Euthanasia in India: Examining the Pros and Cons of This Controversial Practice

Written By: Kumari Shruti

INTRODUCTION

Euthanasia, generally known as “mercy killing,” is the act or practice of putting to death without suffering those who have a physically painful illness or severe, incurable condition, or allowing them to leave this world by delaying treatment or removing artificial life support. Euthanasia can be performed in one of two ways: “Active” or “Passive.” A person who receives active euthanasia is effectively killed; they might receive a morphine overdose, for example. Euthanasia is a complex and controversial topic that involves medical ethics, end-of-life care, and patient autonomy.

Supporters of euthanasia in India and all around the world argue that it offers a way to provide pain relief and a peaceful death to those who are suffering from terminal illnesses or incurable conditions. Others oppose euthanasia on religious, moral, or legal grounds. Physician-assisted suicide, which is a form of active euthanasia, is legal in some countries, including the Netherlands, Belgium, and Switzerland, but is illegal in others, such as India, where it is considered a criminal offense under Section 306 of the Indian Penal Code. A person dies as a result of passive euthanasia when the medication or treatment that is keeping them alive is discontinued.

Euthanasia can also be categorized as:

1. Voluntary euthanasia, in which the individual consciously chooses to pass away and enlists assistance in doing so.
2. Non-voluntary euthanasia occurs when a person cannot give their consent and someone else makes the choice on their behalf, such as a doctor or a family member, who determines that ending the person’s life would be in the best interest of the patient. For instance, if the subject is unconscious.
3. Involuntary euthanasia when someone is killed despite their expressed desire to live. Suppose a physician or a family member determines that ending the person’s life would be in their best interests. For example, if a person has had an accident that will lead to immediate and painful death, a decision might be taken to end their life even if the person chose to live.

The terms “euthanasia” and “physician-assisted suicide” refer to intentional acts done with the goal of ending a person’s life in order to stop their unrelenting suffering.

If the patient and their family agree, a doctor is legally permitted to end a patient’s life in a painless way.

Physician-assisted suicide: When a patient requests help killing themselves, a doctor provides it.

The controversial topic of physician-assisted suicide (PAS) has recently caught the attention of the media, the general public, lawmakers, and the medical community.

There is pressure from some politicians and patient support groups to legalise active euthanasia and PAS in and around Europe, which could potentially have an impact on many other parts of the world, despite the fact that these practises are illegal in the majority of countries around the world—with the exception of Switzerland and the Netherlands. Understanding the influences of culture and religion on decision-making processes is crucial given that we live in a multicultural and multireligious society, particularly in the context of PAS. The cultural, religious, and economical contexts that underlie the differing perspectives on assisted suicide held by various segments of society have received insufficient study. According to recent research, cultural variations may be to blame for some disparities in assisted suicide.

EUTHANASIA IN INDIA: ANALYSIS

A person is blessed with fundamental human rights from the time of his or her birth. One of the most fundamental and fundamental rights is the right to life, without which no other right can be exercised. The term “right to life” refers to a person’s fundamental right to life, notably the right not to be harmed by another person. However, if someone has the right to life, does that mean they also have the right to die?

While providing this response, the Indian courts stated various viewpoints. The Bombay High Court ruled in M.S. Dubal v. State of Maharastra that article 21 of the Indian Constitution’s right to life also includes the “right to die.” In contrast, the AP High Court ruled in Chenna Jagadeeswar v. State of AP that the right to die is not a constitutionally guaranteed right under Article 21. However, the Supreme Court of India noted in the case of P. Rathinam that the “right to live” also encompasses the “right not to live,” or the right to die or end 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.

Current position of Euthanasia and Physician-Assisted Suicide in India:

The Indian Penal Code (IPC), which addresses both active and passive euthanasia, as well as PAS, governs the legal position of both in India. Active euthanasia is illegal in accordance with Penal Code 1860, at the very least under Section 304 and Section 302 (penalty for murder) (punishment for culpable homicide not amounting to murder). The key distinction between euthanasia and physician-assisted death is who delivers the lethal dose; in the former, this is a medical professional or a third party, whereas in the latter, it is the patient. In India, PAS would be considered an offence under Section 306 of the IPC, which deals with aiding suicide. Therefore, legally speaking, anyone interested in PAS or euthanasia must go through the Indian legal system. Under no circumstances, however, have the courts reached a definitive decision on the subject that would permit a PAS to proceed.

