2023 FEB 8
Society > Features of Indian Society > Fundamental rights
- A five-judge Bench of the Supreme Court agreed to significantly ease the procedure for passive euthanasia in the country by altering the existing guidelines for ‘living wills’, as laid down in its 2018 judgment in Common Cause vs. Union of India & Anr, which allowed passive euthanasia.
- Euthanasia refers to the practice of an individual deliberately ending their life, oftentimes to get relief from an incurable condition, or intolerable pain and suffering.
- Euthanasia, which can be administered only by a physician, can be either ‘active’ or ‘passive’:
- Active euthanasia involves an active intervention to end a person’s life with substances or external force, such as administering a lethal injection.
- Passive euthanasia refers to withdrawing life support or treatment that is essential to keep a terminally ill person alive.
EUTHANASIA IN INDIA:
Indian Penal Code provisions:
- Section 306: Abetment of suicide
- If any person commits suicide, whoever abets the commission of such suicide, shall be punished with imprisonment and fine.
- Section 309: Attempt to commit suicide
- Whoever attempts to commit suicide shall he punished with imprisonment up to one year 1 or with fine, or with both.
- Mental Healthcare Act, 2017 says that any person who attempts to commit suicide shall be presumed, unless proved otherwise, to have severe stress and shall not be tried and punished under the said Code.
- So, while there exists a conflict between the Indian Penal Code and Mental Healthcare Act, experts say suicide attempts are only punishable if proven to be not caused by severe stress.
- P Rathinam vs Union of India, 1994:
- The Supreme Court deemed Section 309 of the IPC to be a cruel and irrational provision and should be repealed to make penal rules more humane.
- Gian Kaur vs The State of Punjab, 1996:
- The court overturned the decision in P Rathinam, saying that the right to life under Article 21 did not include the right to die, and only legislation could permit euthanasia.
- Aruna Ramchandra Shanbaug vs Union of India:
- In 2011, the SC allowed passive euthanasia for Aruna Shanbaug, a nurse who had been sexually assaulted in Mumbai in 1973, and had been in a vegetative state since then. The court made a distinction between ‘active’ and ‘passive’, and allowed the latter in “certain situations”.
- Common Cause vs. Union of India, 2018:
- Passive euthanasia was legalised in India, contingent upon the person having a ‘living will’ or a written document that specifies what actions should be taken if the person is unable to make their own medical decisions in the future.
- In case a person does not have a living will, members of their family can make a plea before the High Court to seek permission for passive euthanasia.
- The Court reiterated that the right to die with dignity is a fundamental right and declared that an adult human being, having mental capacity, to take an informed decision, has right to refuse medical treatment including withdrawal from life saving devices.
- The Court issued guidelines regulating the procedure and said that the guidelines would be in force until Parliament passed legislation on this. However, since this has not happened, the 2018 judgment is the last conclusive set of directions on euthanasia.
- In 2023, the Supreme Court has agreed to revamp the cumbersome procedure impeding the execution of passive euthanasia.
EUTHANASIA IN OTHER COUNTRIES:
- Netherlands, Luxembourg and Belgium allow both euthanasia and assisted suicide for anyone who faces “unbearable suffering” that has no chance of improvement.
- Switzerland bans euthanasia but allows assisted dying in the presence of a doctor or physician.
- Canada had announced that euthanasia and assisted dying would be allowed for mentally ill patients by March 2023; however, the decision has been widely criticised, and the move may be delayed.
- United States has different laws in different states. Euthanasia is allowed in some states like Washington, Oregon, and Montana.
- United Kingdom considers it illegal and equivalent to manslaughter.
ARGUMENTS SUPPORTING EUTHANASIA:
- Compassion argument:
- The pain and suffering caused by a terminal disease may make life unbearable that death may seem "an act of humanity" and physician-assisted suicide a way to die with dignity. It can help to shorten the grief and suffering of loved ones.
- Autonomy argument:
- Respect for autonomous persons demands recognition of their right to decide how they will live their lives. Some believe that this includes the dying process, the ability to choose one's own destiny.
- Public policy argument:
- Proponents believe that assisted suicide can be safely regulated by government legislation.
- Resource utilisation:
- Supporters argue that euthanasia enables to channel the resources like medical staff, equipment, hospital beds, and medications toward lifesaving treatments for those who wish to live, rather than those who do not.
ARGUMENTS OPPOSING EUTHANASIA:
- Alternative treatments:
- Palliative care and hospices can provide relief to terminally ill patients’ pain. But legalising euthanasia would divert attention away from such relief and palliative care.
- Studies suggest that the interest of patients in euthanasia stems, in the majority of cases, to depression or psychological distress, rather than pain. However, suffering of psychological origin can also be relieved with adequate counseling and psychiatric intervention.
- Rationality of person’s choice:
- A terminally ill patient is in an extremely vulnerable position. His/her autonomy is diminished due to depression, anxiety, fear, dejection, rejection, and/or guilt. Under these conditions, it is difficult to have a clear conscience and make rational decisions.
- Challenge to professionals:
- By forcing the doctors to decide when a patient’s life is not worth living, euthanasia contradicts the doctor's pledge to heal and treat and the traditional ethical codes like the Hippocratic oath.
- The assumption that patients should have a right to die would impose on doctors a duty to kill, thus restricting the autonomy of the doctor.
- Pressure on vulnerable people:
- Euthanasia can put pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would especially affect people who are disabled, elderly, sick or depressed.
- Also, giving other people the legal power to end a person’s life could create the risk of coercion by others who might stand to gain from their deaths.
- Moral and religious arguments:
- Though attempting suicide has lately been decriminalized, the state's interest in preventing it has not wavered. However, permitting euthanasia contradicts this interest.
- When life of a patient is taken, either by act or by omission of a necessary treatment, death is induced intentionally. But there is no ‘right to be killed’.
- Almost all religions consider life as a gift from God, to be given and taken at the time of His choosing. But euthanasia violates this belief.
- Fear of unethical practices:
- Euthanasia could give rise to practices like organ harvesting and ‘doctor shopping’.
- For eg: In Oregon in 2008, 50% of patients requesting suicide were assisted to die by doctors who had been their physician for eight weeks or less. This indicates that patients were ‘doctor shopping’ for willing practitioners.
- Slippery slope of euthanasia:
- Opening the doors to voluntary euthanasia and assisted suicide could lead to non-voluntary and involuntary euthanasia.
- Detrimental impact on society:
- Assisted suicide is not a private act, but a matter of public concern because they involve one person facilitating the death of another. It would also have profound adverse effects on our attitudes towards the ill and the disabled.
Q. Discuss the ethical dilemmas associated with euthanasia?