Euthanasia, also called mercy killing, act or practice of painlessly putting to death persons suffering from painful and incurable disease or incapacitating physical disorder or allowing them to die by withholding treatment or withdrawing artificial life-support measures.
From the moment of his birth, a person is clothed with basic human rights. Right to life is one of the basic as well as fundamental right without which all rights cannot be enjoyed. Right to life means a human being has an essential right to live, particularly that such human being has the right not to be killed by another human being. But the question arises that if a person has a right to live, whether he has a right not to live i.e whether he has a right to die? Whiling giving this answer, the Indian courts expressed different opinions. In M.S Dubal vs. State of Maharastra, the Bombay High Court held that right to life under article 21 of the Indian Constitution includes ‘right to die’. On the other hand in Chenna Jagadeeswar vs. State of AP, the AP High Court said that right to die is not a fundamental right under Article 21 of the Constitution. However in P. Rathinam’s case Supreme Court of India observed that the ‘right to live’ includes ‘right not to live’ i.e right to die or to terminate one’s life. But again in Gain Kaur vs State of Punjab, a five member bench overruled the P.Rathainam’s case and held that right to life under Article 21 does not include Right to die or right to be killed.
‘Right to life’ including the right to live with human dignity would mean the existence of such right up to the end of natural life. This may include the right of a dying man to die with dignity. But the ‘right to die with dignity’ is not to be confused with the ‘right to die’ an unnatural death curtailing the natural span of life. Thus the concept of right to life is central to the debate on the issue of Euthanasia. One of the controversial issues in the recent past has been the question of legalizing the right to die or Euthanasia. Euthanasia is controversial since it involves the deliberate termination of human life. Patient suffering from terminal diseases are often faced with great deal of pain as the diseases gradually worsens until it kills them and this may be so frightening for them that they would rather end their life than suffering it. So the question is whether people should be given assistance in killing themselves, or whether they should be left to suffer the pain cause by terminal illness.
DIFFERENCE BETWEEN SUICIDE AND EUTHANASIA:
There is a conceptual distinction between suicide and euthanasia. In a suicide a man voluntarily kills himself by stabbing, poisoning or by any other way. No doubt in suicide one intentionally attempts to take his life. It is an act or instance of intentionally killing oneself mostly due to depression or various reasons such as frustration in love, failure in examinations or in getting a good job etc. on the other hand, in euthanasia there is an action of some other person to bring to an end the life of a third person. In euthanasia, a third person is either actively or passively involved i.e he aids or abets the killing of another person. It is important to mention in this context that there is also a difference between ‘assisted suicide’ and ‘euthanasia’.
Assisted suicide is an act which intentionally helps another to commit suicide, for example by providing him with the means to do so. When it is a doctor who helps a patient to kill himself (by providing a prescription for lethal medication) it is a ‘physician assisted suicide’. Thus, in assisted suicide the patient is in complete control of the process that leads to death because he/she is the person who performs the act of suicide. The other person simply helps (for example, providing the means for carrying out the action). On the other hand euthanasia may be active such as when a doctor gives a lethal injection to a patient or passive such as when a doctor removes life support system of the patient.
The Northern Territory of Australia became the first country to legalize euthanasia by passing the Rights of the Terminally ILL Act, 1996. It was held to be legal in the case of Wake v. Northern Territory of Australia by the Supreme Court of Northern Territory of Australia.
Euthanasia was legalized in Albania in 1999, it was stated that any form of voluntary euthanasia was legal under the rights of the Terminally ILL act of 1995. Passive euthanasia is considered legal if three or more family members consent to the decisions
In Canada, patients have the right to refuse life sustaining treatments but they do not have the right to demand for euthanasia or assisted suicide.
According to Article 115 of Swiss Penal Code, suicide is not a crime and assisting suicide is a crime if only if the motive is selfish. It does not require the involvement of physician nor is that the patient terminally ill. It only requires that the motive must be unselfish. In Switzerland, euthanasia is illegal but physician assisted suicide has been made legal.
ARGUMENTS AGAINST EUTHANASIA
- It is feared that if euthanasia is legalised then other groups of more vulnerable people will become at risk of feeling into taking that option themselves. Groups that represent disabled people are against the legalisation 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.