NEW DIMENSION IN INDIAN HISTORY- ARUNA’s CASE

Aruna Ramchandra Shanbaug, the petitioner in this case, was a nurse at King Edward Memorial Hospital in Parel, Mumbai. The same hospital’s sweeper attacked her that evening on November 27, 1973, and used a dog chain to yank her back while encircling her neck. The sweeper attempted to rape her as well, but when he realised she was menstruating, he sodomised her instead. He tightened the chain around her neck in order to stop her from moving or causing any havoc. A cleaner discovered her body the following day, unconscious and covered in blood. It was thought that the chain’s strangulation caused the brain’s oxygen supply to stop, causing the brain to become injured. She entered a persistent vegetative condition as a result of this incident, which permanently injured her brain (PVS). Later, journalist and activist Pinki Virani petitioned the Supreme Court under Article 32 of the constitution, claiming there was little chance of her reviving and recovering. Therefore, she should be freed from her suffering and permitted to die through passive euthanasia. The respondent parties, KEM Hospital and Bombay Municipal Corporation, submitted a counter-petition in response to this petition. The gaps between the two groups widened as a result. Due to the discrepancies, the Supreme Court authorised a group of three distinguished doctors to conduct an investigation and produce a report on the precise mental and physical state of Aruna Shanbaug in order to gain a better understanding of the issue. Doctors looked at her whole medical history during this study and concluded that her brain is not dead. She has her own way of understanding and reacting to situations. Also, Aruna’s body language did not show any sign of her willingness to terminate her life. Neither the nursing staff of the hospital showed any carelessness towards taking care of her. Thus, it was believed by the doctor that euthanasia in the current matter is not essential. She stayed in this position for 42 years and died in 2015.

Issues:

1. Does withdrawal of life sustaining systems and means for a person who is in a permanent vegetative state (PVS), should be permissible?
2. If a patient declares previously that he/she does not want to have life-sustaining measures in case of futile care or a PVS, should his/her wishes be respected in such a situation?
3. Does the family or next of kin of a person get to make a request to withhold or withdraw life sustaining systems, in case a person himself has not placed such a request previously?

Judgement:

The Hon’ble Division bench of the Supreme Court of India, comprising Justice Markandey Katju and Justice Gyan Sudha Mishra delivered this judgment on the 7th of March, 2011. The court declared that Aruna is not brain dead and for its judgment relied on the doctor’s report and definition of brain death given under the Transportation of Human Organs Act, 1994. She was able to breathe on her own without a machine’s support; she had feelings and used to show some symptoms. Though she was in a PVS but still her condition was stable. So the grounds presented here are not sufficient for terminating her life. It would be unjustifiable.

Further, the court while addressing the issue opined that in the present case next to the kin of the patient would be the staff of the KEM Hospital, not Pinki Virani. Thus, the right to take any such decision on behalf of her is vested in KEM Hospital. In the present case, it was the food on which she was surviving. Thus removal of life-saving techniques would here mean depriving her of food which is not justified in Indian Law in any way. The Supreme Court allowed passive euthanasia in certain conditions. But the court decided that in order to prevent misuse of this provision in the future, the power to determine the termination of a person’s life would be subjected to High Court’s approval following due procedure. Whenever any application will be filed in High Court for passive euthanasia, the Chief Justice of the High Court should constitute a Bench of at least two judges deciding the matter that whether such termination should be granted or not. The Bench before laying out any judgment should consider the opinion of a committee of 3 reputed doctors. These doctors are also nominated by the Bench after discussing with the appropriate medical practitioners. Along with appointing this committee, it is also the duty of the court to issue a notice to the state, relatives, kins, and friends and also provide them with a copy of the report made by a committee of doctors, as soon as it is possible. And after hearing all the sides, the court should deliver the judgment. This procedure is to be followed in India everywhere until any legislation is passed on the subject.

