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'''''The Musical Offering''''' (German title '''''Musikalisches Opfer''''' or '''''Das Musikalische Opfer'''''), [[BWV]] 1079, is a collection of [[canon (music)|canon]]s and [[fugues]] and other pieces of [[music]] by [[Johann Sebastian Bach]], based on a musical theme by [[Frederick II of Prussia]] (Frederick the Great) and dedicated to him.
'''Euthanasia''' ([[Greek language|Greek]], "good [[death]]") is the practice of killing a person or animal, in a painless or minimally painful way, for merciful reasons, usually to end their [[suffering]]. This article discusses euthanasia in humans; a separate article covers [[animal euthanasia]].
==The music==
Euthanasia in the strict sense involves actively causing death (''active euthanasia''). This is in some cases legal in [[the Netherlands]] and [[Belgium]], but in no other countries ([[as of 2005]]). Euthanasia in a wider sense includes assisting sufferers to commit [[suicide]], in particular '''physician-assisted suicide'''; this is legal in a small number of jurisdictions.
===The theme from the king===
The collection has its roots in a meeting between Bach and Frederick II on [[May 7]], [[1747]]. The meeting, taking place in the king's residence in [[Potsdam]], resulted from Bach's son [[Carl Philipp Emanuel Bach|Carl Philipp Emanuel]] being employed there as court musician. Frederick wanted to show a novelty to Bach: the [[pianoforte]] had been invented a few years earlier, and the king owned such experimental instrument, allegedly the first Bach ever saw. Bach, who was well known for his skill at [[improvising]], was given the following theme by Frederick to improvise a fugue upon:
[[Image:Musical offering.png|frame|none|The ''Thema Regium'' ("theme from the king")]]
''Allowing'' death—e.g. by not providing [[life support]] or vital medication—is not considered euthanasia if it is the patient's wish. It is sometimes called ''passive euthanasia'' in cases where the patient is unable to make decisions about treatment. [[Living will]]s and [[Do Not Resuscitate]] orders are legal instruments that make a patient's treatment decisions known ahead of time; allowing a patient to die based on such decisions is not considered to be euthanasia.
According to the press of the day, Bach succeeded pretty well in producing an instant fugue, although he must have confided afterwards he felt not very much at ease playing the new type of instrument.
[[Terminal sedation]] is a combination of medically inducing a deep sleep and stopping other treatment, with the exception of medication for symptom control (such as [[analgesia]]). It is considered to be euthanasia by some, but under current law and medical practice it is considered a form of [[palliative care]].
Two months after the meeting, Bach published a set of pieces based on this theme which we now know as ''The Musical Offering''. Bach inscribed the piece "Regis Iussu Cantio Et Reliqua Canonica Arte Resoluta" (the theme given by the king, with additions, resolved in the canonic style), the first letters of which spells out the word ''[[ricercar]]'' (an old name for a fugue).
Advocates of euthanasia generally insist that euthanasia should be voluntary, requiring [[informed consent]], and that it should only be used in cases of terminal illness that cause unbearable suffering, or an eventual, complete loss of awareness. Its opponents challenge it on several ethical grounds, including a [[slippery slope]] argument that it is the first step towards compulsory euthanasia.
===Structure, instrumentation===
In [[Nazi Germany]] the term "euthanasia" (''Euthanasie'') referred to the systematic killing of disabled children and adults under the [[T-4 Euthanasia Program]]. This has tainted the word in [[German language|German-speaking]] countries; the alternate term is "Sterbehilfe", which means "help to die;" though note that "Sterbehilfe" was coined long before the Nazis perverted the term "Euthanasie".
In its finished form, ''The Musical Offering'' comprises:
*Two ricercars, written down on as many [[Musical staff|stave]]s as there are voices:
** a ricercar a 6 (a six voice fugue)
** a ricercar a 3 (a three voice fugue)
*Ten [[canon (music)|canon]]s
*A four-movement [[trio sonata]] featuring the [[flute]], an instrument which Frederick played.
Apart from the trio sonata, which is written for flute, [[violin]] and [[basso continuo]], the pieces have few indications of which instruments are meant to play them.
