Doctors need law to turn off life support
Doctors need law to turn off life support
Moch. N. Kurniawan, The Jakarta Post, Jakarta
A number of doctors are urging the government to resize Health
Law No. 22/1999 to provide doctors with legal protection when
declaring a patient clinically brain dead.
Dr. Iqbal Mustafa from the Harapan Kita Cardiac Hospital in
Jakarta and Dr. Tri Wahyu from the Hasan Sadikin Hospital in
Bandung, West Java said here on Monday that under the Criminal
Code, a doctor could be charged with murder if they switched off
life-support for a patient who was diagnosed as brain dead.
"What will doctors do if a patient's brain no longer functions
although his heart is still beating? Should we declare him dead?
In medical science they are dead already," Iqbal said.
"But if we declare them dead we will be punished as a
murderer. A doctor is not a killer, therefore he or she needs
protection."
To date, Tri said doctors must reach a consensus with the
family to ensure there is no lawsuit if they switch off life-
support.
Without such a consensus, doctors here would not dare to
announce the patient deceased, she added.
Iqbal and Tri are the president and secretary general of the
Association of Indonesian Critical Care Medicine (PKGDI)
respectively.
Under normal circumstances, a person whose breathing and
heartbeat has stopped is considered dead. But today doctors
sometimes prolong the functioning of the lungs and heart by
artificial means, even if a patient's brain is already damaged.
Developments in life support machines have led to a new
definition of death called brainstem death.
A brainstem death diagnosis is reached only after repeated
medical tests confirm that the brain is no longer functioning.
Iqbal said a decision to declare such a patient dead had to be
taken by at least two doctors: a neurologist and an intensive
care unit (ICU) doctor.
Tri said several countries, such as the Netherlands, had
legally allowed doctors to announce the brain dead as dead.
Tri went on to say that the government should establish a
special team to review the law and include the brain-dead issue
in the revision.
Should the revision be approved, a doctor could refuse to
treat a brain-dead patient even if family members attempt to
force the doctors to continue with medical treatment.
Furthermore, Tri suggested brain-dead patients donate their
hearts, livers, eyes and other organs to those in need.
Meanwhile, Iqbal said that his organization would host the
12th meeting of the Western Pacific Association of Critical Care
Medicine in Bali from Aug. 22 to Aug. 25.
He said 1,300 participants from Indonesia, Singapore,
Malaysia, Thailand, Vietnam, Philippines, South Korea, Taiwan,
Japan, China, Hong Kong and Australia would attend the biannual
congress.
"We'll mainly talk about a comprehensive approach from pre-
hospital treatment to the hospital," he said.
Other issues, including brain death and bioterrorism,
particularly anthrax attacks, would also be discussed, he added.