A Matter of Life and Death

With the advent of scientific technology, machines and medicines the life span of a man has increased drastically. There are ways in which anyone can be kept alive artificially with the use of ventilators, artificial feeding etc. But there are patients who are terminally ill and though they are kept alive artificially but that does not mean that there are in no pain. They are left to live with the prolonged agony, mounting medical expenses, emotional stress and other issues. But is it morally right to take someone’s life? The topic of Euthanasia thus raises hard hitting questions on ethics, rights and liberty.

“Marte hain aarzoo mein marne ki

Maut aati hai par nahi aati”

Judges quoted Mirza Ghalib to show their concern for Aruna Shanbaug while pronouncing the judgement for legalising Passive Euthanasia. It translates to mean that you live with the hope to die, which however still eludes you. The dilemma that is faced when you desire for death to come to you but it never seems to come. So what is this dilemma that we are talking about here? It is Euthanasia or mercy killing. This is the topic which fuels the debate between death and living artificially with the help of machines.

Meaning and forms of Euthanasia

Euthanasia is described as deliberate killing of a person in order to relieve him from pain and suffering. Debate on Euthanasia has raised questions in medical ethics, moral theology, civil rights and liberty. Euthanasia is of two types – active and Passive.

Active Euthanasia is explained as where death is caused by administering a lethal substance. This form of Euthanasia is a crime in India and most of the countries in the world. Passive Euthanasia, on the other hand, is where medical treatment is either withheld or withdrawn causing the death of the patient. For instance removing the heart-lung machine from a person who is in a coma is Passive Euthanasia. Euthanasia is different from Physical Assisted Suicide (PAS). In PAS, the medical practitioner provides advice or medications to enable the patient to end his life.

Further Active Euthanasia can be classified into three types voluntary, involuntary and non-voluntary. Voluntary is where Euthanasia is carried out at the request of the patient. Involuntary Euthanasia also called mercy killing is taking a patient’s life even though he has not requested for it, with the intention of relieving him of pain and suffering. In non-voluntary Euthanasia, the process is carried out even though the patient has not in a position to give consent.

Voluntary Euthanasia is illegal in India and is punishable under S. 309 of the Indian Penal Code (attempt to commit suicide). This issue was discussed at length in the case of Gian Kaur v. State of Punjab where the Supreme Court held that right to life under Art. 21of the Constitution does not include the right to die.

Euthanasia in other countries

These are some countries and their stance on this topic:

Country	Status of Euthanasia law
Luxembourg	Both PAS and Euthanasia is legal since 2008 but imperative to follow directives
Netherlands	PAS or Euthanasia legal if proper guidelines are followed
Belgium	Became the second country after the Netherlands to legalise Euthanasia
USA	Active Euthanasia is illegal except in the states of Montana, Washington and Oregon
Switzerland	PAS or Euthanasia legal. PAS can be performed by non-physicians.
UK, Spain, Austria, Germany, France etc.	PAS or Euthanasia is illegal

Euthanasia in India

In India Euthanasia is a crime under section 306 and 309 of the Indian Penal Code; Section 306 deals with abetment to suicide and Section 309 deals with attempt to commit suicide. The apex court has further stated that right to die does not come within the ambit of right to life under Article 21 of the Constitution.

However, the Supreme Court in March 2011 allowed Passive Euthanasia with guidelines in the landmark judgement. It refused mercy killing to Aruna Shanbaug as the court held that Pinki Virani, the petitioner in the case was not Aruna’s next of friend. Plus Aruna was not brain dead but at the same time there was little possibility of her coming out of the permanent vegetative state. The KEM staff which was looking after Aruna for past 40 years, expressed that she should be allowed to live. The court legalised Passive Euthanasia in this judgement though it has laid down some guidelines which are to be strictly followed till legislation is made by the government.

The guidelines to be followed are

Any petition for Passive Euthanasia has to be filed with the relevant High Court. The Chief Justice then should constitute a bench of two judges who would decide to grant approval or not.
A committee of three doctors is to be constituted of which one should be a neurologist; one should be a psychiatrist and third a physician.
Before taking a decision, the High Court should consider the opinion of the committee.
It should issue notice to the State and close relatives such as parents, spouse, brother, sister of the patient and in their absence, the next friend.

By legalising Passive Euthanasia, India has joined handful of countries where some form of Euthanasia is legal. Major concerns about its misuse should be properly addressed before a law is passed. The person should be in a permanent vegetative state, or in coma, or brain dead. It is a must to have patient’s consent in discontinuing his life support. If the patient is not in the position to give consent then the consent can be obtained from his parents, spouse, and relative and in absence of any of them, the decision can be taken by a person who is his next friend. However, bonafide and best interest of the patient is of paramount importance while considering the plea of Euthanasia.

-Ruchika Thakur
The Infomission Project BLOG Team Leader