By Priyanka Agrawal, Chaudhary Charan Singh University.
The phenomenal advances in medical sciences and technology have altered balance of human life and societal values. Pari-passu with these changes is the upsurge of affirmation of human rights, autonomy, and freedom of choice. These issues compel us to re-evaluate our concepts of societal, medical ethics and value systems.
Euthanasia has always been a topic of debate not only in India but also around the world. There are different perspective and ethical views about it. In India, euthanasia drew attention of Indian doctors and socialists in April 2002, when the Dutch Parliament legalised it making the Netherlands the only country in the world to do so. Although doctors had already been providing euthanasia services to ill patients in Netherlands since two decades.[1]Earlier, Oregon was the only State in the U.S. to pass the “Death with Dignity Act” in 1997 enabling patients to administer lethal injections themselves[2].
One of the earliest case of euthanasia occurred in the 19th century, when Dr. Haiselden denied to perform a possibly lifesaving surgery on a deformed body of a new born. He let the baby die at the hands of nature.[3] Euthanasia is translated from Greek as (eu = good, thanatos = death) which means good death or easy death.
Euthanasia may be classified:
- Active Euthanasia – Involves painlessly putting individuals to death for merciful reasons, as when a doctor administers a lethal dose of medication to a patient.
- Passive Euthanasia – Involves not doing something to prevent death, as when doctors refrain from using devices necessary to keep alive a terminally ill patient or a patient in a persistent vegetative state.
- Voluntary Euthanasia – When a person asks for death (by either active or passive euthanasia).
- Non-voluntary euthanasia -Ending the life of a person who is not mentally competent, such as a comatose patient, to make an informed request for death.
- Involuntary Euthanasia– This is said to occur when a patient is killed against his express will[4].
Some religions condemn euthanasia as unethical and believe that it is in God’s hand when to take a person life, but in some religions like Jainism, euthanasia has always been practised.It recommends voluntary death or sallekhana for both ascetics and srāvaka (householders) at the end of their life[5] which is embracing the death voluntarily when both householders and ascetics foresee that the end of the life is very near either due to the old age, incurable disease, severe famine, etc. One overcomes all the passions and abandons all the worldly attachments and gives up food and water, and simultaneously meditates until the soul parts the body.Some may think of this practice as a mere act of stupidity but for some it is a whole mantra of attaining ‘moksha’.[6] So we can clearly see that euthanasia is just a subject of varied perspective.
In the year 2001 only, two cases of Indian courts turning down requests of the patients to die were reported. The Patna High Court dismissed Tarakeshwar Chandravanshi’s[7] plea seeking mercy killing for his 25-year-old wife Kanchan, who had been comatose for 16 months[8].The Kerala High Court said no to the plea of BK Pillai[9], who had a disabling illness, to die.
In spite of clear legal mandates, passive euthanasia, although sporadic, is prevalent in India.[10].Sometimes when the patient has no hope doctors call for removal of life support machines in order to let him die naturally[11]. It is in the medical rules too. It is just that, practise of euthanasia has never been legalised in our country until the year 2011.
It was in the year 2011, in Aruna Ramchandra Shanbaug vs Union of India & Ors,7 March, 2011[12], a landmark judgement was made on 7th March 2011, which allowed “passive euthanasia“of withdrawing life support to patients in (PVS)with certain guidelines but rejected outright active euthanasia of endinglife through administration of lethal substances. Although the final decision in Aruna’s case was left in the hands of nurses who took care of her but it has brought some relief to patients with similar conditions and their families too.
The petition in this case was filed under Article 32, on the basis of ‘Right to life with dignity’ under Article 21. The court clearly specified by giving example of judgement in Gian Kaur vs. State of Punjab (1996) 2 SCC 648[13] that the Article is concerned with ‘Right to live’ and does not include ‘Right to Die’.
Now, an important question arises who should truly be given the power to decide, whether a person should be given a right to die? To live in misery, with deteriorating health, lying on bed or sitting in wheel chair, depending on others for every other basic need, screaming in pain, fighting with severe illness which not only dismiss the physical hopes but also psychological hope. These situations are not only hard to bear for the patient, but also for their families. To give such power to a person who is not bearing such pain, and can in no way understand the exact mental and physical condition of a person is not right in my view.
It is true that right to die must not be given to every other personwho has a tendency to commit suicide. But a person who is in constant vegetative state, or in coma since decades or a person who has severe incurable illness should possess a right to die with dignity.There is no point in waiting to die along with bearing intense pain and distress.
We know that there are risks included as people could take improper advantage of such law. But if such law is legalised with strict guidelines then there is no harm. In our country, the essential life-supporting equipment are limited and difficult to afford so, if the Doctors are given a right through legalisation of such law to remove life-supporting machines from a person who has no hope at all, and transfer it to a person who has some hope, then they may save more lives.
If we throw some light upon a case in which Susan[14], 27 a lively girlmeets with accident and her whole body from neck is paralyzed. She loses friends, fiancé and love, and is a burden over her old mother. After suffering for 23 months, she decides to give up nutrition and asks the nurses and doctors to let her die. Although they loved her but her decision was supported and respected by everyone[15].
It may be opined that practicing euthanasia shall constitute unethical conduct but to let a person suffer in misery and pain and still keeping silent about it, is also ethically wrong.
[1]Available at www.wisegeek.com last seen on 06/08/2015
[2] Available at www.thehindu.com last seen on 06/08/2015
[3] Available at www.euthanasia.procon.org last seen on 06/08/2015
[4] Available at www.ebc-india.com last seen on 06/08/2015
[5] Available at www.en.wikipedia.org last seen on 06/08/2015
[6] Available at www.bbc.uk.in last seen on 07/08/2015
[7] Tarakeshwar Chandrawanshi v Union of India, decided on 22/02/2001
[8] Available at www.thehindu.com last seen on 07/08/2015
[9] BK Pillai v State of Kerala
[10] Available at www.thehindu.com last seen on 07/08/2015
[11] Available at www.ibnlive.com last seen on 08/08/2015
[12] Available at www.indiankanoon.org last seen on 07/08/2015
[13] Available at www.indiankanoon.org last seen on 08/08/2015
[14]1998 Blackwell Science Ltd, Journal of Advanced Nursing, 28(1)
[15]Available at www.hadassah.org.il last seen on 08/08/2015