==Types of euthanasia==
Apart from the above classifications three types of euthanasia may be identified, depending upon the sentience of the individual.
The ricercars and canons have been realised in various ways: The ricercars are frequently performed on keyboard instruments, an ensemble of [[chamber music]]ians with alternating instrument groups, comparable to the instrumentation of the trio sonata, often playing the canons. But also recordings on one or more keyboard instruments (piano, harpsichord) exist, as well as with a more ample orchestra-like instrumentation.
''Voluntary euthanasia''<br />
This is the truest and fullest form of euthanasia wherein the individual requests euthanasia - either during [[illness]] or before, if complete incapacitation is expected ([[coma]] would be an example). Euthanasia in these cases differs from [[suicide]] by existing only within the context of the amelioration of suffering in the process of death. Volition must be informed and free (i.e. not under duress from any third party).
As the printed version gives the impression to be organised for (reduction of) page turning when sight-playing the score, the order of the pieces intended by Bach (''if'' there was an intended order), remains uncertain.
''Non-voluntary euthanasia''<br />
Where an individual lacks sentience (in a coma, for example) and hence cannot decide, or distinguish, between [[life]] and [[death]], such a person cannot give consent or cannot give informed consent, and therefore any euthanasia is not voluntary but also not involuntary. Famously notable as "turning off life-support", it is often done when resuscitation is not expected, or after severe [[brain damage]] that renders a person incapable of making life decisions. See [[Terri Schiavo]].
===Musical riddles===
''Involuntary euthanasia''<br />
Some of the canons of the Musical Offering are represented in the original score by not more than a short monodic melody of a few measures, with a more or less enigmatic inscription in [[Latin]] above the melody. These compositions are called the '''''riddle fugues''''' (or sometimes, more appropriately, the ''riddle canons''). The performer(s) is/are supposed to interpret the music as a multi-part piece (a piece with several intertwining melodies), while solving the "riddle". Some of these riddles have been explained to have more than one possible "solution", although nowadays most printed editions of the score give a single, more or less "standard" solution of the riddle, so that interpreters can just play, without having to worry about the Latin, or the riddle.
Where an individual may distinguish between life and death - and may fully realise the difference between them, any medical killing against the person's wishes is involuntary. If, for example, a man knows he is going to experience severe agony, and does not consent to death, euthanasia imposed upon him is legally, classed as [[murder]]. Any time that medical personnel determine on behalf of a sentient and responsible individual that his or her life is not worth living, the medical killing of such a person ''as it is considered to be done for the prevention of suffering'' is involuntary euthanasia. This is not to be confused with medical killing in cases of [[capital punishment]] or as part of [[genocide]].
One of these ''riddle canons'', "in augmentationem" (i.e. the length of the notes gets longer), is inscribed "Notulis crescentibus crescat Fortuna Regis" (may the fortunes of the king increase like the length of the notes), while a [[Modulation (music)|modulating]] canon which ends a tone higher than it starts is inscribed "Ascendenteque Modulationis ascendat Gloria Regis" (may the king's glory rise like the ascending modulation).
== Arguments for and against euthanasia ==
==Reception==
=== Personal choice/right to death ===
Little is known about how Frederick would have received the score dedicated to him, and whether he tried to solve any riddle or played the flute part of the trio sonata. Frederick's musical taste supposedly did not very much cherish ''complicated'' music, and soon after Bach's visit he was on his next war campaign, so it is possible it was not well received.
Proponents of euthanasia argue that only patients can determine when suffering makes life worse than death and that such persons can and should be allowed to make the decision. Some also argue that terminally ill patients are respected more by having their suffering ended than by being kept alive against their will. Additionally, a [[utilitarian]] argument can be made about the harms to the whole of maintaining the individual beyond viability. Philosopher [[Peter Singer]] has been one of the most outspoken proponents of euthanasia, arguing from a [[Utilitarian Bioethics|utilitarian]] philosophical point of view. [[Joseph Fletcher]] used his [[situational ethics]] model to view euthanasia as an expression of love.
