euthanasie
Die Human Rights Commission of Australia veröffentlichte 1985 ein Occasional Paper (No. 10) "Legal and Ethical Aspects of the Management of
Newborns with Severe Disabilities", durch das sie keine Lösung anbieten,
sondern einen umfassenden Beitrag zur allgemeinen Diskussion beisteuern
wollte.
Dabei wird besonders der Einfluß der internationalen Abkommen berücksichtigt (Art. 6, 7, 17 des International Covenant on Civil and Political
Rights; Prinzip 2, 4, 5 der Declaration of the Rights of the Child; §§ 3, 6, 9
der Declaration on the Rights of Disabled Persons; §§ 1, 7 der Declaration on
the Rights of Mentally Retarded Persons) und z.B. diskutiert, ob das Recht,
medizinische Behandlung abzulehnen, nicht als Teil der "rights of privacy"
zugebilligt werden muß.
5
Briscoe, H.G., Enduring Powers of Attorney for Health Care Decisions, Nov. 1983
(unveröffentlichtes Arbeitspapier).
Übersicht
227
In Victoria wurde 1981-82 eine Umfrage innerhalb des medizinischen Personals darüber durchgeführt, welche Behandlung bei schwer behinderten
Neugeborenen angewandt werden solle. Nur zwei von 198 Befragten sprachen sich dafür aus, daß immer das Maximum an lebenserhaltenden Maßnahmen durchgeführt werden soll.6
4.
Richtlinien
4.1
Sterbehilfe
In den Einzelstaaten existieren keine Richtlinien. Dies war auch das Ergebnis
einer Umfrage, die die Voluntary Euthanasia Society of Victoria 1984 durchführte. Ihre Frage, ob für die Fälle unheilbar Kranker Anweisungen von seiten des Krankenhauses bestünden, verneinten alle Krankenhäuser und wiesen
auf die Autonomie des Arztes und auf die besonderen Umstände jedes einzelnen Falles hin.
4.2
Neugeborenen-Euthanasie
Das Australian College of Paediatrics erstellte in seinem Bericht von 1983
"Non-intervention in children with major handicaps" (Dokument 2) Richtlinien zur Behandlung schwer behinderter Kinder, die als Hilfestellung und
Provisorium gedacht und somit unverbindlich sind.
4.3
Todeszeitpunkt
Im Rahmen von Richtlinien bezüglich der Entnahme von Organen zu Transplantationszwecken, die vom National Health and Medical Research Council
im "Code of Practice for Transplantation of Cadaver Organs" 1982 veröffentlicht wurden, wird auf das Vorliegen des Hirntodes abgehoben.
6
Singer/Kuhse/Singer, Medical Journal of Australia 1983, S. 275.
228
5.
Australien
Reformbestrebungen
Das Australian College of Paediatrics veröffentlichte im März 1983 einen
Bericht über "Non-intervention in children with major handicaps: Legal and
ethical issues". Darin wurde empfohlen, sowohl einen Medical Intervention
Advisory Board zu gründen, der ermächtigt werden soll, einheitliche Richtlinien für die Nichtbehandlung von schwer behinderten Kindern zu entwickeln, als auch Hospital Ethics Committees zu errichten, die im Entscheidungsprozeß helfen sollen.
Die Human Rights Commission von Australien schlägt in ihrem Bericht
Nr. 11 "Human Rights of the Terminally Ill - The Right of Terminally Ill Patients to have Access to Heroin for Painkilling Purposes" von 1985 vor, die
gesetzlich sehr eingeschränkte (Customs Act, National Health Act, Narcotics
Drugs Act, Therapeutic Goods Act) Verwendung von Heroin zu erweitern
und unheilbar Kranken - auch außerhalb des Krankenhauses Zugang zu Heroin zur Schmerzlinderung zu ermöglichen (Dokument 3.1).
Die Australian Reform Commission brachte in ihrem Report Nr. 28 von 1985
"Community Law Reform for the Australian Capital Territory" die Empfehlung ein, im Rahmen des Community Law Reform Program die rechtliche
Behandlung von Suizid und Euthanasie im A.C.T. ausführlich untersuchen
und überprüfen zu lassen.7
Die Law Reform Commission of Western Australia hat im Juni 1988 ein
Discussion Paper on Medical Treatment for the Dying (Project No. 84) veröffentlicht (Dokument 3.2). Darin wird eine gesetzliche Regelung des Rechts
von Todkranken zur Verweigerung weiterer medizinischer Behandlung (in
Anlehnung an die gesetzlichen Regelungen in South Australia und Victoria)
und eine gesetzliche Regelung des Todeszeitpunkts befürwortet.
In Tasmania wurde am 3.4.1990 eine Natural Death Bill 1990 beim Parlament eingebracht. Der Entwurf ist nahezu inhaltsgleich mit dem Natural
Death Act (1983) von South Australia. Über den Fortgang dieser Gesetzesvorlage ist noch nichts bekannt.
7
ALRC, Report No. 28: Community law reform for the Australian Capital Territory,
First Report, 1985, S. 10, 36.
Dokumentation
229
Dokumentation
Seite
1.
2.