- It is totally against the medical ethics, morals and public policy. Medical ethics call for nursing, care giving and healing and not ending the life of the patient. In the present time, medical science is advancing at a great pace. Thus even the most incurable diseases are becoming curable today. Thus instead of encouraging a patient to end his life, the medical practitioners should encourage the patients to lead their painful life with strength which should be moral as well as physical. The decision to ask for euthanasia is not made solely by the patient. Even the relatives of the patient pay an important role in doing that. Hence, it is probable that the patient comes under pressure and takes such a drastic step of ending his life. Of course in such cases the pressure is not physical, it is rather moral and psychological which proves to be much stronger. The patient himself starts to feel that he is a burden on the relatives when they take such a decision for him and finally he also succumbs to it.
- Acceptance of euthanasia as an option could exercise a detrimental effect a societal attitudes and on the doctor patient relationship. The doctor patient relationship is based on mutual trust, it is feared this trust may be lost if euthanasia is legalised.
- The human life is gift of God and taking life is wrong and immoral human beings cannot be given the right to play the part of God. The one who suffers pain is only due to one’s karma. Thus euthanasia devalues human life.
- Patient would not be able to trust either doctors or their relatives as many of them were taking about patient’s painless dignified death and it became a euphemism for assisted murder.
REASONS TO LEAGALISE EUTHANASIA
- Euthanasia means ending the life a person who is suffering from some terminal illness which is making his life painful as well as miserable or in other words ending a life which is not worth living. But the problem is that how should one decide whether his life is any longer worth living or not. Thus, the term euthanasia is rather too ambiguous. This has been a topic for debate since a long time i.e. whether euthanasia should be allowed or not. At present, the debate is mainly regarding active euthanasia rather than passive euthanasia. The dispute is regarding the conflicts of interests: the interest of the society and that of the individual. Which out of these should prevail over the other? According to the supporters of euthanasia the decision of the patients should be accepted. If on the other hand we weigh the social values with the individual interest then we will clearly see that here the interest of the individual will outweigh the interest of the society. The society aims at interest of the individuals rather it is made with the purpose of assuring a dignified and a peaceful life to all. Now if the individual who is under unbearable pain is not able to decide for himself then it surely will hamper his interest. In that case it will surely be a negation of his dignity and human rights.
- A point which is often raised against the supporters of euthanasia is that if such right will be granted to the terminally ill patients then there will be chances of abusing it. But the supporters argue that every right involves a risk of being abused but that doesn’t mean that the right itself should be denied to the people. We should rather look at the brighter side of it than thinking of it being abused.
- Article 21 of the Indian Constitution 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. Supporters of euthanasia also point out to the fact that as passive euthanasia has been allowed, similarly active euthanasia must also be allowed. A patient will wish to end his life only in cases of excessive agony and would prefer to die a painless death rather than living a miserable life with that agony and suffering. Thus, from a moral point of view it will be better to allow the patient die painlessly when in any case he knows that he is going to die because of that terminal illness.
- 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.
PRESENT POSITION IN INDIA
Aruna Shanbaug, who was working as a nurse at KEM Hospital, was assaulted on the night of November 27, 1973 by a ward boy. He sodomised Aruna after strangling her with a dog chain. The attack left Aruna blind, paralysed and speechless and she went into a coma from which she has never come out. She is cared for by KEM hospital nurses and doctors. The woman does not want to live any more. The doctors have told her that there is no chance of any improvement in her state. Her next friend (a legal term used for a person speaking on behalf of someone who is incapacitated) describes Shanbaug: “her bones are brittle. Her skin is like ‘Paper Mache’ stretched over a skeleton. Her wrists are twisted inwards; her fingers are bent and fisted towards her palms, resulting in growing nails tearing into the flesh very often. Her teeth are decayed and giving her immense pain. Food is completely mashed and given to her in semisolid form. She chokes on liquids and is in a persistent vegetative state.” So, she, through her ‘next friend’ Pinki Virani, decided to move the SC with a plea to direct the KEM Hospital not to force feed her. And on 16th December 2009, the Supreme Court of India admitted the woman’s plea to end her life. The Supreme Court bench compromising Chief Justice K G Balakrishnan and Justices A K Ganguly and B S Chauhan agreed to examine the merits of the petition and sought responses from the Union Government, Commissioner of Mumbai Police and Dean of KEM Hospital.
