DR CHETAN LAVU KAREKAR
Euthanasia (Greek: “good death”) is the practice of intentionally ending a life so that pain and suffering are relieved.
Euthanasia undoubtedly falls in the grey zone. It is “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering”. In the Netherlands and Flanders, euthanasia is explained as “termination of life by a doctor at the request of a patient”.
Euthanasia is categorised in different ways, which include voluntary, non-voluntary, or involuntary. Voluntary euthanasia is legal in some countries. Non-voluntary euthanasia (patient’s consent unavailable) is illegal in all countries. Involuntary euthanasia (without asking consent or against the patient’s will) is also illegal in all countries and is usually considered murder.
In some countries, there is major controversy over the moral, ethical, and legal issues of euthanasia. Those who are against euthanasia argue for the sanctity of life, while proponents of euthanasia rights emphasize alleviating suffering, and preserving bodily integrity, self-determination, and personal autonomy. Jurisdictions where euthanasia is legal include the Netherlands, Canada, Colombia, Belgium, and Luxembourg.
The word “euthanasia” was first used in a medical context by Francis Bacon in the 17th century to refer to an easy, painless, happy death, during which it was a “physician’s responsibility to alleviate the ‘physical sufferings’ of the body.” Bacon referred to an “outward euthanasia””the term “outward” he used to distinguish from a spiritual concept”the euthanasia “which regards the preparation of the soul.”
The definition offered by the Oxford English Dictionary incorporates suffering as a necessary condition, with “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma”.
Euthanasia opposers argue that if we embrace ‘the right to death with dignity’, people with incurable and debilitating illnesses will be disposed from our civilised society. The practice of palliative care counters this view, as palliative care would provide relief from distressing symptoms and pain, and support to the patient as well as the caregiver. Palliative care is active, compassionate and creative care for the dying. In the Constitution of India ‘Right to life’ is a natural right embodied in Article 21 but suicide is an unnatural termination of life and, therefore, incompatible and inconsistent with the concept of ‘right to life’. It is the duty of the State to protect life and the physician’s duty to provide care and not to harm patients. If euthanasia is legalised, then there is a grave apprehension that the State may refuse to invest in health (working towards Right to life). Legalised euthanasia has led to a severe decline in the quality of care for terminally-ill patients in Holland. Hence in a welfare state, there should not be any role of euthanasia in any form. ‘Mercy killing’ should not lead to ‘killing mercy’ in the hands of the noble medical professionals. Hence, to keep control over the medical professionals, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 discusses euthanasia briefly and it is in accordance with the provisions of the Transplantation of Human Organ Act, 1994. Passive euthanasia occurs in majority of the hospitals across the county, where poor patients and their family members refuse or withdraw treatment because of the huge cost involved in keeping them alive.
If euthanasia is legalised, then the commercial health sector will serve death sentence to many disabled and elderly citizens of India for a meagre amount of money. This has been highlighted in a Supreme Court judgement. Research has revealed that many terminally ill patients requesting euthanasia undergo major form of depression and that the desire for death in terminal patients is correlated with the depression. They need palliative and rehabilitative care. They want to be looked after by enthusiastic, compassionate and humanistic team of health professionals and the complete expenses need to be borne by the State so that ‘Right to life’ becomes a reality and succeeds before ‘Right to death with dignity’.
‘Right-to-die’ supporters argue that people who have an incurable, degenerative, disabling or debilitating condition should be allowed to die in dignity. This argument is further defended for those who have chronic debilitating illness even though it is not terminal such as severe mental illness. Majority of such petitions are filed by the sufferers or family members or their caretakers. The caregiver’s burden is huge and cuts across various domains such as financial, emotional, time, physical, mental and social. Hence, it is uncommon to hear requests from the family members of the person with psychiatric illness to give some poison either to the patient or else to them. Coupled with the states’ inefficiency, apathy and no investment in health is a mockery of the ‘Right to life’.
Many patients in a persistent vegetative state or else in chronic illness do not want to be a burden on their family members. Euthanasia can be considered as a way to uphold the ‘Right to life’ by honouring ‘Right to die’ with dignity. Euthanasia in terminally ill patients provides an opportunity to advocate for organ donation. This, in turn, will help many patients with organ failure waiting for transplantation. Not only euthanasia gives ‘Right to die’ for the terminally ill, but also ‘Right to life’ for the organ needy patients. Hence, there is an urgent need to fulfil this obligation of ‘Right to life’ by providing ‘food, safe drinking water and health care’. There is a need to enact a legislation to protect terminally ill patients and also medical practitioners caring for them as per the recommendation of Law Commission Report-1961. There is also an urgent need to invest in our healthcare system, so that poor people suffering from ill health can access free healthcare. Investment in healthcare is not a charity; ‘Right to Health’ is bestowed under ‘Right to Life’ as guaranteed by our constitution.