==20th century adaptations and citations==
===Arrangements===
The "Ricercar a 6" has been arranged on its own on a number of occasions, the most prominent arranger being [[Anton Webern]], who in [[1935]] made a version for small [[orchestra]], noted for its [[Klangfarbenmelodie]] style (i.e. melody lines are passed on from one instrument to another after every few notes, every note receiving the "tone color" of the instrument it is played on):
[[Image:Webern's Ricercar arrangement opening.PNG|550px|The opening of Webern's arrangement of "Ricercar a 6"]]
=== Natural Law ===
Euthanasia has been criticised as an unnatural interference on the part of human beings with 'Natural Law.' This argument can be criticised by recourse to the entire idea of medicene - a discipline which by its very nature keep people alive 'unnaturally' via drugs, operations etc.
===As Religious objections reference===
''The Musical Offering'' is cited and deliberately interpreted by [[Douglas Hofstadter]] in his famous book ''[[Gödel, Escher, Bach]]''.
Many people object to euthanasia on [[religion|religious]] grounds. Some believe that their religion [[moral absolute|absolutely prohibits]] all forms of killing; others, who may consider [[capital punishment]] or [[self-defence]] acceptable, nevertheless see euthanasia as usurping decision-making authority that belongs to a [[Creator]] i.e. that humans are '[[Playing God]].' This has come in for similar criticisms as the Natural Law view. An opponent of this view would say that keeping people alive by the use of medicines is also 'playing God.'
==See also==
The second type of argument against euthanasia is that it is not prudent to advocate it; that is, eventually we all may be suffering, and if we think ahead, we may think it better if the doctors on whom we depend are not tempted to perform euthanasia. Euthanasia is inherently less complex than palliative care, and training for euthanasia does not qualify a physician to estimate a patient's response to palliation. Like all medical procedures, euthanasia can fail, or bring additional suffering. Some claim that if euthanasia were allowed, doctors might press people into euthanasia to reduce medical costs, or because their family wants them to die. (Many people believe that saving medical costs is a coercive argument that should disqualify a person from giving free consent.) Many doctors argue against euthanasia, as providing death is antithetical to their primary function and training. If, some have argued, a doctor is trained both to cure and kill, then he or she is being told always to judge when to kill, and his or her best efforts at saving life will not be expended.
* [[Johann Sebastian Bach]]
* [[List of compositions of Johann Sebastian Bach]]
* [[Bach compositions printed during the composer's lifetime]]
* [[Perpetuum mobile]]
* [[Canon_%28music%29]]
* [[Fugue]]
== External links ==
== Legislation and national political movements ==
* [http://jan.ucc.nau.edu/~tas3/musoffcanons.html Canons of the Musical Offering]
=== Australia ===
* The [[Mutopia Project]] has some of the music of [http://www.mutopiaproject.org/cgibin/make-table.cgi?preview=1&searchingfor=1079&Composer=BachJS&Instrument=&Style=&timelength=1&timeunit=week&lilyversion= The Musical Offering]
Euthanasia was legalized in [[Australia]]'s [[Northern Territory]], by the [[Rights of the Terminally Ill Act (Australia)|Rights of the Terminally Ill Act 1995]]. However, this law was soon made ineffective by an amendment by the Commonwealth to the Northern Territory (Self-Government) Act 1978. (The powers of the Northern Territory legislature, unlike those of the State legislatures, are not guaranteed by the Australian Constitution.) Four people had already been legally euthanised, however, before the Commonwealth government made this amendment.
[[Category:Compositions by Johann Sebastian Bach]]
Although it has for some time been a crime in most Australian states to assist another to commit suicide, prosecutions have been rare. In Queensland recently (2003 or 2004??) a group of relatives and friends who provided moral support to an elderly lady who committed suicide were extensively investigated by police, but no charges were laid. The Commonwealth government is now trying to hinder euthanasia and to further inhibit discussion of the concept by the passage of the Criminal Code Amendment (Suicide Related Materials Offences) Bill 2004. That Bill will probably become law (an Act)sometime after the conservative government gains control of the Senate on 01/07/05. Campaigners, beware!
