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This article is written by Sabaat Fatima.

Introduction

What is the first thought when you hear the word ‘Euthanasia’? Is it against the Right to life or a blessing for the sufferer? Can you say that it is a form of murder? Or it gives a person the right to die with dignity? As said by Lao Tzu, “Life and death are one thread, the same line viewed from different sides”. Everyone in this world wants a protracted life and wishes a painless death. There is a fact that cannot be ignored that for some people life can become a liability due to the endless sufferings attached to it. Mercy killing or Euthanasia may sound to be cruel and against the law of nature but it eases a person from his lifelong illness and helpless state.

Quality of life is vital and precious and consequently a human right which is defined by the patient, not the doctor or government. When the patient feels that their life is unproductive and meaningless, the least a doctor can do is let the patient choose what they want to do. If he or she wants to die, then so it be. The role of the doctors and medical science should be to help the living. It’s not for them to enter the domain of death. Let’s look the other side, it would be a remarkable thing if the medical professionals could tell when to do so but a high misuse will happen because they will pull the plug on people who cannot afford to pay the bills so we are allowing it to go as it is going. So, you see we support life only with the hope that the patient will revive. Nobody is supporting it with the intention to just run the machines forever; the hope is because a few have recovered after years being in a coma.

There are two conditions of people in a coma –

i) the body has become motionless, that you are not able to get the body going i.e. the mind is active, the emotion is active and all perceptions are there. Therefore, this is torture because the body is refusing to move.

ii) But in other cases the body seems to be vibrant, digesting food and is fully active but the inside is blank. If the inside has become blank then you wait for 5 cycles of 21 days then for sure life is gone but the body can be still kept alive because of various medical processes which are helping to keep the body going. So you can say without life you are keeping a body alive then this is not a good thing to do. But if the person within is alive it’s just the body which is not responding then it’s a very difficult situation to make any decision i.e. whether to pull the plug or not everything the patient understands.

What is euthanasia?

The phrase “euthanasia” was coined by Sir Francis Bacon. It is also called as ‘mercy killing’. The term “Euthanasia” has been derived from the two Greek words ‘eu’ and ‘thanotos’, which literally means ‘good death’. Euthanasia is the practice of intentionally ending a life in order to relieve pain and suffering (provided motive should be good & death must be painless as much as possible) or “A deliberate intervention was undertaken with the express intention of ending a life, to relieve intractable suffering.” – British House of Lords Select Committee on Medical Ethics.

Forms of Euthanasia

  1. Voluntary Euthanasia (with patients’ consent) – Euthanasia is performed with the patient’s consent. It is legitimate in certain nations like Belgium, Netherlands, etc.
  2. Non-voluntary Euthanasia (patient’s consent unavailable) – Where a person is unable to give their consent (for example –the patient is in a state of coma or severely brain-damaged) and someone else make the choice for their benefit, frequently in light of the fact that the ill person had expressed a wish beforehand to end their life in such circumstances.
  3. Involuntary Euthanasia (without asking consent or against the patient’s will)–Euthanasia conducted against the will of the patient is termed involuntary euthanasia. It is also regarded as murder.
  4. Physician-Assisted Suicide – When a doctor helps a patient in finishing their own life. For instance, the doctor provides the patient with clinical knowledge (i.e., describing painless and effective clinical means of suicide) enabling the patient to end his/her own life (Vij Kishan, 2005).

Difference between Euthanasia and physician-assisted suicide

Physician-assisted suicide is often misunderstood with euthanasia. The distinction is in who directs the deadly medication. In euthanasia -a physician or third party directs it. In physician-assisted suicide- it is the patient who on his own regulates it, though on the advice of the doctor. Assisted suicide and euthanasia are in some cases called under the umbrella term “assisted dying”

Types of euthanasia

  1. Active Euthanasia– Where a person purposefully intercedes to finish someone’s life with the use of deadly substances or forces. For example- Injecting a person with a lethal dose of drugs.
  2. Passive Euthanasia– Where a person cause’s death by retaining or pulling back the treatment that is essential to maintain life. For example- removal of life support system, etc.
  3. A living will – It is a will in which a person states that if they do not recover after a certain period then they should be removed from life support.

Religious arguments

Religions are against euthanasia for a number of reasons.

  1. Euthanasia is against the will of God i.e. only God has the power to take one’s life and therefore carrying out any of these would be against God’s command.
  2. According to Hinduism and Buddhism, mortal life is a part of a continuing cycle in which we take birth, live, die, suffer, and are reborn over again and again. So, according to them, suffering has some value attached to it, and therefore, shortening life interferes with the law of karma.
  3. Most religions disapprove of euthanasia. Some absolutely forbid it. For example, the Roman Catholic Church is one of the foremost active organizations in opposing euthanasia.
  4. All religions in their scriptures state that those who become vulnerable through illness or disability deserve special care and protection, and proper care of life is a much better thing than euthanasia.

Cases

Aruna Shanbaug case v. Union of India

In this case, a nurse was sexually assaulted by a sweeper at the hospital and was nearly killed employing a dog chain that was wrapped around her neck. Due to the lack of oxygen that reached her brain, she fell into a coma which she was in for 48 years. In this case, the court stated that only passive euthanasia was allowed in India. Moreover, they said that passive euthanasia could only be done by parents, guardians, spouses, close relatives, and close friends. If they are not present, then the individual closest to her during the treatment could do the same. The court finally allowed passive euthanasia in 2011.

Common Cause v. Union of India 2018

This case features a bench of judges led by Ex-Chief Justice of India, Deepak Mishra. In this case, he said that the fundamental right to life and dignity also included the right to refuse treatment and die with dignity. This case legalized the use of passive euthanasia in India on 9th March 2018.

