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Why Euthanasia Should Be Illegal: the Ethics of the Assisted Death

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The right to life is the most fundamental right that a person can have without which all other rights cannot be enjoyed. Article 21 of the Indian Constitution states, “No person shall be deprived of his life or personal liberty except according to a procedure established by law.” It has become the core of the Indian Constitution, which has become the foundation for all other laws in the country. This right applies to every person, be it a citizen or a foreigner. However, a question arises, if a person is allowed to live with dignity, does he also have the right to die with dignity? This has been the most pressing issue wherein the Indian Courts have frequently questioned: “if a person has the right to end his own life?”

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In Maruti Shripati Dubal v. State of Maharashtra [1986] , it was decided by the Bombay High Court that the right to live as mentioned in Article 21 of the Indian Constitution also includes a right to die or end one’s life. But, in Chenna Jagadeeswar vs. State of AP [1988] , it was held that the constitutional validity of Section 309 IPC was to be rejected and that the argument for involving “Right to Die” under Article 21 was also to be rejected therein. However, the Supreme Court came to reasoning in P. Rathinam v Union of India [1994] , that the right to end one’s life is irrational and an infringement of the law. But it is to be seen that there is a huge difference between the Right to Die with dignity and the Right to die an unnatural death. A death which is caused due to an unnatural event would not come under the scope of section 309 of the IPC. This is where the issue of Euthanasia arises. This issue is so controversial due to the fact that it is an intentional termination of human life. Euthanasia is seen in cases where the patient in a hospital bed has been suffering for a prolonged period with a terminal illness and have to go through a lot of pain. In such cases, it is be observed whether the patient should be suffering such treacherous pain or should be killed by a third person to relieve them of their pain.

Euthanasia is a word that has Greek roots. It is derived from two Greek words – ‘Eu’ and ‘Thantos’, which when put together means ‘good death’. As explained above, Euthanasia refers to the act of killing a person by injection or extreme medical measures from a terminal disease in order to free him of such sickness. The main objective of committing Euthanasia is to let the patient die in a peaceful manner instead of letting him have a painful death. When a person is suffering from a lot of pain and moreover there is no meaning left for him to live, then it might be best to let such a person have a painless death. There are thousands of people in the country who are on their deathbed, without any physical movement and depending on others. We might feel that such a person should have a peaceful death and not go through physical and mental torture. On the other hand, by intentionally letting the person die, there is a loss of innocent life. Thus, the question of legalizing Euthanasia arises!

There are two categories wherein Euthanasia can be distinguished. Firstly, (A) On the basis of the nature of act being done:

  • Active Euthanasia: It refers to the act of commission which involves the use of lethal substances or forces to kill a person. Providing large dosage of drugs or giving a lethal injection to a patient to fasten his/her death are considered to be prime examples of Active Euthanasia.
  • Passive Euthanasia: It refers to the act of omission which involves the withdrawal of medical life support for the purpose of continuance of life. An example of Passive Euthanasia would be withholding or removing the heart-lung equipment from a patient in the state of coma. Thus, it is to be noted that if the methods to keep the patient alive are still available, the person is allowed to die due to natural circumstances. In simple terms, it refers to the non-use of measures that might delay death. In these cases, patients are made to die a natural death.

The second category of differentiating Euthanasia is (B) On the basis of consent:

  • Voluntary Euthanasia: It refers to a situation when a patient gives his consent to terminate his/her life in order to avoid future suffering.
  • Non-Voluntary Euthanasia: It refers to a situation in which the patient himself is not able to give his consent, so the consent is given by persons closely related to the patient.

This form of euthanasia is mostly seen in cases associated with cases involving young infants or patients in the state of coma, who cannot make any decision for themselves, due to their age and severity of their condition.

The debate of legalizing Euthanasia in India has proven to be both prolonged and uncontrollable . This is a very pressing issue and people are not of the same opinion. While some think that their ‘sanctity of life’ is being violated by infringing their basic right to life, others are of the opinion that if a person has the right to live it should also include the additional right to decide when such ‘life’ is worth living or not. But it is the crux of the issue that needs to be addressed. Is it guaranteed that a patient in a really severe condition will be able to come back to his original state and recover within a definite period by providing life supporting treatment? Doctors are not able to predict how long would the patient take to come back to his original state. It might take weeks, months or even years to recover. Moreover, patients would be suffering a lot as artificial drugs and injections would be used to maintain the patient in a steady state. For this reason, the concept of morality pitches in. The main basis for this argument is that it is against morality to leave a patient in a state of suffering and do nothing to provide relief to him/her. By leaving a person lying on his hospital bed in a lot of pain, we are infringing their fundamental right of staying alive or living with dignity. We can also apply the utilitarian principle, which always looks at providing the greatest amount of happiness to the greatest number of people. Hence, applying this principle to the case of Euthanasia, it can be seen that when a person is left to suffer a lot of pain, it is not only lowering the degree of happiness of the patient himself, but also the happiness of the family and persons who are closely related to the patient. Thus, the same question is reiterated that is whether Right to life under Article 21 of the Indian Constitution also includes the Right to Die with dignity.

