*7.1.1 The Roman Catholic Church*

According to the Catholic Catechism *"Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome, can be legitimate; it is the refusal of "over-zealous" treatment*" (treatment stubbornness) [17].

Regarding euthanasia the catechism says that an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator.

The position of Catholic Church in relation to nutrition and hydration through artificial means was clarified by Pope John Paul II when he stated that its administration, even when provided by artificial means represents a natural means of preserving life, not a medical act. According to him, its use should be considered ordinary and proportionate. However, he added*" insofar as and until it is seen to have attained its proper finality, which in case of a vegetative state consists in providing nourishment to the patient and alleviating his suffering*" [18]. This conditioning has raised some doubts in theologians and clinicians.

#### *7.1.2 The Greek orthodox church (GOC)*

The GOC rejects death resulting from human decisions and condemns as unethical any medical procedure that does not commit to the prolongation of life.

According to the bioethics committee of the Greek Church, withholding or withdrawing of treatment including artificial nutrition is not allowed since there is a possibility of a medical mistake, an unforeseen outcome or even a miracle. Euthanasia is not allowed, and pain relief medication prescription is allowed only in doses that are certain not to depress the respiratory center [19].

#### *7.1.3 Protestant churches*

In Protestant churches euthanasia is accepted.

#### **7.2 Judaism**

According to the Jewish law, euthanasia is not allowed. A significant divergence regarding Western medical and Jewish ethics, resides in withdrawing and withholding treatments, since in Jewish law, treatments may be withheld while withdrawal is not allowed, considering that this deed may be a factual cause of patient death.

Artificial nutrition and hydration are considered as a form of primary care, and, as such, must be provided.

Treatment for the palliation of pain can be prescribed without fear of an eventual respiratory compromise [19].

#### **7.3 Islam**

In Islamic principle, life-sustaining treatments can be withheld or withdrawn in terminally ill patients, while euthanasia is proscribed. The withdrawal of nutrition is considered an unlawful act; however, no reference is made in case the nourishment is through artificial methods. Mitigation of pain is admitted even if death is hastened, provided it was not the physician intention [19].

#### **7.4 Buddhism**

From a Buddhist ethics perspective, there is no moral obligation to preserve life at all costs (rejection of dysthanasia). The respect for life forbids killing of living things (euthanasia is outlawed). Artificial nutrition and hydration are not imperative, since they may avert the individual from securing the next stage of his life, the rebirth.

The use of pain killers and the principle of double effect is accepted [19].

#### **7.5 Hinduism**

In Hinduism there is no single central authority to enforce submission to Hinduism. When making concrete end-of-life decisions, their attitudes are flexible;

**41**

the health care.

diffusing the living will.

Anglo-Saxon countries.

*End-of-Life Ethical Dilemmas*

and arguments can be added.

*DOI: http://dx.doi.org/10.5772/intechopen.93616*

**7.6 Confucian and Taoist perspective**

the natural course should not be attempted [20].

**8. The living will in the end-of-life**

How to downsize this problem?

acceptable accordance is far from being a reality.

among others, but each one with some drawbacks.

will have hardly made any inroad in this matter.

this includes the individual circumstantial background to which religious analysis

Most Chinese do not consider Confucianism a religion but rather a philosophical system. Unlike the West, in China, cultural and social relations sustain the basis for moral judgment. Thus, it is the family who is responsible for decision making. There is a difference in religious and philosophical Taoism in regard to the end-of-life: in the former case (religious Taoism), one should accede longevity and immortality, while for the latter (philosophical Taoism) death should be perceived with peace of mind and detachment, and, as such, artificial measures that confront

The controversies about the end-of-life ethical dilemmas can be traced to ancient

In a nearby future, with an increase in average life expectancy and innovations in medical technoscience it seems little probable that there will be a decrease in these disputes. Anyhow, a realistic hope in the reduction of the controversies should have its mainstay based in prevention. Hence, an objective of all those who have a leading position in the society should be to curtail the disposition towards this confrontation.