What is a “living will”?

A living will is a document that sets out a patient’s desires with respect to health care and how they want to be treated if they become seriously ill and unable to make or communicate their own choices. Living wills are also called as active declarations. In 2014, the Supreme Court issued a notice to all the states for looking at their perspective on whether a person who is in the critical condition can execute a ‘living will’ or not? Or in more simple language can a person in critical state make a will that his or her life support system is pulled back if he or she reaches a state where no hope of recovery can be seen. The court on this issue appointed amicus curiae.

Guidelines given for a Living Will are as follows –

1 – Adults with a sane mind without coercion.

2 – Signed in front of a first-class judicial magistrate.

3 – The individual should be aware of the pain they will suffer upon the removal of life support.

4 – The person closest to the patient should be present. The hid name should be mentioned in the living will as it is only that individual who can give consent to remove life support.

Supreme Court guidelines on passive euthanasia-

Guidelines to be followed while carrying out passive euthanasia:

  1. The choice of discontinuing life support should either be taken by the parents or the spouse or any other close relative or in the absence of any of them, such decision could be taken by the person himself or a body of person’s acting like close friends.
  2. Such a decision can also be taken by the doctors attending the patient as genuine in the best interest of the patient.
  3. While taking any decision to carry out passive euthanasia one should first seek the approval of the concerned High Court. After receiving the application, the Chief Justice of the High Court should then constitute a bench of at least two judges who would then decide whether to grant approval or not. The bench can further nominate three reputed doctors and ask them to submit the reports on this matter.
  4. Before giving the judgement a notice concerning the report should be given to the close relatives and the State. After hearing the parties, the High Court can give its adjudication.

The Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill

Salient Provisions of the Draft Bill:

Every equipped patient, including minors aged above 16 years, has a right to make a decision and express their desire to the physician attending on her or him on whether to continue further treatment or permit nature to take its own course. The Bill gives security to patients and doctors from any liability for retaining or pulling back any medical treatment and states that palliative care (pain management) can continue.

When a patient communicates her or his decision to the physician, such a choice is binding on the medical man. However, it also notes that the physician must be “satisfied” that the patient is “competent” and that the decision has been taken on free will.

There are going to be a panel of medical doctors to decide on a case by case basis. The physician has to maintain all details of the patient and ensure he/she takes an informed decision. He is also required to inform the patient whether it might be best to withdraw or continue treatment. If the patient is not in a conscious state, the medical practitioner needs to inform family members. In the absence of family members, the physician needs to inform a person who is a regular visitor. 

The draft also lays down the tactic for seeking euthanasia, right from the composition of the medical team to manoeuvre the high court for permission. Permission to be acquired from the high court. Any near relative, friend, trustee, medical doctor/staff attending the patient, the other person obtaining the leave of the court can apply to the jurisdictional high court. Such an application is treated as an ingenious petition and therefore the chief justice of the high court shall assign the same to the divisional bench without loss of time and the same should be disposed of as far as practical within a month. This bench will nominate and need a report from a committee of three reputed doctors.

The Bill only indicates to legalize what is called “passive euthanasia”, as discussed in the judgement concerning to Aruna Shaunbaug. Active euthanasia is not being considered “as it is likely to be employed by immoral individuals to achieve their underlying motives.” A living will is void and not binding on any physician or surgeon. The medical council of India may issue guidelines according to the provisions of the bill. It may review and can also modify from time to time.

In India, Section 309 of the Indian Penal Code deals with an attempt to commit suicide whereas Section 306 of the Indian Penal Code deals with the abetment of suicide. Both actions are a crime in the eyes of law and therefore punishable. The issue which arises here is that to be able to make a living will, the legislation would need to decriminalize both. Though the court will consider the authenticity of the bill still there are many issues. For instance, if the demise of the patient is of material incentive to those who are close to him/her (for example, property), the doubt over the authenticity of the living can transform into a legitimate issue. In this manner, there is a need to deliberately set up conditions under which a living will be executed.

Conclusion

Today there is a debate going everywhere on the world regarding its lawful standing beside the righteous and moral issues included. Having seen that the law isn't ill-equipped to re-evaluate previous unbending demeanour toward the sanctity of life those for Euthanasia show some enthusiasm in supporting their perspectives (Vij Krishan, 2008). The rivals of Euthanasia express that there are good, strict, and moral commitments that can’t be disregarded. They contend that nobody has a right to remove the life of an individual, not even the individual oneself. The idea of the sanctity of life is sacred and specialists have made a vow (The Hippocratic pledge); to protect life at all expense; cannot legitimize a patient to die or latent methods (Pillay, 2010). Euthanasia is might be useful for the individual who is truly in a serious torment however at same side it might be hazardous if advantage is taken in incorrect manner, so it is must fundamental that it ought to be done in supervision with the principles. In any case, the consequence of connotation of euthanasia should be re-examined again at ordinary intervals relying on the development of society as to giving medical care to handicapped and to the person who cannot be cured and will eventually lead to death.

References

https://www.justvocateslaw.com/post/euthanasia-the-mercy-killing

https://byjus.com/free-ias-prep/euthanasia-or-mercy-killing/

https://byjus.com/free-ias-prep/medical-treatment-of-terminally-ill-patients-bill-2016/

https://www.alllaw.com/articles/wills_and_trusts/article7.asp

https://www.lawbhoomi.com/post/case-brief-aruna-ramachnadra-shanbaug-v-union-of-india

http://lawtimesjournal.in/common-cause-vs-union-of-india/


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