Accompanied by his daughter Siti Hardimanti Rukmana, Suharto is wheeled to a ward. --------------------------------------
* Suharto's care has sparked a quiet debate in the predominantly Muslim nation
* Indonesia provides no legal guidelines for doctors in end-of-life issues
* Islam says all possible steps should be taken to save a dying patient
* However, care should end when the risks outweigh the benefits
JAKARTA, Indonesia (AP), January 17, 2008:
Former Indonesian President Suharto's care during his two-week hospitalization has sparked quiet debate in this predominantly Muslim nation. Doctors said the 86-year-old suffers from multiple organ failure, pneumonia and sepsis, a potentially lethal blood infection.
When Suharto began struggling to breathe last week, his doctors asked Health Minister Siti Fadilah Supari if he should be placed on a ventilator, to which she responded "no," let him die naturally -- advice the family ignored.
By early Wednesday, Suharto was starting to breathe on his own, prompting doctors to decrease dependence on the machine, said Dr. Mardjo Soebiandono.
When it comes to end-of-life issues in Indonesia, a country that provides no legal guidelines for doctors, religion plays a role.
Islam says all possible steps should be taken to save a dying patient, unless the risks outweigh the benefits, said Dr. Rusdy Malueka, an Islamic ethics specialist.
Malueka was among more than 100 hospital directors, doctors and researchers taking part in an end-of-life workshop in the city of Yogyakarta. The meeting, a collaboration between Harvard Medical School and the University of Gadjah Mada, was organized before Suharto fell ill.
"There really is no systematic policy at hospitals on how to deal with end-of-life patients," said Retna Siwi Padmawati, a bio-ethics researcher, describing the burden doctors may face in trying to convince families that some cases are futile.
Some physician base their decisions on international guidelines, she said, adding that others look for advice wherever they can find it, "from the Internet, for instance."
The last time the issue captured Indonesia's attention was in 2004, when a man filed a motion with a court asking to authorize lethal injection for his wife, who had been in a "persistent vegetative state" for three months after a Caesarean section. She regained consciousness before a ruling was issued.
The octogenerian Suharto shown on his birthday in June. Like many Javanese, Suharto used only his given name, without a surname.Suharto was chased from office in 1998 after the Asian financial crash triggered riots and huge rallies. He has been accused of overseeing the deaths and imprisonment of hundreds of thousands of political opponents -- crimes for which no one has ever been tried -- and amassing billions of dollars in state funds.
Copyright 2008 The Associated Press