Gesetzliche Bestimmungen ..................................................................... 230
1.1
Northern Territory: Criminal Code 1983 (Auszug) ...................... 230
1.2
Western Australia: Criminal Code 1913 (Auszug) ....................... 231
1.3
South Australia: Criminal Law Consolidation Act 1935-1966
(Auszug) ....................................................................................... 233
1.4
South Australia: Natural Death Act 1983 ..................................... 234
1.5
Northern Territory: Natural Death Act 1988 und Natural Death
Regulations 1989 .......................................................................... 236
1.6
Victoria: Medical Treatment Act 1988 ......................................... 239
1.7
Victoria: Human Tissue Act 1982 (Auszug) ................................ 241
Richtlinien .............................................................................................. 243
Australian College of Paediatric Surgeons: Non-intervention
in children with major handicaps ............................................................ 243
3.
4.
Reformbestrebungen ............................................................................... 244
3.1
Human Rights Commission (Australia) - Report No. 11: Human Rights of the Terminally Ill - The Right of Terminally Ill
Patients to have Access to Heroin for Painkilling Purposes
(1985) ........................................................................................... 244
3.2
Law Reform Commission of Western Australia: Discussion
Paper on Medical Treatment for the Dying (1988) ...................... 245
Literatur .................................................................................................. 245
Abkürzungsverzeichnis ..................................................................................... 248
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1.
Gesetzliche Bestimmungen
1.1
Northern Territory: Criminal Code8 (Auszug)
26. Execution of Law, etc. (...)
(3) A person cannot authorize or permit another to kill him or, except in the case of
medical treatment, to cause him grievous harm.
149. Duty of Person in Charge of Child or Others. It is the duty of every person
having charge of a child under the age of 16 years or having charge of any person
who is unable to withdraw himself from such charge by reason of age, sickness, unsoundness of mind, detention or other cause and who is unable to provide himself
with the necessaries of life (a) to provide the necessaries of life for that child or other person; and
(b) to use reasonable care and take reasonable precautions to avoid or prevent danger to the life, safety or health of the child or other person and to take all
reasonable action to rescue such child or other person from such danger.
150. Duty of Person Engaging in Dangerous Conduct. It is the duty of every person who, except in the case of necessity, undertakes to administer medical treatment
to another or to engage in any other conduct that is or may be dangerous to health
and that requires special knowledge, skill, attention or caution to have the requisite
knowledge or skill and to employ such knowledge, skill, attention and caution as is
reasonable in the circumstances.
151. Duty of Person in Charge of Things Applied to a Dangerous Purpose. It is
the duty of every person who manages, uses or has in his possession anything that
when so managed, used or had in possession may, in the absence of reasonable care
and reasonable precautions, endanger the life, safety or health of another to use
reasonable care and take reasonable precautions to avoid such danger.
152. Duty to Do Certain Acts. When a person undertakes to do any act, the omission of which is dangerous to human life or health, it is his duty to do that act.
153. Effect of Breach of Duty. A person who omits to perform any duty imposed
upon him by this Division is held to have caused any consequences to the life or
health of any person to whom he owes the duty by reason of such omission, but
whether or not he is criminally responsible therefor is to be determined by the other
provisions of this Code.
154. Dangerous Acts or Omissions. (1) Any person who does or makes any act or
omission that causes serious danger, actual or potential, to the lives, health or safety
of the public or to any member of it in circumstances where an ordinary person similarly circumstanced would have clearly foreseen such danger and not have done
or made that act or omission is guilty of a crime and is liable to imprisonment for 5
years.
8
An Act to establish a Code of Criminal law, No. 47 of 1983 (assented to 4 October
1983).
Dokumentation/Gesetzliche Bestimmungen
231
(2) If he thereby causes grievous harm to any person he is liable to imprisonment for
7 years.
(3) If he thereby causes death to any person he is liable to imprisonment for 10 years.
(4) If at the time of doing or making such act or omission he is under influence of an
intoxicating substance he is liable to further imprisonment for 4 years.
(5) Voluntary intoxication may not be regarded for the purposes of determining
whether a person is not guilty of the crime defined by this section.
155. Failure to Rescue, Provide Help, etc. Any person who, being able to provide
rescue, resuscitation, medical treatment, first aid or succour of any kind to a person
urgently in need of it and whose life may be endangered if it is not provided, callously fails to do so is guilty of a crime and is liable to imprisonment for 7 years.
160. Injuries Causing Death in Consequence of Subsequent Treatment. When a
person does grievous harm to another and such other person has recourse to medical
treatment and death results either from the injury or the treatment, he is deemed to
have killed that other person although the immediate cause of death was the medical
treatment, provided that the treatment was reasonably proper under the circumstances and was applied in good faith.
161. Unlawful Homicide. Any person who unlawfully kills another is guilty of a
crime that is called murder or manslaughter according to the circumstances of the
case.
168. Aiding Suicide. Any person who (a) procures another to kill himself;
(b) counsels another to kill himself and thereby induces him to do so; or
(c) aids another in killing himself,
is guilty of a crime and is liable to imprisonment for life.
169. Attempting to Commit Suicide. Any person who attempts to kill himself is
guilty of a crime and is liable to imprisonment for one year.
183. Failure to Supply Necessaries. Any person who, being charged with the duty
of providing for another the necessaries of life, unlawfully fails to do so whereby the
life of that other person is or is likely to be endangered or his health is or is likely to
be permanently injured, is guilty of a crime and is liable to imprisonment for 7 years.
1.2
Western Australia: Criminal Code9 (Auszug)
23. Intention: Motive. (...)
(3) Unless otherwise expressly declared, the motive by which a person is induced to
do or omit to do an act, or to form an intention, is immaterial so far as regards criminal responsibility.