Euthanasia should be considered as a helping hand and does not intend to cause harm in any way as its basic motive is to let a person die in a natural manner without causing any pain to the patient. As mentioned earlier, euthanasia not only looks at relieving the patient of his suffering, it also helps in providing relief to the family members and close relatives of the patient from the extreme mental agony caused. Another argument that is in favour of legalizing Euthanasia is that when a person is made to die a natural death, the organs of the patient may be used in helping other patients for organ transplantation. This way, not only does euthanasia relieve the patient of his suffering, it also reinvigorates the right to life to the organ recipient. Thus, Euthanasia should be seen as a boon to society as it has many characteristics that is beneficial for stabilizing society .

In India, active euthanasia would be considered as a punishable offence under Section 302 of the IPC which talks about the punishment for murder. If it does not come under the scope of Section 302, then it would most definitely come under Section 304, IPC, which states the punishment for culpable homicide not amounting to murder. However, there has not been any sort of clear stance made by the Indian Courts on the whole issue of Euthanasia. Social Activists and individuals in the field of law are being made aware of the whole idea of legalizing Euthanasia in case of terminally ill patients, because of the passing of the judgement in Aruna Shanbaug v Union of India [2011] .

In the Aruna Shanbaug case, the Supreme Court allowed Passive Euthanasia to an extent with certain guidelines attached to it. In the case, the petitioner, Aruna Ramachandra Shanbaug, a nurse at KEM Hospital, Mumbai, was attacked by a sweeper in the hospital who strangled her neck with a dog-chain. As she was menstruating, the defendant sodomized her. Her body was found the next, lying unconscious with blood all around the floor. The doctors stated that the supply of oxygen to the brain had stopped due to the strangulation of the victim’s neck. Thirty-six years had passed since the incident and the victim was surviving on mashed food and immovable. The case was filed as a writ petition under Article 32 of the Constitution by Ms. Pinky Virani, who was a close friend of the victim.

Answering to the plea made by Ms. Pinky Virani, the Supreme Court set up a three-member medical panel which consisted of three established doctors from Mumbai. They were directed to submit a report explaining the physical and mental condition of the victim. After a list of tests of being conducted, the doctors came to the conclusion that the victim is not brain dead. Hence, the Supreme Court stated that euthanasia would not be necessary in the case as the victim was showing some signs of response when exposed to certain circumstances. On March 07, 2012, the Supreme Court gave the verdict regarding the case. The Court of the opinion that as the victim could respond to any kind of stimulus and even though she was in a permanent vegetative state, she was stable in nature. Thus, it is morally right to terminate the life of an individual.

However, the court did state that the High Court was to be vested with the power in order to determine the decision regarding the termination of a person’s life in future cases. This power of the High Court would come under Article 226 of the Constitution which states, “Every High Court shall have the power to pass suitable orders on the application filed by the near relatives or next friend or the doctors/hospital staff praying for permission to withdraw the life support to an incompetent person”. There were three main guidelines that was issued by the Supreme Court:

  • When a plea petition has been filed, the Chief Justice of the High Court is required to form a bench of two Judges who, in turn, would decide the outcome of the case. The two-judge Bench should first consult a three-member medical panel after choosing the doctors from appropriate medical authorities.
  • The panel of doctors should examine the physical and mental condition of the victim, take into consideration the previous record of the victim and take the advice of the hospital staff before submitting the report to the High Court Bench.
  • As soon as the report is available, the High Court Bench should issue a notice to the State and to the close relatives of the victim, and in case of their absence, it should be notified to their close friends and should issue a copy of the doctor’s medical examination report to them as soon as it is submitted to the Court. After all these steps have been taken, it is upon the discretion of the bench to deliver its decision. The aforementioned procedure should be followed in every part of the country until the next legislation has been passed by the Parliament.
  • It is required that the High Court Bench may deliver their verdict at the earliest as possible, as any form of delay may lead to causing extreme mental misery to the relatives and people close to the patient. The Court should provide relevant reasons for giving its decision and that the decision in the ‘best interest of the patient’. Before giving its final verdict, it is necessary that the Court listen to the perspectives of the committee of doctors and the persons close to the patient.

The Supreme Court, in its judgement, did not see Ms Pinky Virani as the ‘next friend’ of the victim, rather, it was the Hospital that was recognized as the ‘next friend’ as they wished that the victim should not be stripped of her life-sustaining treatment. As a result, the petition bought in by Ms. Pinky Virani was declined. The Court legalized passive euthanasia with the above-mentioned guidelines that need to be followed in future cases involving the issue of Euthanasia.

Thus, in India, unlike other countries like Belgium and Holland, active euthanasia still remains illegal and is punishable under Indian Criminal Law. However, the concept of Passive Euthanasia has taken a huge turn and has been legalized after the Aruna Shanbaug judgment. As there are still no common thoughts among the people regarding the issue of Euthanasia, it has been suggested that there should be measures made in order to see that there is no misuse of the concept of Euthanasia. It has been bought up that Active Euthanasia should not be practised as it is clearly an offence under IPC, however, there should be a situation where people who are in a severe condition and are terminally ill should still be given the option of Passive Euthanasia as the decision is being taken by their close relatives on behalf of the patient, so there is valid consent being taken. Instead of wasting time and effort in trying to make euthanasia illegal, people should look at taking proper measures and see to it that there is no misuse of this controversial issue. Thus the question of allowing or not allowing euthanasia still remains open due to varying factors. 

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