Date: 1 November, 2020
by Shwas Bajaj, UILS, Panjab University
Euthanasia, mercy killing or Physician Assisted Suicide is causing of gentle death of a patient in the case of a painful, chronic and incurable disease or in a Permanant Vegitative State (PVS). The basic principle behind this act is that one attains death with dignity and reduction in suffering.
TYPES OF EUTHANASIA
Voluntary Euthanasia: When the person who is killed has requested to be killed.
Non-voluntary Euthanasia: When the person who is killed made no request and gave no consent.
Involuntary Euthanasia: When the person who is killed made an expressed wish to the contrary.
Active Euthanasia: Intentionally causing a person's death by performing an action such as by giving a lethal injection.
Passive Euthanasia: Intentionally causing death by not providing necessary and ordinary (usual and customary) care or food and water
CONTENTIONS FOR LEGALISING EUTHANASIA
The life of the patient is taken with his own consent. The decision is free willed; not coerced or forced upon the patient.
A person has a right to live a life with at least minimum dignity and if that standard is falling below that level then a person should be given a right to end his life. Chief Justice Misra wrote that allowing a patient to wait for death when he does not know if he is living ‘corrodes the essence of dignity’.
Not allowing euthanasia would mean to forcing people to suffer against their will, which would be cruel and a negation of their human rights and dignity.
By denying euthanasia, it also deprives another person to enjoy his 'right to life' by getting the organs which former would have donated. The medical facilities and funds which are being used by a terminally ill patient who is incurable can be of a greater value to a patient who has a better chance of recovery.
Creation of a law can regulate and keep a check on illegal use of euthanasia. Law in itself becomes a deterrent to any criminal activity.
Anticipatory suffering is the worst type of suffering. It includes depression and anxiety that accompanies inevitable suffering from fear of death. One cannot rule out the placebo effect that occurs for those who find their suffering relieved by the simple knowing that they have a choice.
CONTENTIONS AGAINST LEGALISING EUTHANASIA
Even the most incurable diseases eventually become curable. As long as there is hope, the medical practitioners should encourage the patients to live.
The decision to ask for euthanasia is made by the patient and his relatives.
Drugs used in euthanasia cost much less than the costs to treat the patient properly. In absence of health insurance, such financial considerations, added to the concern about "being a burden," could serve as powerful forces; making him "choose" euthanasia.
Who/what determines the criteria of the suffering, for a patient to embrace death. The relatives or doctors might have hidden interest. If euthanasia is administered at the consent of the patient but he is in great physical and mental pain then the person is not in a position to make a free and balanced decision.
If the patient is in coma, should the relatives be allowed to make the decision? In the era of family disputes over property and money, people could get away with cold-blooded murder.
Advances are constantly being made in the treatment of pain and, as they advance, the case for euthanasia is proportionally weakened. There are virtually no uncontrolled pain cases which can be found – in those rare cases where it can't be eliminated - it can still be reduced significantly if proper treatment is provided.
Euthanasia isn’t ‘choice’; it is the end of all choices. Such death is not ‘death with dignity’; it is really the euthanasia of hope.
LEGAL POSITION IN INDIA
Currently, we don’t have any statute in India concerning Euthanasia. The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002, regulation 6.7 declares 'euthanasia' as an unethical act. In the famous Aruna Shanbaug case (AIR 2011 SC 1290) ,the Supreme Court held that passive euthanasia was legal and issued guidelines for its implementation till the time Parliament makes a law. The guidelines are as follows:
A decision has to be taken to discontinue life support by closest relative or a person or a body of persons acting as a next friend.
The decision should be taken (bona fide) for the patient. As per the legal principle of parens patriae the hospital would have to apply to the High Court for approval of the decision.
The Bench should seek the opinion of a committee (preferably a neurologist, a psychiatrist, and a physician) of three reputed doctors.
The committee should carefully examine the patient then take the views of the hospital staff and submit its report to the High Court.
The High Court shall also issue notice to the State and such close relatives or next friend of the patient and supply a copy of the report of the doctor's committee. After hearing them, the High Court should give its verdict.
In the case of Common Cause (A Registered Society) v. Union of India ((2018) 5 SCC 1), a 5 Judge Bench comprising Chief Justice Dipak Misra and Justices A K Sikri, A. M. Khanvilkar, D Y Chandrachud and Ashok Bhushan held that the right to die with dignity is a fundamental right. The court legalising euthanasia observed that an individual's right to execute advance medical directives is an assertion of the right to bodily integrity and self-determination and does not depend on any recognition or legislation by a State.