9
An Act to enact a compilation of the Criminal Code Act, 1902, with its amendments
and portion of the Secret Commissions Act, 1905, and for other related purposes,
No. 28 of 1913 (assented to 30 December 1913).
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259. Surgical operations. A person is not criminally responsible for performing, in
good faith and with reasonable care and skill, a surgical operation upon any person
for his benefit, or upon an unborn child for the preservation of the mother's life, if
the performance of the operation is reasonable, having regard to the patient's state at
the time and to all the circumstances of the case.
261. Consent to death immaterial. Consent by a person to the causing of his own
death does not affect the criminal responsibility of any person by whom such death
is caused.
262. Duty to provide necessaries. It is the duty of every person having charge of
another who is unable by reason of age, sickness, unsoundness of mind, detention, or
any other cause, to withdraw himself from such charge, and who is unable to provide himself with the necessaries of life, whether the charge is undertaken under a
contract, or is imposed by law, or arises by reason of any act, whether lawful or unlawful, of the person who has such charge, to provide for that other person the necessaries of life; and he is held to have caused any consequences which result to the
life or health of the other person by reason of any omission to perform that duty.
277. Unlawful homicide. Any person who unlawfully kills another is guilty of a
crime which, according to the circumstances of the case, may be wilful murder,
murder, manslaughter, or causing death by the negligent use or management of a
vehicle.
278. Definition of wilful murder. Except as hereinafter set forth, a person who
unlawfully kills another, intending to cause his death or that of some other person, is
guilty of wilful murder.
279. Definition of murder. Except as hereinafter set forth, a person who unlawfully
kills another under any of the following circumstances, that is to say:
(1) If the offender intends to do to the person killed or to some other person some
grievous bodily harm;
(2) If death is caused by means of an act done in the prosecution of an unlawful
purpose, which act is of such a nature as to be likely to endanger human life;
(3) If the offender intends to do grievous bodily harm to some person for the purpose of facilitating the commission of a crime which is such that the offender
may be arrested without warrant, or for the purpose of facilitating the flight of
an offender who has committed or attempted to commit any such crime;
(4) If death is caused by administering any stupefying or overpowering thing for
either of the purposes last aforesaid;
(5) If death is caused by wilfully stopping the breath of any person for either of
such purposes;
is guilty of murder.
In the first case it is immaterial that the offender did not intend to hurt the particular
person who is killed.
In the second case it is immaterial that the offender did not intend to hurt any person.
In the three last cases it is immaterial that the offender did not intend to cause death
or did not know that death was likely to result.
Dokumentation/Gesetzliche Bestimmungen
233
280. Definition of manslaughter. A person who unlawfully kills another under
such circumstances as not to constitute wilful murder or murder is guilty of manslaughter.
288. Aiding suicide. Any person who (1) Procures another to kill himself; or
(2) Counsels another to kill himself and thereby induces him to do so; or
(3) Aids another in killing himself;
is guilty of a crime, and is liable to imprisonment with hard labour for life.
289. [Repealed by No. 21 of 1972, s. 10.]
1.3
South Australia: Criminal Law Consolidation Act10 (Auszug)
13a. Criminal liability in relation to suicide. (1) It is not an offence to commit or
attempt to commit suicide.
(2) Notwithstanding the provisions of subsection (1), a person who finds another
committing or about to commit an act which he believes on reasonable grounds
would, if committed or completed, result in suicide is justified in using reasonable
force to prevent the commission or completion of the act.
(3) If on the trial of a person for the murder of another the jury is satisfied that the
accused killed the other, or was a party to the other being killed by a third person,
but is further satisfied that the acts or omissions alleged against the accused were
done or made in pursuance of a suicide pact with the person killed, then, subject to
subsection (11), the jury shall not find the accused guilty of murder but may bring in
a verdict of manslaughter.
(4) The killing of another or an attempt to kill another in pursuance of a suicide pact
shall, for the purposes of determining the criminal liability of a person who was a
party to the killing or attempt but not a party to the suicide pact, be regarded as murder or attempted murder, as the case may require.
(5) A person who aids, abets or counsels the suicide of another, or an attempt by
another to commit suicide, shall be guilty of an indictable offence.
(6) The penalty for an offence against subsection (5) shall be (a) subject to paragraph (b) (i) where suicide was committed - imprisonment for a term not exceeding
fourteen years;
(ii) where suicide was attempted - imprisonment for a term not exceeding
eight years;
(b) where the convicted person committed the offence in pursuance of a suicide
pact and (i) suicide was committed - imprisonment for a term not exceeding five years;
(ii) suicide was attempted - imprisonment for a term not exceeding two years.
10
An Act to consolidate certain Acts relating to the Criminal law; and for other purposes,
No. 2252 of 1935 (assented to 21 December 1935).
234
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(7) A person who, by fraud, duress or undue influence, procures the suicide of another or an attempt by another to commit suicide shall (whether or not he was a
party to a suicide pact with the other person) be guilty of murder or attempted murder, as the case may require.
(8) If on the trial of a person for murder or attempted murder the jury is not satisfied
that the accused is guilty of the offence charged but is satisfied that he is guilty of an
offence against subsection (5), the jury may bring in a verdict that he is guilty of an
offence against that subsection.
(9) In any criminal proceedings in which it is material to establish the existence of a
suicide pact and whether an act was done, or an omission made, in pursuance of the
pact, the onus of proving the existence of the pact and that the act was done, or the
omission made, in pursuance of the pact shall lie on the accused.