[[fi:Musikalisches Opfer]]
=== Belgium ===
[[de:Musikalisches Opfer]]
After an extensive discussion the [[Belgium|Belgian]] parliament legalised euthanasia in late September 2002. The new legislation, however, institutes a complicated process, which has been criticized as an attempt to establish a ''bureaucracy of death''. Nevertheless, euthanasia is now legal and its proponents in the country hope that it will stop many illegal practices (it is said that several thousand illegal acts of euthanasia have been carried out in Belgium each year).
[[hu:Musikalisches Opfer]]
[[ja:音楽の捧げもの]]
=== Canada ===
On January 28, 2005, [[Marcel Tremblay]] of [[Kanata, Ontario]] held a press conference to announce plans to kill himself, saying his life with [[pulmonary fibrosis]] was unbearable. After attending his own living wake, the 78-year-old man committed suicide at 11:51 pm Eastern time.[http://www.cbc.ca/story/canada/national/2005/01/28/assisted-suicide-050128.html] He had previously said he would be surrounded by his wife and adult children while he placed a bag over his head and filled it with helium. Tremblay said that he publicized his suicide plans to help change laws over assisted suicide. His lawyer said police were satisfied that Tremblay had a sound mind and that authorities would not intervene. Canada decriminalized committing suicide and attempting to commit suicide in 1972.
In the early 1990s, 42-year-old [[Sue Rodriguez]], who had [[amyotrophic lateral sclerosis]] ([[ALS]] or [[Lou Gehrig's disease]]), fought to overturn the law against assisted suicide. She lost her court battle, but died by assisted suicide with the help of an anonymous doctor. Under Canada's Criminal Code, assisted suicide is illegal and punishable by up to 14 years in prison.
=== The Netherlands ===
In the [[Netherlands]] the ''Termination of Life on Request and Assisted Suicide (Review Procedures) Act'' took effect on April 1, 2002. It legalizes euthanasia and physician assisted suicide in certain circumstances.
The law recognized a practice that had been tolerated for some 20 years.
From the time that euthanasia first came to be widely practiced in the Netherlands, it was formally subject to review by boards of doctors in each hospital. The law essentially codified what had already become tolerated practice and unofficial law by judgments in the courts.
The law permits euthanasia and physician assisted suicide when each of the following conditions is fulfilled:
*the patient has asked repeatedly
*the patient's suffering is unbearable with no prospect of improvement
*the doctor has prior to the act consulted an independant colleague.
*the patient has to be at least 12 years old; patients between 12 and 16 years of age require consent of their parents
The doctor must also report the cause of death to the municipal [[coroner]] in accordance with the relevant provisions of the Burial and Cremation Act. A regional review committee assesses whether a case of termination of life on request or assisted suicide complies with the due care criteria. Depending on its findings, the case will either be closed or brought to the attention of the Public Prosecutor. Finally, the legislation offers an explicit recognition of the validity of [[living will|a written declaration of will]] of the patient regarding euthanasia (a "euthanasia directive"). Such declarations can be used when a patient is in [[coma]] or otherwise unable to state whether they want euthanasia or not.
The legislation has wide support among the socially libertarian Dutch, who have one of the world's highest [[life expectancy|life expectancies]]. There is however persistent opposition, mainly organized by the churches.
Euthanasia remains a criminal offense in cases not meeting the law's specific conditions, with the exception of several situations that are not subject to the restrictions of the law at all, because they are considered normal medical practice:
*stopping or not starting a medically useless treatment
*stopping or not starting a treatment at the patient's request
*speeding up death as [[side-effect]] of treatment necessary for alleviating serious suffering
Euthanasia of children under the age of 12 remains technically illegal, however Dr. [[Eduard Verhagen]] has documented several cases and, together with colleagues and prosecutors, has developed a protocol to be followed in those cases. Prosecutors will refrain from pressing charges if this ''Groningen protocol'' is followed.
====Statistics and methods====
In 2003, in the Netherlands 1626 cases were officially reported of euthanasia in the sense of a physician causing death (1.2 % of all deaths). Usually the [[sedative]] [[sodium thiopental]] is [[intravenous]]ly administered to induce a [[coma]], and after making sure the patient is in a deep coma, typically after some minutes, a [[muscle relaxant]] is administered to stop the [[breathing]] and cause death.
