EUTHANASIA: RIGHT TO DIE WITH DIGNITY

EUTHANASIA: RIGHT TO DIE WITH DIGNITY

Euthanasia can be defined as the intentional killing by act or omission of a dependent human being for his or her alleged benefit. It is also known as ‘Mercy Killing’ which is an act where the individual who, is in an irremediable condition or has no chances of survival as he is suffering from painful life, ends his life in a painless manner. Recently, a man in Colombia became first person with non-terminal illness to die by legal euthanasia.

Types of Euthanasia

1. Active Euthanasia: where a person intentionally intervenes to end someone’s life with the use of lethal substances or forces.
   • Example: Administering a lethal injection to end life.
2. Passive Euthanasia: where a person causes death by withholding or withdrawing treatment that is essential to maintain life.
   • Example: stoppage of antibiotics treatment in certain cases where it is necessary for the continuance of life, removal of life support system, etc.

Euthanasia in India

• Legality: Active euthanasia is a crime under section 302 or 304 of IPC. The Supreme Court in 2011 in Aruna Ramchandra Shanbaug v. Union of India had held that passive euthanasia can be allowed under exceptional circumstances.
• Use of living will: In Common Cause v. Union of India case, the Supreme Court held that a person in persistent vegetative state can opt for passive euthanasia, and that a person can execute a living will to refuse medical treatment in case of a terminal illness.

Timeline of Euthanasia in India

• Maruti Shripati Dubal vs State of Maharashtra, 1986: The court held that Section 309 IPC (criminalizing attempt to suicide) was violative of Article 14, 19, and 21 of the constitution and thus declared the section as ultra-vires of the constitution.
• Naresh Maratra Sakhee vs Union of India, 1994: SC held that suicide by its nature is an act of self-killing or self-destruction, an act of terminating one’s own act and without the aid or assistance of any other human agency and it is different from euthanasia.
• P. Rathinam vs Union: SC held that criminal penalties for suicide violate the constitutional right to life by amounting to a double punishment; especially, a woman who attempts suicide after abuse cannot be criminally penalized for their suicide attempt.
• Gyan Kaur case, 1996: Supreme Court held that both euthanasia and assisted suicide are not lawful in India and right to life under Article 21 of the Constitution does not include the right to die.
• Aruna Shanbaug versus Union of India case, 2011: It laid down guidelines to process pleas for passive euthanasia. It also spelled out differences between active and passive euthanasia.
• Law Commission’s 241st report, 2012: It proposed making legislation on passive euthanasia and prepared a draft bill called the Medical Treatment of Terminally Ill Patients (protection of patients and medical practitioners) Bill. It didn’t recommend active euthanasia.
• Common Cause v Union of India, 2018: Supreme Court of India legalised passive euthanasia by means of the withdrawal of life support to patients in a permanent vegetative state.

Arguments in Favour of legalising euthanasia

1. Political

• Right to die with dignity: Article 21 clearly provides for living with dignity. A person has a right to live a life with at least minimum dignity and if that standard is falling below that minimum level then a person should be given a right to end his life.
• Right to choose: The essence of human life is to live a dignified life and to force the person to live in an undignified way is against the person’s choice. Thus, it expresses the choice of a person which is a fundamental principle.

• Global examples: It can be understood from other examples that following euthanasia will not necessarily lead to unacceptable consequences.
  • Example: Countries like the Netherlands, Belgium, Luxembourg, etc., where euthanasia has been legalized to justify that it is mostly trouble-free.

2. Practical

• Redistributing efforts to save more lives: In many developing countries like India, there is a shortage of funds and hospital space. Energy of doctors and hospital beds can be used for those people whose life can be saved instead of continuing the life of those who want to die.
• Helping rather than harming: Its aim is altruistic and beneficial as it is an act of painlessly putting to death those persons who are suffering from painful and incurable diseases. So, the motive behind this is to help rather than harm.
• Choice to say no to suffering: Many people feel that it is better to die than to go through the pain of diagnosed diseases as well as treatment which are even more painful.
  • Example: Cancer and chemotherapy.

Arguments against euthanasia

1. Ethical and moral

• Medical ethics: It is totally against medical ethics, morals, and public policy. Medical ethics call for nursing, caregiving, and healing, not ending the life of the patient.
• Religious arguments: The human life is a gift of God and taking life is wrong and immoral; human beings cannot be given the right to play the part of God.
  • Example: Roman Catholic Church is one of the most active organizations in opposing euthanasia.
• Life’s importance: Euthanasia could weaken society’s respect for the sanctity of life.
• Assessing value of life: Accepting euthanasia would mean that some lives (those of the sick or disabled) are worth less than others.

2. Social

• Can motivate people into decision of euthanasia: It is feared that if euthanasia is legalized, then other groups of more vulnerable people will become at risk of feeling compelled to take that option themselves.
• Motivates vulnerable people: Groups that represent disabled people are against the legalization of euthanasia on the ground that such groups of vulnerable people would feel obliged to opt for euthanasia as they may see themselves as a burden to society.
• Killing people for their wealth: Patients would not be able to trust either doctors or their relatives as many of them were talking about the patient’s painless, dignified death, and it became a euphemism for assisted murder.

3. Practical

• Advanced medical science to help: In the present time, medical science is advancing at a great pace. Thus, even the most incurable diseases are becoming curable today.

Way Forward

• Living will: The decision of the Supreme Court to allow passive euthanasia and living will is a landmark judgment and upholds the fundamental right of life, which includes the right to die with dignity.
• Legislative efforts: The 241st report of the Law Commission states that passive euthanasia should be allowed with certain safeguards and there is a proposed law—Medical Treatment of Terminally Ill Patient Bill, 2006, in this regard.

• Medical Attorney: Supreme Court decision on a living will from a patient quells misgivings from the family, and there are chances of criminal action against doctors. Thus, a living will make sense when coupled with a medical power of attorney and independent third-party monitoring.
• Quality healthcare: India needs improved access to high-quality healthcare for the terminally ill so that they go in peace, whenever they do. This is referred to as palliative care from the time an illness is diagnosed till the end of life.

Euthanasia is indeed a contentious issue, with the heart of the debate lying at active voluntary euthanasia and physician-assisted suicide. There is an urgent need to invest in our health care system so that people suffering from serious ill health can access free health care. Investment in health care is under ‘Right to Health’ which is bestowed under ‘Right to Life’ of our Constitution. Thus, the complete expenses need to be borne by the State so that ‘Right to life’ becomes a reality and succeeds before ‘Right to death with dignity’.