(10) For the purposes of this section (a) "suicide pact" means an agreement between two or more persons having for its
object the death of all of them whether or not each is to take his own life; and
(b) nothing done or omitted to be done by a person who enters into a suicide pact
shall be treated as done or omitted to be done in pursuance of the pact unless it
is done or omitted to be done while he has the settled intention of dying in pursuance of the pact.
(11) Where a person induced another to enter into a suicide pact by means of fraud,
duress or undue influence, the person is not entitled in relation to an offence against
the other to any mitigation of criminal liability or penalty under this section based on
the existence of the pact.
1.4
South Australia: Natural Death Act11
Be it enacted by the Governor of the State of South Australia, with the advice and
consent of the Parliament thereof, as follows
1. Short title. This Act may be cited as the "Natural Death Act, 1983".
2. Commencement. This Act shall come into operation on a day to be fixed by proclamation.
3. Interpretation. In this Act "extraordinary measures" means medical or surgical measures that prolong life, or
are intended to prolong life, by supplanting or maintaining the operation of bodily
functions that are temporarily or permanently incapable of independent operation;
"recovery", in relation to a terminal illness, includes a remission of symptoms or effects of the illness;
"terminal illness" means any illness, injury or degeneration of mental or physical
faculties (a) such that death would, if extraordinary measures were not undertaken, be imminent; and
11
An Act to provide for, and give legal effect to, directions against artificial prolongation
of the dying process, No. 121 of 1983 (assented to 22 December 1983).
Dokumentation/Gesetzliche Bestimmungen
235
(b) from which there is no reasonable prospect of a temporary or permanent recovery, even if extraordinary measures were undertaken.
4. (1) A person of sound mind, and of or above the age of eighteen years, who desires not to be subjected to extraordinary measures in the event of his suffering from
a terminal illness, may make a direction in the prescribed form.
(2) The direction must be witnessed by two witnesses.
(3) Where a person who is suffering from a terminal illness has made a direction
under this section and the medical practitioner responsible for his treatment has notice of that direction, it shall be the duty of that medical practitioner to act in accordance with the direction unless there is reasonable ground to believe (a) that the patient has revoked, or intended to revoke, the direction; or
(b) that the patient was not, at the time of giving the direction, capable of understanding the nature and consequences of the direction.
(4) This section does not derogate from any duty of a medical practitioner to inform
a patient who is conscious and capable of exercising a rational judgment of all the
various forms of treatment that may be available in his particular case so that the
patient may make an informed judgment as to whether a particular form of treatment
should, or should not, be undertaken.
(5) The Governor may, by regulation, prescribe a form for the purposes of subsection (1).
5. (1) This Act does not affect the right of any person to refuse medical or surgical
treatment.
(2) This Act (other than section 6) does not affect the legal consequences (if any) of
(a) taking, or refraining from taking, therapeutic measures (not being extraordinary
measures) in the case of a patient who is suffering from a terminal illness
(whether or not he has made a direction under this Act); or
(b) taking, or refraining from taking, extraordinary measures in the case of a patient who has not made a direction under this Act.
(3) A medical practitioner incurs no liability for a decision made by him in good
faith and without negligence as to whether (a) a patient is, or is not, suffering from a terminal illness;
(b) a patient revoked, or intended to revoke, a direction under this Act; or
(c) a patient was, or was not, at the time of giving a direction under this Act, capable of understanding the nature and consequences of the direction.
6. (1) For the purposes of the law of this State, the non-application of extraordinary
measures to, or the withdrawal of extraordinary measures from, a person suffering
from a terminal illness does not constitute a cause of death.
(2) This section does not relieve a medical practitioner from the consequences of a
negligent decision as to whether or not a patient is suffering from a terminal illness.
7. (1) Nothing in this Act prevents the artificial maintenance of the circulation or
respiration of a dead person (a) for the purpose of maintaining bodily organs in a condition suitable for transplantation; or
236
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(b) where the dead person was a pregnant woman - for the purpose of preserving
the life of the foetus.
(2) Nothing in this Act authorizes an act that causes or accelerates death as distinct
from an act that permits the dying process to take its natural course.
1.5
Northern Territory: Natural Death Act 198812
Be it enacted by the Legislative Assembly of the Northern Territory of Australia,
with the assent as provided by the Northern Territory (Self-Government) Act 1978 of
the Commonwealth, as follows:
1. Short title. This Act may be cited as the Natural Death Act 1988.
2. Commencement. This Act shall come into operation on a date to be fixed by the
Administrator by notice in the Gazette.
3. Definitions. In this Act, unless the contrary intention appears "extraordinary measures" means medical or surgical measures that prolong life, or
are intended to prolong life, by supplanting or maintaining the operation of bodily
functions that are temporarily of permanently incapable of independent operation;
"recovery", in relation to a terminal illness, includes a remission of symptoms or effects of the illness;
"terminal illness" means such an illness, injury or degeneration of mental or physical
faculties (a) that death would, if extraordinary measures were not undertaken, be imminent;
and
(b) from which there is no reasonable prospect of a temporary or permanent recovery, even if extraordinary measures were undertaken.
4. Power to make direction. (1) A person of sound mind who has attained the age
of 18 years, and who desires not to be subjected to extraordinary measures in the
event of his or her suffering from a terminal illness, may make a direction in the
prescribed form.