:Officially reported were also 148 cases of physician assisted suicide (0.1 % of all deaths), usually by drinking a strong [[barbiturate]] [[potion]]. The doctor is required to be present for two reasons:
*to make sure the potion is not taken by a different person, by accident (or, theoretically, for "unauthorized" suicide or perhaps even murder)
*to monitor the process and be available to apply the combined procedure mentioned below, if necessary.
In two cases the doctor was reprimanded for not being present while the patient drank the potion. They did not realize that this is required.
Forty-one cases were reported to combine the two procedures: usually in these cases the patient drinks the potion, but this does not cause death. After a few hours, or earlier in the case of [[vomiting]], the muscle relaxant is administered to cause death.
By far, most reported cases concerned [[cancer]] patients. Also, in most cases the procedure was applied at home.
Note that some medical authorities and investigative reporters claim there are substantial numbers of euthanasias in the Netherlands performed without consultation or official notice - see links below.
=== United States ===
====Oregon====
Contrary to the rest of the United States, [[Oregon]] has legalized physician assisted suicide (but not euthanasia in the sense of a physician or anyone else causing death): residents have voted for it at the [[Oregon Ballot Measure 16 (1994)]], and voted against repealing it at the [[Oregon Ballot Measure 51 (1997)]]. Oregon's law has been attacked by various organizations, and federal government parties that support those organizations, ever since it was first enacted.
Legal Times reports that former [[United States Attorney General|Attorney General]] "[[John Ashcroft]], a longtime opponent of assisted suicide, stated that Oregon's practice violated the [[Controlled Substances Act]] because it lacked a 'legitimate medical purpose.'," and physicians who prescribe controlled substances to assist with suicided will have their [[medical license]]s taken away. [http://www.law.com/jsp/article.jsp?id=1108389918088] The issue of whether the Federal Government or the State of Oregon has jurisdiction over this issue is now before the United States Supreme Court. '''INSERT:''' Oregon has passed the [http://egov.oregon.gov/DHS/ph/pas/index.shtml Death With Dignity Act].
=====Statistics and methods=====
In 2003, in Oregon 42 cases of physician assisted suicide were reported (0.14 % of all deaths), all by drinking a strong [[barbiturate]] [[potion]]. The doctor is not required to be present, in 12 cases he/she was.
Since 1998, 171 Oregonians have relied on the assisted suicide law.
There were three cases of [[regurgitation]]. In each case at least one third of the potion was retained, which caused death anyway, though in one case only after 48 hours.
The time from ingestion to unconsciousness was 1 to 20 minutes ([[median]] 4 minutes), the time from ingestion to death 5 minutes to 48 hours (median 20 minutes).
By far, most reported cases concerned [[cancer]] patients. Also, in most cases the procedure was applied at home.
====Florida====
A controversial case is that of [[Terri Schiavo]] and the legislation inspired by her in Florida, under Governor [[Jeb Bush]]. In [[1990]], Schiavo collapsed in her home of an [[eating disorder]]. She spent the next 15 years on a [[feeding tube]] in the local [[hospice]] center. Her husband fought to have the feeding tube removed, but her parents fought to have it stay. In [[March]] of [[2005]], the feeding tube was removed. Two weeks later, on [[April 1]], [[2005]], Schiavo died of [[starvation]]. Some consider the death to be a [[murder]].
