Bioethics in Faith and Practice, Volume 3, Number 1

24 Swazo ⦁ Non-voluntary Euthanasia 24 hope of recovery. I can’t bear it any longer.” 7 The Meherpur commissioner’s office visited Hossain’s home to assess the situation and informed the relevant central government ministry accordingly. It is well known that DMD is a currently incurable genetic disease transmitted primarily from mother to sons; those affected having low life expectancy (death usually by teenage years, but in some cases longer); these individuals likely manifesting sequelae of the muscular defects, including compromised respiratory function (thus less breathing efficiency and mental dullness due to hypoxia, estimated at 30% probability of learning disability or serious mental deficiency); and damage to the heart muscle (cardiomyopathy) leading to circulatory problems including blood clots. According to the Muscular Dystrophy Association 8 in the USA, options for treatment are limited to assistive devices (ankle-foot braces; standing walkers; wheel chairs; transfer boards; etc.) and alleviation of symptoms (physical therapy with range-of-motion and progressive resistive exercise; medication (corticosteroids in Bangladesh are available at a cost of BDT250 per 100 20 mg. tablets, equivalent to US$3.11 cost), 9 with special education service for developmental disability. These services are of such cost that Mr. Hossain cannot afford either the assistive devices or the medication for the three individuals, not to mention the problem of managing their care at home without others within the family to assist with regularity. In short, his burden, he asserts, exceeds his personal ability to manage. Local Reaction Subsequent to government review, the decision was taken to assist Mr. Hossain with some (minimal) medical care at government cost. Nonetheless, the case is especially of concern as a request to government authorities, because it amounted to a request for both involuntary and non-voluntary active euthanasia, the former in the case of the elder son and the latter in the case of the younger son and grandson. All three individuals are aware of their physical condition, despite the difficulties they have with mobility at home and confinement to bed except for occasional assisted transfer outdoors. All three are cognitively functional, although perhaps with some mental dullness onset characteristic of the disease’s progressive degeneration. The eldest son provided no opinion to the public media on his father’s request, except to say he counsels his father not to worry. A medical doctor who has assisted with treatment of the family remarked, “It’s a humanitarian case. Everyone should come forward [to help]. ” 10 This physician, of course, does not look to euthanasia as the solution to Mr. Hossain’s dilemma. However, the case has provided an opportunity for government authorities and medical professionals to engage a rather difficult, even usually unengaged, subject, viz., euthanasia in general. “Nezamuddin Ahmed, head of Bangladesh’s sole palliative care centre in the country’s capital, Dhaka, said: ‘I think this will lead to a healthy debate about assisted death,’” even as he believes the government should improve palliative care service options before moving to consider any legislative or public policy engagement of euthanasia. 11 By contrast, Nur Khan Liton, head of local rights group Aim O Salish Kendra, opined that, “[most] Bangladeshis would oppose the mere discussion of euthanasia. ” 12 Voicing the expected religious view, cleric and Islamic scholar Fariuddin Masoud commented that, “Euthanasia is completely illegal in Islam. It is the government’s duty to take responsibility of every citizen, ” 13 in which case there should be no public discussion of any form of euthanasia . 14 Clearly, if there is to be no “public” discussion on this moral issue as a matter of Islamic doctrine, then a fortiori neither is there to be any specifically government discussion of this issue in the Parliament or by the Ministry of Health. (In Bangladesh public law follows due process of proposals considered by Parliament and the relevant ministries of government, with approval by the Prime Minister’s Cabinet and implementation under the regulatory authority of the superintending ministry.)