(2) A direction under subsection (1) is of no effect unless witnessed by 2 witnesses
who have attained the age of 18 years, neither of whom is the medical practitioner
responsible for the treatment of the person.
(3) Subject to subsection (2), where a person who is suffering from a terminal illness
has made a direction under this section and the medical practitioner responsible for
the treatment of the person has notice of that direction, it shall be the duty of that
medical practitioner to act in accordance with the direction unless there is reasonable
ground to believe that the person (a) has revoked, or intended to revoke, the direction; or
(b) was not, at the time of making the direction, capable of understanding the nature and consequences of the direction.
12
An Act to provide for, and give legal effect to, directions against artificial prolongation
of the dying process (assented to 17 November 1988).
Dokumentation/Gesetzliche Bestimmungen
237
(4) This section does not derogate from any duty of a medical practitioner to inform
a patient who is conscious and capable of exercising a rational judgment of all the
various forms of treatment that may be available to the patient's particular case so
that the patient may make an informed judgment as to whether a particular form of
treatment should, or should not, be undertaken.
(5) The Administrator may, by regulation, prescribe a form for the purposes of subsection (1).
5. Act not to affect other rights. (1) This Act does not affect the right of a person to
refuse medical or surgical treatment.
(2) This Act (other than section 6) does not affect the legal consequences (if any) of
taking, or refraining from taking (a) therapeutic measures (not being extraordinary measures) in the case of a patient
who is suffering from a terminal illness, whether or not the patient made a direction under this Act; or
(b) extraordinary measures in the case of a patient who has not made a direction
under this Act.
(3) A medical practitioner incurs no liability for a decision made by him or her in
good faith and without negligence as to wether a patient (a) is, or is not, suffering from a terminal illness;
(b) revoked, or intended to revoke, a direction under this Act; or
(c) was, or was not, at the time of making a direction under this Act, capable of
understanding the nature and consequences of the direction.
6. Certain aspects of causation of death. (1) For the purposes of the law of the
Territory, the non-application of extraordinary measures to, or the withdrawal of
extraordinary measures from, a person suffering from a terminal illness does not
constitute a cause of death where the non-application or withdrawal was as a result
of and in accordance with a direction made under section 4 (1) by the person.
(2) This section does not relieve a medical practitioner from the consequences of a
negligent decision as to whether or not a patient is suffering from a terminal illness.
7. Savings. (1) Nothing in this Act prevents the artificial maintenance of the circulation or respiration of a dead person (a) for the purpose of maintaining bodily organs in a condition suitable for transplantation; or
(b) where the dead person was a pregnant woman - for the purpose of preserving
the life of the foetus.
(2) Nothing in this Act authorizes an act that causes or accelerates death as distinct
from an act that permits the dying process to take its natural course.
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Natural Death Regulations13
1. Citation. These Regulations may be cited as the Natural Death Regulations.
2. Form of direction. For the purposes of section 4 (1) of the Act, a direction shall
be in the form specified in the Schedule.
SCHEDULE
Regulation 2
NOTICE OF DIRECTION PURSUANT TO
NATURAL DEATH ACT
To: The Medical Practitioner responsible for my treatment at such time when I am
suffering from a terminal illness*
I, .............................................................. declare that I am of sound mind and
have
(name of person making direction)
attained the age of 18 years AND in the event that I may suffer from a terminal illness* within the meaning of the Natural Death Act AND having the desire not to be
subjected to extraordinary measures, namely medical or surgical measures that prolong life, or which are intended to prolong life, by supplanting or maintaining the
operation of bodily functions that are temporarily or permanently incapable of independent operation, or to particular extraordinary measures specified below, DO
HEREBY make the direction that I not be subjected to ±
extraordinary measures generally
±
extraordinary measures, being ..........................................................................
(specify particular kind of measures)
Dated .................... 19...........
Signature of person making direction: ..............................................................................
WITNESSED in the presence of 2 witnesses who have attained the age of 18 years
1 ........................................................... 2 .....................................................................
...............................................................
.....................................................................
...............................................................
.....................................................................
(Name, address, occupation)
(Name, address, occupation)
*
Terminal illness means any illness, injury or degeneration of mental or physical
faculties (a) such that death would, if extraordinary measures were not undertaken, be
imminent; and
(b) from which there is no reasonable prospect of a temporary or permanent
recovery, even if extraordinary measures were undertaken.
±
Delete whichever is not applicable.
13
Regulations 1989, No. 14* vom 29.6.1989.
Dokumentation/Gesetzliche Bestimmungen
1.6
239
Victoria: Medical Treatment Act 198814
Preamble
The Parliament recognises that it is desirable (a) to give protection to the patient's right to refuse unwanted medical treatment;
(b) to give protection to medical practitioners who act in good faith in accordance
with a patient's express wishes;
(c) to recognise the difficult circumstances that face medical practitioners in advising patients and providing guidance in relation to treatment options;
(d) to state clearly the way in which a patient can signify his or her wishes in regard to medical care;
(e) to encourage community and professional understanding of the changing focus
of treatment from cure to pain relief for terminally-ill patients;
(f) to ensure that dying patients receive maximum relief from pain and suffering.
The Parliament of Victoria therefore enacts as follows:
Part 1 - Preliminary
1. Purpose. The purposes of this Act are (a) to clarify the law relating to the right of patients to refuse medical treatment;
(b) to establish a procedure for clearly indicating a decision to refuse medical
treatment.