The struggle to curtail has evolved through the years and there has been no consensus for an acceptable agreement. Starting with the denomination of the dilemmas, passing to the definition itself and ending with the parties involved, an

For example, so far as the denomination of futility is concerned there have been various suggestions to shift for a different terminology like non-beneficial treatment, medically inappropriate, medically inadvisable or not medically indicated,

In any dispute of end-of-life dilemmas, there is an involvement of three parties, the patient, the family, and the team of physicians and the institution that provides

In my opinion, the solution to ease this challenging problem will be met, at least partially, by the unveiling of the living will. Henceforth, in this demanding issue, every effort should be directed to engage all the involved parties in supporting and

In the western societies there have been a progressive acceptance and legislation

Other arguments for its recommendations are religious creeds (no acceptance of blood transfusions by Adventists cult) and those who reject resuscitation maneu-

On the other side, in the eastern countries, or societies where there is a predominance of principle of beneficence and family-oriented decision-making, the living

of the living will. The main reason for its broad recognition and approval is the affirmation of the principle of autonomy, through the informed consent, in the

vers fearing a bed quality of life that could result from this procedure.

Greece and Rome. In that distant past, it was mainly focused in the treatment stubbornness. However, it is with the development of knowledge and research in lifesaving drugs and technologies, that the debates medialize on various fields, the

main point of convergence being euthanasia and dysthanasia.

*Bioethics in Medicine and Society*

raised some doubts in theologians and clinicians.

*7.1.2 The Greek orthodox church (GOC)*

*7.1.3 Protestant churches*

as such, must be provided.

respiratory compromise [19].

**7.2 Judaism**

**7.3 Islam**

**7.4 Buddhism**

rebirth.

**7.5 Hinduism**

administration, even when provided by artificial means represents a natural means of preserving life, not a medical act. According to him, its use should be considered ordinary and proportionate. However, he added*" insofar as and until it is seen to have attained its proper finality, which in case of a vegetative state consists in providing nourishment to the patient and alleviating his suffering*" [18]. This conditioning has

The GOC rejects death resulting from human decisions and condemns as unethical any medical procedure that does not commit to the prolongation of life. According to the bioethics committee of the Greek Church, withholding or withdrawing of treatment including artificial nutrition is not allowed since there is a possibility of a medical mistake, an unforeseen outcome or even a miracle. Euthanasia is not allowed, and pain relief medication prescription is allowed only in

According to the Jewish law, euthanasia is not allowed. A significant divergence regarding Western medical and Jewish ethics, resides in withdrawing and withholding treatments, since in Jewish law, treatments may be withheld while withdrawal is not

Artificial nutrition and hydration are considered as a form of primary care, and,

Treatment for the palliation of pain can be prescribed without fear of an eventual

In Islamic principle, life-sustaining treatments can be withheld or withdrawn in terminally ill patients, while euthanasia is proscribed. The withdrawal of nutrition is considered an unlawful act; however, no reference is made in case the nourishment is through artificial methods. Mitigation of pain is admitted even if death is

From a Buddhist ethics perspective, there is no moral obligation to preserve life at all costs (rejection of dysthanasia). The respect for life forbids killing of living things (euthanasia is outlawed). Artificial nutrition and hydration are not imperative, since they may avert the individual from securing the next stage of his life, the

The use of pain killers and the principle of double effect is accepted [19].

In Hinduism there is no single central authority to enforce submission to Hinduism. When making concrete end-of-life decisions, their attitudes are flexible;

allowed, considering that this deed may be a factual cause of patient death.

doses that are certain not to depress the respiratory center [19].

In Protestant churches euthanasia is accepted.

hastened, provided it was not the physician intention [19].

**40**

this includes the individual circumstantial background to which religious analysis and arguments can be added.