== See also ==
*[[Jack Kevorkian]], [[Sue Rodriguez]], [[Edward Brongersma]], [[Robert Latimer]]
*[[Infanticide]]
*Oregon's [[Death with Dignity Act]]
*[[Lethal injection]]
*[[Medical ethics]], [[Hippocratic Oath]]
*[[T-4 Euthanasia Program]], [[Eugenics]]
*[[Patient refusal of nutrition and hydration]]
*[[Culture of Life]] vs. [[Culture of Death]]
*[[Right to die|Right to Die]] vs. [[Right to Life]]
==External links==
;For euthanasia:
*[http://www.worldrtd.net/ World Federation of Right To Die Societies]
*[http://www.assistedsuicide.org/ Assisted Suicide]
*[http://www.endoflifechoices.com/ End of Life Choices]
*[http://www.atheistfoundation.org.au/ve.htm Voluntary Euthanasia]- Atheist Foundation of Australia Inc
*[http://plato.stanford.edu/entries/euthanasia-voluntary/ Stanford Encyclopedia of Philosophy entry]
;Against euthanasia:
*[http://www.euthanasia.com/ euthanasia.com]
*[http://www.nrlc.org/euthanasia/ National Right to Life articles on euthanasia]
*[http://www.internationaltaskforce.org/ International Task Force against Euthanasia]- many resources
;Netherlands:
*Official:
**[http://www.minvws.nl/images/broch-euthanasie-nl_tcm10-16130.pdf Ministry of Justice brochure on euthanasia and PAS] (PDF, in Dutch)
**[http://www.minvws.nl/en/themes/euthanasia/ Ministry of Health on euthanasia and PAS]
**[http://www.toetsingscommissieseuthanasie.nl/pdf/jaarverslag2003_engels.pdf Joint annual report 2003 of the Regional Euthanasia Review Conmmittees] (PDF)
*For:
**[http://www.nvve.nl/english/ Right to Die-NL] - Dutch union for voluntary termination of life NVVE
**[http://www.internationaltaskforce.org/holbors.htm NRC Handelblad April 14, 2001 interview of Els Borst: Transparency in Euthanasia]- Note that this is from an anti-euthanasia web site, but claims to be merely a translation of a [http://www.nrc.nl/W2/Nieuws/2001/04/14/Vp/01a.html Dutch article]. Els Borst is a prominent Dutch advocate of Euthanasia.
*Against:
**[http://content.nejm.org/cgi/content/abstract/342/8/551?hits=20&where=fulltext&andorexactfulltext=and&searchterm=complications+from+assisted+suicide&sortspec=Score%2Bdesc%2BPUBDATE_SORTDATE%2Bdesc&excludeflag=TWEEK_element&searchid=1100279357113_6876&FIRSTINDEX=0&journalcode=nejm Clinical Problems with the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands, NEJM, February 24, 2000]
**[http://www.mja.com.au/public/issues/apr19/hendin/hendin.html Consultants or Facilitators? Medical Journal of Australia, 1999 Editorial]- Cites original research, including that on alternative palliative care
**[http://opinionjournal.com/editorial/feature.html?id=95000390 Wall Street Journal Article on Dutch Euthanasia] The article claims that unofficial Euthanasia is performed on as many as sixteen adults per day (90% of adult physician-assisted deaths), and 8% of all infants, often without patient consultation, according to Dutch statistics. This source claims that many old Dutch people are afraid to go to the hospital.
**[http://www.weeklystandard.com/Content/Public/Articles/000/000/004/616jszlg.asp Weekly Standard Article Claiming Unauthorized Euthanasia of Dutch Infants]
**[http://www.nationalreview.com/comment/comment121800d.shtml December 18, 2000 National Review Opinion, Wesley Smith]- Cites statistics showing frequent involuntary physician-assisted deaths in the Netherlands.
;Oregon:
*[http://www.ohd.hr.state.or.us/chs/pas/pas.cfm Oregon's Death with Dignity Act (State Website)]
<!-- Categorization -->
[[Category:Core issues in ethics]]
[[Category:Death]]
[[Category:Medical ethics]]
[[Category:Palliative medicine]]
[[Category:Suicide]]
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[[be:Эўтаназія]]
[[de:Sterbehilfe]]
[[es:Eutanasia]]
[[eo:Eŭtanazio]]
[[et:Eutanaasia]]
[[fa:قتل ترحمی]]
[[fr:Euthanasie]]
[[he:המתת חסד]]
[[nl:Euthanasie]]
[[ja:安楽死]]
[[no:Eutanasi]]
[[pl:Eutanazja]]
[[pt:Eutanásia]]
[[sv:Eutanasi]]
[[zh:安乐死]]
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