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What is Euthanasia?

Euthanasia is the termination of a very sick person's life in order to relieve them of their suffering. A person who undergoes euthanasia usually has an incurable condition. But there are other instances where some people want their life to be ended.

In many cases, it is carried out at the person's request but there are times when they may be too ill and the decision is made by relatives, medics or, in some instances, the courts. The term is derived from the Greek word euthanatos which means easy death.

Euthanasia is against the law in the UK where it is illegal to help anyone kill themselves. Voluntary euthanasia or assisted suicide can lead to imprisonment of up to 14 years. The issue has been at the centre of very heated debates for many years and is surrounded by religious, ethical and practical considerations.
The ethics of euthanasia

Euthanasia raises a number of agonising moral dilemmas:

·         is it ever right to end the life of a terminally ill patient who is undergoing severe pain and suffering?

·         under what circumstances can euthanasia be justifiable, if at all?

·         is there a moral difference between killing someone and letting them die?

At the heart of these arguments are the different ideas that people have about the meaning and value of human existence.

Should human beings have the right to decide on issues of life and death?

There are also a number of arguments based on practical issues. Some people think that euthanasia shouldn't be allowed, even if it was morally right, because it could be abused and used as a cover for murder.

Killing or letting die

Euthanasia can be carried out either by taking actions, including giving a lethal injection, or by not doing what is necessary to keep a person alive (such as failing to keep their feeding tube going).

'Extraordinary' medical care

It is not euthanasia if a patient dies as a result of refusing extraordinary or burdensome medical treatment.

Euthanasia and pain relief

It's not euthanasia to give a drug in order to reduce pain, even though the drug causes the patient to die sooner. This is because the doctor's intention was to relieve the pain, not to kill the patient. This argument is sometimes known as the Doctrine of Double Effect.

Mercy killing

Very often people call euthanasia 'mercy killing', perhaps thinking of it for someone who is terminally ill and suffering prolonged, unbearable pain.

Why people want euthanasia?

Most people think unbearable pain is the main reason people seek euthanasia, but some surveys in the USA and the Netherlands showed that less than a third of requests for euthanasia were because of severe pain.

Terminally ill people can have their quality of life severely damaged by physical conditions such as incontinence, nausea and vomiting, breathlessness, paralysis and difficulty in swallowing. Psychological factors that cause people to think of euthanasia include depression, fearing loss of control or dignity, feeling a burden, or dislike of being dependent.

Forms of euthanasia

Euthanasia comes in several different forms, each of which brings a different set of rights and wrongs.

Active and passive euthanasia

a.       Active euthanasia is when death is brought about by an act - for example when a person is killed by being given an overdose of pain-killers.

b.      Passive euthanasia is when death is brought about by an omission - i.e. when someone lets the person die. This can be by withdrawing or withholding treatment:

·         Withdrawing treatment: for example, switching off a machine that is keeping a person alive, so that they die of their disease.

·         Withholding treatment: for example, not carrying out surgery that will extend life for a short time.

Types of Euthanasia

Voluntary and involuntary euthanasia

Voluntary euthanasia occurs at the request of the person who dies.

Non-voluntary euthanasia occurs when the person is unconscious or otherwise unable (for example, a very young baby or a person of extremely low intelligence) to make a meaningful choice between living and dying, and an appropriate person takes the decision on their behalf.

Involuntary euthanasia occurs when the person who dies chooses life and is killed anyway. This is usually called murder, but it is possible to imagine cases where the killing would count as being for the benefit of the person who dies.

Physician assisted suicide

Assisted suicide is suicide committed with the aid of another person, sometimes a physician.[1] The term is often used interchangeably with physician-assisted suicide (PAS), which involves a doctor "knowingly and intentionally providing a person with the knowledge or means or both required to commit suicide, including counseling about lethal doses of drugs, prescribing such lethal doses or supplying the drugs."

Laws in other countries

1.        Netherland – It is the first country in the world which leagalise euthanasia and assisted suicide.

2.       United States – in 5 states, euthanasia is allowed by doctors where in other states it is illegal.

3.       Germany – Physician assisted suicide is legal and the drug is self administered by the patient only.

4.      In South Africa- Since 2018, “die-well” law allows the incurably ill patient to refuse life- prolonginf treatment.

How this is highlighted in India?

Ø  In 1973, Nov 27, Nurse Aruna was sexually assaulted and strangulated by a ward boy. After the incident she was in coma till death.

Ø  In 2009, Jounalist Pinki Virani, who authored book Shanbaug, approached the Supreme Court with a petition seeking passive euthanasia, which involve stopping all of her active treatment. Because she was struggling for life since 36 years.

Ø  In 2011, SC verdict came to the petition allowing “passive euthanasia” for patients in permanent vegetative state. But it turned down the mercy killing plea for Shanbaug.

Ø  In 2013, Shanbaug was shifted to ICU with severe pneumonia.

Ø  In 2015, After spending 5 days in ICU, Aruna suffered a cardiac arrest, she died on May 18.

Similarly, a couple in Maharashtra they also requested for euthanasia passive or active as they are having any offsprings and they don’t want anybodies help. And they have mentioned this in their will also.

Current Scenario in India

The Supreme Court has given legal sanction to passive euthanasia in a landmark verdict, permitting 'living will' by patients on withdrawing medical support if they slip into irreversible coma.

What is a living will?
A living will is a written document by way of which a patient can give his explicit instructions in advance about the medical treatment to be administered when he or she is terminally ill or no longer able to express informed consent. Passive euthanasia, meanwhile, is a condition where there is withdrawal of medical treatment with the deliberate intention to hasten the death of a terminally-ill patient.

On 9 March 2018, Supreme Court of India declared passive euthanasia permissible and also legalised living will under Article 21 of the Constitution.  The verdict was given by a constitution bench of five judges.

Guidelines on Euthanasia by Supreme Court

According to these guidelines, passive euthanasia involves the withdrawing of treatment or food that would allow the patient to live. As India had no law about euthanasia, the Supreme Court's guidelines are law until and unless Parliament passes legislation.  India's Minister of Law and Justice, Veerappa Moily, called for serious political debate over the issue.  The following guidelines were laid down:

1.        A decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend. It can also be taken by the doctors attending the patient. However, the decision should be taken bona fide in the best interest of the patient.

2.       Even if a decision is taken by the near relatives or doctors or next friend to withdraw life support, such a decision requires approval from the High Court concerned.

3.       When such an application is filled the Chief Justice of the High Court should forthwith constitute a Bench of at least two Judges who should decide to grant approval or not. A committee of three reputed doctors to be nominated by the Bench, who will give report regarding the condition of the patient. Before giving the verdict a notice regarding the report should be given to the close relatives and the State. After hearing the parties, the High Court can give its verdict.

Article by:

Ruchi Lonare