In the Ultimate decision of this case, by keeping all the important facts of the case in consideration, Aruna Shanbaug was denied euthanasia. Court also opined that if at any time in the future, the hospital staffs feels a need for the same, they can approach the High Court under these prescribed rules. The verdict of this case has helped in clarifying the issues relating to passive euthanasia in India by providing a broad structure of guidelines that are to be followed. The court also recommended the repealing of section 309 of the IPC. We have discussed all the cases. Now let’s discuss the emergence of two important features which came out in this case and have been discussed a lot in subsequent events.

PROS OF EUTHANASIA

1. There is no more fundamental question of individual liberty than the right to choose whether to live or die, thus everyone should be free to make their own decisions. One’s right to possess one’s own body should be absolute.
2. By easing those who are in excruciating pain, euthanasia can lessen or even eliminate suffering in humans. It is wrong to subject someone to suffering against their will.
3. Additionally, it can ease suffering in cases where a person’s quality of life has dramatically declined.
4. It could release medical resources to assist someone else who is very ill.
5. In order to avoid a blanket ban on life termination in some situations, it is crucial to establish guidelines for when it is appropriate to end a person’s life. Modern medicine can frequently keep people alive forever, even if they are not conscious.
6. The patient’s needs are prioritised; euthanasia does not imply a lack of compassion or caring.
7. Allowing living wills gives people the option to decide for themselves if their life is artificially prolonged after suffering from a serious disease or other health problems.

CONS OF EUTHANASIA

1. Euthanasia challenges the notion that every human life is valuable and precious.
2. The majority of medical professionals do not want to be involved in patient killing since it is completely at odds with their perception of their mission, which is to heal people and save lives.
3. The risk of using euthanasia to reduce healthcare expenses, with the patient’s needs and wishes coming second, is present.
4. Regardless of the principle, disagreements over mercy killings can frequently be very challenging in practise because it is not always clear what the patient wants or what is in their best interests. More requests for euthanasia would probably lead to longer court fights. Consider the story of Terri Schiavo, a Florida lady who spent years in a coma. Her parents engaged in a legal struggle to try to prevent her husband’s request for the hospital to remove her feeding tube.
5. If voluntary euthanasia is permitted, there is a risk that it could become a slippery slope where, for example, sick elderly people’s lives wind up being taken because greedy relatives don’t want to care for them or out of a desire for inheritance money.
6. The practise of euthanasia has a sordid past and was employed in Nazi Germany to eliminate children and adults who the government deemed unsuitable, such as the handicapped. By keeping it illegal, no government will ever be able to utilise it for political purposes.

CONCLUSION

uthanasia could be made legal, but very strict regulations would need to be in place. Each case will need to be closely watched while taking into account the opinions of the patient, their loved ones, and the doctors. It has to be seen, however, whether Indian culture is prepared to deal with this given that it is a question of life and death. Advanced, potentially fatal patients should be able to anticipate and receive dependable, skilled, and supportive care, as well as assistance from those around them. A commitment must be made by doctors, nurses, social workers, and other healthcare professionals to enhance care for patients who are dying and to make the best use of current knowledge to prevent and treat pain and other symptoms. If not a medical specialty, palliative care ought to at least be recognised as a specific field of knowledge, study, and research. The nation’s research establishment has to create priorities for expanding the body of knowledge regarding end-of-life care. Personally, I think that passive euthanasia has to be protected by the law and made lawful.

References

https://www.legalserviceindia.com/legal/article-6715-a-critical-analysis-of-mercy-killing-a-good-or-harm-to-humanity.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440914/#:~:text=In%20India%2C%20euthanasia%20is%20a,the%20help%20of%20family%20members.

https://soapboxie.com/social-issues/Euthanasia-pros-and-cons-Should-people-have-the-right-to-die

https://www.britannica.com/topic/euthanasia