On 24th January 2011, the Supreme Court of India responded to the plea for euthanasia filed by Aruna’s friend journalist Pinki Virani, by setting up a medical panel to examine her. The three-member medical committee subsequently set up under the Supreme Court’s directive, checked upon Aruna and concluded that she met “most of the criteria of being in a permanent vegetative state”. However, it turned down the mercy killing petition on 7th March, 2011. The court, in its landmark judgement, however allowed passive euthanasia in India. While rejecting Pinki Virani’s plea for Aruna Shanbaug’s euthanasia, the court laid out guidelines for passive euthanasia. According to these guidelines, passive euthanasia involves the withdrawing of treatment or food that would allow the patient to live.
Ms Shanbaug has, however, changed forever India’s approach to the contentious issue of euthanasia. The verdict on her case today allows passive euthanasia contingent upon circumstances. So other Indians can now argue in court for the right to withhold medical treatment – take a patient off a ventilator, for example, in the case of an irreversible coma. Today’s judgement makes it clear that passive euthanasia will “only be allowed in cases where the person is in persistent vegetative state or terminally ill.”
Recently in November 2007, a member of Indian parliament who belongs to the Communist Party of India introduced a bill to legalize euthanasia to the Lok Sabha, the lower house of representatives in the Indian parliament. C.K. Chandrappan, a representative from Trichur, Kerala, introduced a Euthanasia Permission and Regulation Bill that would allow the legal killing of any patient who is bedridden or deemed incurable. The legislation would also permit any person who cannot carry out daily chores without assistance to be euthanized.
“If there is no hope of recovery for a patient, it is only humane to allow him to put an end to his pain and agony in a dignified manner,” said Dr. B. K. Rao, chairman of Sir Ganga Ram Hospital in New Delhi. “If it is established that the treatment is proving to be futile, euthanasia is a practical option for lessening the misery of patients.”
If we carefully examine the opposition to the legalization of euthanasia, we can conclude that the most important point that the opponents raise is that it will lead to its misuse by the doctors. Thus, it is submitted that when a patient or his relatives can willingly put his life in the hands of the doctor trusting him, then why can’t a doctor be given such discretion to decide what will be in favour of his patient. Another doubt that is often raised is that if the doctors will be given discretion to practice voluntary euthanasia then surely it will gradually lead to asking for involuntary or non-voluntary euthanasia. But it is humbly submitted that a separate legislation should be made allowing only voluntary euthanasia and not involuntary or non-voluntary euthanasia. As has already been pointed out earlier, we also have to keep in mind the limited medical facilities available in India and the number of patients. This question still lies open that who should be provided with those facilities; a terminally ill patient or to the patient who has fair chances of recovery. As the patient himself out of his pain and agony is asking for death, doctor should not increasing that pain of his should allow euthanasia. It has been ruled in the Gian Kaur case that Article 21 does not include right to die by the Supreme Court. But one may try to read it as is evident in the rights of privacy, autonomy and self-determination, which is what has been done by the Courts of United State and England. Thus, we can see that as the said right has been included in the ambit of Article 21, so this can also be included in Article 21. This question was not raised in the case earlier. Again the point that remains unanswered is regarding the abuse of this right by the doctors. But relevant safeguards can be put on this right and thus its abuse can be avoided. One of the safeguards can be that a proper quasi-judicial authority having a proper knowledge in the medical field can be appointed to look into the request of the patient and the steps taken by the doctor. To make it more full proof some two or three assistant officials including one from the legal field can also be appointed. This will avoid any abuse of this right granted to the terminally ill patients. Here, we have to regard the painful situation in which the patient is and top priority should be lessening his pain. Now when we already know that he is anyways going to die today or tomorrow and he himself is asking for death, there is no point that he should be denied with this right of at least leading a life with minimum dignity and willingly. Otherwise his life will be no better in that situation. Thus, considering the financial and medical facilities also, the question still lies open that what will be better-allowing euthanasia or not allowing euthanasia.