2. Commencement. This Act comes into operation on a day to be proclaimed.
3. Definitions. In this Act "Medical practitioner" means a legally qualified medical practitioner.
"Medical treatment" means the carrying out of (a) an operation; or
(b) the administration of a drug or other like substance; or
(c) any other medical procedure but does not include palliative care.
"Palliative care" includes (a) the provision of reasonable medical procedures for the relief of pain, suffering
an discomfort; or
(b) the reasonable provision of food and water.
"Refusal of treatment certificate" means a certificate in the form of Schedule 1 and,
if that certificate is modified, includes that certificate as modified and in force for
the time being.
4. Other legal rights not affected. (1) This Act does not affect any right of a person
under any other law to refuse medical treatment.
(2) This Act does not apply to palliative care and does not affect any right, power or
duty which a medical practitioner or any other person has in relation to palliative
care.
14
Act No. 41 of 1988 (assented to 24 May 1988).
240
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Part 2 - Refusal of Treatment
5. Refusal of treatment certificate. (1) If a medical practitioner and another person
are each satisfied (a) that a patient has clearly expressed or indicated a decision (i) to refuse medical treatment generally; or
(ii) to refuse medical treatment of a particular kind for a current condition; and
(b) that the patient's decision is made voluntarily and without inducement or compulsion; and
(c) that the patient has been informed about the nature of his or her condition to an
extent which is reasonably sufficient to enable the patient to make a decision
about whether or not to refuse medical treatment generally or of a particular
kind (as the case requires) for that condition and that the patient has appeared
to understand that information; and
(d) that the patient is of sound mind and has attained the age of 18 years the medical practitioner and the other person may together witness a refusal of
treatment certificate.
(2) A refusal of treatment certificate must be in the form of Schedule 1.15
(3) For the purposes of sub-section (1) (a), the patient may clearly express or indicate a decision in writing, orally or in any other way in which the person can communicate.
6. Offence of medical trespass. A medical practitioner must not, knowing that a refusal of treatment certificate applies to a person, undertake or continue to undertake
any medical treatment which the person has refused, being treatment for the condition in relation to which the certificate was given.
Penalty: 5 penalty units.
7. Cancellation, modification or cessation of certificate. (1) A refusal of treatment
certificate may be cancelled or modified by the patient to whom the certificate applies clearly expressing or indicating to a medical practitioner or another person a
decision to cancel or modify the certificate.
(2) For the purposes of sub-section (1), a person may clearly express or indicate a
decision in writing, orally or in any other way in which the person can communicate.
(3) A refusal of treatment certificate ceases to apply to a person if the medical condition of the person has changed to such an extent that the condition in relation to
which the certificate was given is no longer current.
8. Effect of certificate or notice issued under this Part. (1) This section applies to
a refusal of treatment certificate and to a written notice of a cancellation or modification of a refusal of treatment certificate.
(2) In any civil or criminal proceeding, production of either of the instruments mentioned in sub-section (1) is (a) evidence; and
(b) in the absence of evidence to the contrary, proof 15
Abgedruckt auf S. 242.
Dokumentation/Gesetzliche Bestimmungen
241
that the patient has refused medical treatment or has cancelled or modified a refusal
of treatment certificate.
(3) This section does not affect other methods of proving a decision to refuse medical treatment.
Part 3 - Protection of Medical Practitioners
9. Protection of medical practitioners. (1) A medical practitioner or a person acting under the direction of a medical practitioner who, in good faith and in reliance
on a refusal of treatment certificate, refuses to perform or continue the medical
treatment which the person has refused is not (a) guilty of misconduct or infamous misconduct in a professional respect; or
(b) guilty of an offence; or
(c) liable in any civil proceedings because of the failure to perform or continue that treatment.
(2) For the purposes of this section and section 6, a person who acts in good faith in
reliance on a refusal of treatment certificate but who is not aware that the certificate
has been cancelled or modified, is to be treated as having acted in good faith in reliance on a refusal of treatment certificate.
1.7
Victoria: Human Tissue Act 198216 (Auszug)
Section 41. For the purposes of the law of Victoria, a person has died when there
has occurred (a) irreversible cessation of circulation of blood in the body of the person; or
(b) irreversible cessation of all function of the brain of the person.
16
An Act to make provision for and in relation to the removal of human tissue for transplantation, for post-mortem examination, for the definition of death, for the registration
of schools of anatomy, to repeal certain Acts and enactments and for other purposes,
No. 9860 of 1982 (assented to 5 January 1983).
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Schedule 1
Sections 3, 5 (2)
REFUSAL OF TREATMENT CERTIFICATE: COMPETENT PERSON
We certify that we are satisfied (a) that ....................................................................................... (name of patient)
has clearly expressed or indicated a decision, in relation to a current condition,
to refuse *
medical treatment generally; or
*
medical treatment, being ...................................................................................
(specify particular kind of medical treatment);
(b) that the patient's decision is made voluntarily and without inducement or
compulsion;
(c) that the patient has been informed about the nature of his/her current condition to an extent which is reasonably sufficient to enable him/her to
make a decision about whether or not to refuse medical treatment generally or of a particular kind (as the case requires) and that he/she has appeared to understand that information; and
(d) that the patient is of sound mind and has attained the age of 18 years.
Dated:
Signed .......................................................................................... (Medical Practitioner)
Signed .................................................................................................. (Another person)
Verification to be completed by patient, if physically able to do so.
