Saying that “keeping a brain-dead patient alive on ventilator is torture,” the Bench sought the Centre’s response within a fortnight on the plea for legalizing ‘Living Will,’ in which a person, when in sound mind and good health, records his wish that he should not be kept alive on ventilators if doctors at any stage of his life opine that he cannot be kept alive without life support system. Brain-dead means dead, even if the heart is beating due to life-support systems. (Interestingly, one of the means to establish brain-death is by the Doll’s Eye movement where the eyes remain fixed when the head is turned from side to side.)
Euthanasia has been defined as the deliberate ending of life to relieve suffering. It is sometimes derisively called therapeutic homicide. Euthanasia is classified into four types.
1.Active Euthanasia: Life is ended by a deliberate action such as a pre-planned or intentional administration of a toxic substance calculated to end the life of a patient, e.g., injecting a poison into the patient.
2.Passive Euthanasia: Withdrawal of life-sustaining systems, e.g., if the patient is on life support, disconnecting the tubes conveying oxygen or medication so that the patient eventually dies.
3.Voluntary Euthanasia: Person makes a conscious decision to die, e.g., someone who cannot endure the agony of living any longer asks for his/her life to be ended by the doctor or health carer.
4.Involuntary Euthanasia: Someone killed against his will, e.g., someone who is killed using medical means.
Thus active euthanasia is akin to ‘killing’ someone while passive euthanasia is like ‘letting someone die’. The Indian Supreme Court has permitted passive euthanasia in the rarest of rare circumstances.
The proposed legislation on passive euthanasia is supposed to address several prime concerns about the issue, throw light on grey areas and to formulate guidelines. At present euthanasia is not legal in India. Only in specific cases such as when someone is diagnosed with a terminal, incurable and irreversible illness that may lead to death within six months can such a decision be taken. But even then there are checks and a single doctor may not be in a position to take a decision to stop treatment. That this eventuality cannot be infallibly predicted goes without saying, and many a miracle cure has been documented in cases of extreme and terminal ailments.
It is the government’s responsibility to protect the rights of terminally ill persons, especially when they are suffering and unable to take clear decisions. Some points for consideration are:
1)Can anyone in severe pain, and thereby under severe mental stress, make a conscious decision to die?
2)Can a mentally disabled person make an informed decision?
3)Can an infant or child make an informed decision to die?
4)Does a child have no right to decide his/her fate?
5)Does the child in the womb have the right to live if mother is euthanized?
6)In case of different religious persuasions within any one family, is it ethical for any one person of that family to deny the right of personal choice? Which would prevail—Law or Religion?
The morality of euthanasia is laden with uncomfortable questions.
In the USA legislative support for people came in the form of Patient Self-Determination Act of 1990 that gave patients the right to make advance directives about their health care desires when they were no longer able to express themselves. Commonly called the ‘Living Will’ it has become widely accepted with over 41% of the population choosing to make one.
In countries rife with corruption, collusive ‘therapeutic homicide’ could be perpetrated without the slightest compunction, to the economic benefit of all parties involved, including, maybe, the police. After all, it is physically, mentally and economically consuming having to care for the elderly and disabled. Not to mention the diminishing of any forthcoming inheritance.
With due respect to the concerns of the Apex Court, may it be pointed out that when a person is of sound mind and health, he may not give consideration to the thought of future terminal illness.
Debating the pros and cons of Euthanasia, it could very well be that there is less pro-ing and more con-ning in the decision-making of Right to Life of any individual, given the fact that the doctor’s decision is almost always regarded as sacrosanct, and if the doctor is hand-in-glove in complicity, then the patient has already been consigned to a hasty end!
The only difference between an act of killing a patient and an act of murder appears to be whether or not the patient consented. If in the affirmative, then what is euphemistically called The Living Will has, in fact, will become his Death Warrant.