Palliative care: definition of euthanasia.

The potential benefits of integrating helminth control programmes into existing HIV and TB services warrant consideration. Such efforts should be supported by operational research to evaluate the impact of helminth control on HIV/AIDS and TB disease progression. Epidemiological and immunological research is also essential to understand the complexities of immunity during co-infections with helminths, HIV and TB. 1. Borkow G, Bentwich Z. Chronic immune activation associated with chronic helminthic and human immunodeficiency virus infections: Role of hyporesponsiveness and anergy. Intestinal helminth co-infection has a negative impact on both anti-Mycobacterium tuberculosis immunity and clinical response to tuberculosis therapy. Evaluation of how integrated HIV and TB programs are implemented in South Africa and the implications for rural-urban equity. To the Editor: Euthanasia is defined as 'conduct that brings about an easy and painless death for persons suffering from an incurable or painful disease or condition'. Active euthanasia is the intentional killing of a person suffering from an incurable disease, and fulfils the legal criteria for murder. There is intent, causation, a human is the victim, and the act, whether by omission or commission, is unlawful. Motive, albeit the altruistic desire to relieve unnecessary suffering in the face of futility, is irrelevant to criminal intent. [2] The term passive euthanasia includes withholding extreme medical measures or removing life support in the presence of futile or non-beneficial treatment. McQuoid-Mason [2] outlines the reason why, in the eyes of the law, passive euthanasia is not a criminal offence, and withholding or withdrawing life-sustaining treatment or administering sufficient analgesia and sedation during the latter cannot be construed as murder. Of the four legal prerequisites for the definition of murder, namely intent, causation, a human victim and contravention of the law, only the last-mentioned is not fulfilled and spares the doctor from a conviction. Although reassuring to those working in critical care, where withholding or withdrawing support is a fact of life (or death), the fact that only one component of the legal definition spares us from being labelled criminals is somewhat disconcerting. We would argue that in addition to the lack of unlawfulness, neither intent nor causation applies, and furthermore that the term 'passive euthanasia' is an oxymoron and should be abandoned. In the situation of withholding or withdrawing treatment, which hastens death, the legal concept of eventual intent applies whereby the perpetrator does not mean to kill the person but does foresee death as a …