In relation to my current condition, I refuse *
medical treatment generally; or
*
medical treatment, being ...................................................................................
(specify particular kind of medical treatment).
I give the following instructions as to palliative care:
............................................................................................................................................
Dated:
Signed ................................................................................................................ (Patient)
* Delete whichever is not applicable
NOTE:
"Medical treatment" means the carrying out of (a) an operation; or
(b) the administration of a drug or other like substance; or
(c) any other medical procedure but does not include palliative care.
"Palliative care" includes (a) the provision of reasonable medical procedures for the relief of pain, suffering and discomfort; or
(b) the reasonable provision of food and water.
The refusal of palliative care is not covered by the Medical Treatment Act 1988.
243
Dokumentation/Richtlinien
2.
Richtlinien
Australian College of Paediatric Surgeons: Non-intervention in children with
major handicaps17 (Auszug)
7. Overview of Possible Legal Sanctions: The possible legal sanctions for inappropriate decision making about intervention in children with major disabilities can be
set out in tabular form, as follows:
Medical Issue
Legal Issue
Civil
Sanction
Criminal
Sanction
Other Avenues
Doctor not obtaining consent
of parents.
Parents withholding consent to
treatment with
death subsequently ensuing.
Trespass to the
person of the
child in question. Did this
"cause" death
and were they
guilty of "gross
negligence"?
Action on
its behalf
for damages.
Prosecution
against the
parents for
manslaughter,
or even murder.
Child made a
ward of the
court, or placed
under ministerial guardianship so that the
treatmentdesired
by the doctor .
can go ahead
Doctor "letting
nature take its
course" without
seeking the concurrence of the
parents, allowing preventable
death.
Did this "cause"
death, and was he
guilty of "gross
negligence"?
Criminal prosecution of the
doctor for
manslaughter.
Child made a
ward of the
court, or placed
under ministerial
guardianship on
the initiative of a
stranger seeking
authority for
active interven
tion by another
doctor on behalf
of thechild.
Active deathmaking by the
doctor, with or
without the complicity of the
parents.
"Causation" and
"intention to
kill"?
Prosecution of
the doctor for
murder, and
of the parents,
if actively
involved, as
accessories.
Child made a
ward of the
court, or placed
under ministerial guardianship to enable
his removal
from the "care"
of the treating
doctor, and if
necessary, his
parents.
17
Australian Paediatric Journal 19 (1983), S. 217-222.
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14. Provisional Guidelines. Pending the formulation of guidelines as envisaged
above, the College recommends to its members the following general principles to
assist them in their ethical decision making in regard to severely handicapped
newborns.
(a) The doctrine of informed consent is basic to the doctor-patient relationship and
the guidelines set out in Section 6 of this document should be scrupulously observed.
(b) Decisions should wherever possible be arrived at by consensus of parents and
medical attendants, having paid due regard to the views of other interested parties (Section 10).
The agreement of an experienced Medical Officer not directly concerned in the
management of the patient should be sought in all possibly controversial decisions relating to the life or death of the handicapped newborn.
The management of the hospital concerned should be informed of all such decisions, either directly or via the Hospital's Ethics Committee.
(c) The overriding principle in all such cases must always be the best interest of
the child.
(d) The law must be respected and these guidelines must not be construed as giving the paediatrician licence to disobey the law (Section 5).
(e) If the paediatrician finds himself in serious conflict with the parents of a handicapped newborn about the right course to follow, it is ethically correct for him
to refer the patient to another doctor (Section 5).
3.
Reformbestrebungen
3.1
Human Rights Commission, Report No. 11: Human Rights of the Terminally Ill - The Right of Terminally Ill Patients to have Access to Heroin for Painkilling Purposes, 1985, S. 12
Recommendations
The Commission recommends that:
(1) Heroin should be made available to terminally ill patients who cannot obtain
effective pain relief through other treatments or drugs.
(2) Heroin should be listed as a pharmaceutical benefit and its administration by or
under the immediate supervision of a medical practitioner should be allowed outside
hospitals. This would mean that it could be administered to all terminally ill patients
who may benefit from the drug.
(3) The Minister for Health should:
(i) take up the matter with the State Ministers for Health;
(ii) in consultation with the States, license the manufacture of a limited quantity of heroin for medical use by terminally ill patients (Narcotic Drugs
Ordinance 1967, section 9).
(4) Amendments should be made to A.C.T. Poisons and Narcotic Drugs Ordinance
1967 legislation to make heroin available for terminally ill patients in the A.C.T.
Dokumentation/Reformbestrebungen
3.2
245
Law Reform Commission of Western Australia: Discussion Paper on
Medical Treatment for the Dying, Project No. 84, 1988, S. 23
Chapter 3 - Options for Reform
1. Introduction
3.1 The major problem with the existing law is that doctors who comply with a patient's request to withdraw or withhold treatment may, in doing so, breach obligations imposed on them under the civil and criminal law and the Medical Act 1894.
Where patients are incompetent to make decisions about their treatment it is not
clear in most cases that any other person may make those decisions on their behalf.
Further, there is no legal authority for individuals, in anticipation of being at some
time incompetent to make decisions on their own behalf, to give advance written
directions as to how they wish to be treatet or to appoint an agent to make those
decisions on their behalf.
