Breaking The Euthanasia Taboo through The Gateway of Medical Futility: The Concept of Pseudoeuthanasia in Indonesian Criminal Law Reform

Abstract

Background: End-of-life care in Indonesia remains a legal taboo reinforced by the fear of criminal prosecution [1]. This taboo is reinforced by Articles 344 and 345 of the Old Criminal Code (Wetboek van Strafrecht) [2] and strictly maintained in Articles 461 and 462 of the new Law Number 1 of 2023 (National Criminal Code) [3], which categorize euthanasia and assisted suicide as criminal offenses. However, modern medical reality presents conditions of medical futility, where basic life support only serves to postpone death without hope of recovery [4]. The disconnect between rigid criminal law and Minister of Health Regulation No. 37 of 2014 [5], which allows for withdrawing life support, creates a legal grey area. Consequently, the concept of "futility" emerges as a potential juridical "gateway" to legalize the termination of care without falling into the delict of euthanasia [6]. Objective: This research aims to deconstruct the euthanasia taboo by formulating a legal construction where medical futility serves as a ground for criminal exclusion validating the concept of Pseudoeuthanasia. Method: This normative legal research utilizes statute and conceptual approaches to analyze the Criminal Codes (Old and New), Health Law [10], and global bioethical principles to achieve legal coherence. Arguments: Equating the withdrawal of futile support with euthanasia is a legal fallacy. Through the gateway of futility, the act is reclassified as Pseudoeuthanasia. In true euthanasia, the doctor is the cause of death; conversely, in pseudoeuthanasia, the underlying disease is the causa proxima (proximate cause), while the doctor merely ceases to impede the inevitable natural process [7]. This distinction aligns with the bioethical separation of "killing" and "letting die" [8]. Thus, medical futility nullifies the element of "unlawfulness", fulfilling the professional duty of non-maleficence [9]. Conclusion: Medical futility is the key to breaking the euthanasia taboo. It transforms the withdrawal of life support from a suspected murder into a lawful medical action protected by the Health Law [10].