3.2 A number of options for reform are discussed below. There are four general
approaches (1) The existing right of patients to control their own treatment could be specified
in legislation so that those acting in accordance with their wishes would not
commit an offence in so acting. This would address the concern of many of
those who made preliminary submissions who feared that they would lose this
right should they become terminally ill.
(2) People could be given an opportunity to make advance written directions to the
effect that they do not wish to receive certain treatment if they become terminally ill, or to appoint an agent by an enduring power of attorney to make decisions on their behalf should they become incompetent.
(3) Where a person is incompetent, decisions as to treatment could, subject to certain qualifications and safeguards, be made by a proxy.
(4) Doctors could be permitted to decide to withdraw or withhold treatment from a
patient in certain circumstances.
Other possible reforms discussed in subsequent chapters deal with the definition of
death and with palliative care.
246
4.
Australien
Literatur
Australian College of Paediatrics, Non-intervention in children with major handicaps: legal and ethical issues. Report of a Working Party (Mr. Douglas Cohen,
Chairman). Australian Paediatric Journal 19 (1983), S. 217-222.
Australian Law Reform Commission, Report No. 7: Human Tissue Transplants.
1977.
-
Report No. 28: Community Law Reform for the Australian Capital Territory,
First Report. 1985.
Australian Medical Association, The Quinlan Case: Some Implications. Medical
Journal of Australia 1976, S. 515.
-
The Problems of Legalising Euthanasia - and the Alternative. Medical Journal
of Australia 1976, S. 607.
-
Transplants and the Determination of Death. Medical Journal of Australia
1977, S. 313.
Bentil, J.K., Voluntary Euthanasia and Criminal Law. Solicitor's Journal 128 (1984),
S. 826.
Bravender-Coyle, P., Refusal of Medical Treatment under South Australian's Natural Death Legislation. Australian Law News 20 (1985), S. 22.
British Medical Association, The handbook of medical ethics. London 1980, S. 29.
Cohen, B., The right to live and the right to die. Medical Journal of Australia 1984,
S. 60.
Fletcher, J., Paediatric euthanasia: the ethics of selective treatment for spina bifida.
In: C. Swinyard (Hrsg.), Decision making and the defective newborn. Springfield, Ill. 1978, S. 485-86.
Glover, Jonathan, Causing death and saving lives. Harmondsworth 1977.
Human Rights Commission (Australia), Report No. 11: Human Rights of the Terminally Ill - The Right of Terminally Ill Patients to have Access to Heroin for
Painkilling Purposes. Canberra 1985.
-
Occasional Paper No. 10: Legal and Ethical Aspects of the Management of
Newborns with Severe Disabilities. Canberra 1985.
Koop, L. Everett, Ethical and surgical considerations in the care of the newborn
with congenital abnormalities. In: Horan, Dennis J./Oelahoyde, Melinda
(Hrsg.), Infanticide and the handicapped newborn. Provo, Utah 1982.
Kuhse, H., A modern myth. That letting die is not the intentional causation of death:
some reflections on the trial and acquittal of Dr. Leonard Arthur. Journal of
Applied Philosophy 1 (1984), S. 21-38.
Dokumentation/Literatur
247
Kuhse, H./Singer, P., Practices and Attitudes Regarding Voluntary Euthanasia. Medical Journal of Australia 148, S. 623.
Law Reform Commission of Western Australia, Discussion Paper on Medical Treatment for the Dying. Project No. 84. Perth 1988.
Lipman, Z., The Criminal Liability of Medical Practitioners for Withholding Treatment from Severely Defective Newborn Infants. Australian Law Journal 60
(1986), S. 286.
Lorber, J., Early results of selected treatment of spina bifida cystica. British Medical
Journal 4 (1973), S. 189-197.
Luntz, H., The Time of Death. Australian Current Law Digest 1974, S. 156.
Manitoba Law Reform Commission, Report on a Statutory Definition of Death. Report No. 16. Winnipeg 1974.
McCormick, R., To save or let die. Journal of the American Medical Association 229
(1974), S. 172.
Merker, F., Euthanasia. Law Institute Journal 1985, S. 445.
Murphy, J., Is killing the innocent absolutely immoral? The Marist 57 (1973), S. 4.
O'Sullivan, J., Mental Health and the Law. Sydney 1981.
-
Law for nurses and allied health professionals in Australia. Sydney 1983.
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Defining Death - A Report on the Medical, Legal and Ethical Issues in the Determination of Death. Washington 1981.
Shepperdson, B., Abortion and euthanasia of Down's Syndrome children - the parents' view. Journal of Medical Ethics 9 (1983), S. 153.
Singer, P./Kuhse, H./Singer, C., The treatment of newborn infants with major handicaps. Medical Journal of Australia 1983, S. 275.
Social Development Comittee (Victoria), First Report on Inquiry into Options for
Dying with Dignity. Melbourne 1986.
Tew, B./Laurence, K. H., Mothers, brothers and sisters of patients with spina bifida.
Developments Medicine and Child Neurology 15 (1973), Supp. 29, S. 72, 75.
248
Australien
Abkürzungsverzeichnis
A.C.T.
Australian Capital Territory
ALRC
Australian Law Reform Commission
CA
Crimes Act
CC
Criminal Code
CLCA
Criminal Law Consolidation Act
Ill.
Illinois
No.
Number
R.
Regina, Rex
s.
section
ss.
sections
Supp.
Supplement
v.
versus
VR
Victorian Reports
WCR
Worker's Compensation Reports
WLR
Weekly Law Reports, England