Euthanasia: Changing Perceptions of Acceptability
As human beings, we possess a sense that allows us to feel pain that is beyond physical. This ability to sympathize, empathize, and “feel for” someone, is what makes humans “humane”. We find ourselves feeling this way when we read the news, hear horrifying realities, and when we find people suffering in pain. Putting out misery seems to be the only humane solution to this. Euthanasia is the deliberate and voluntary act of ending a person’s life in order to relieve his or her suffering. It is carried out with no pejorative intent and is probably the only humane way of dealing with someone when his or her health is incapable of improving and medical science provides no way to remedy the situation and can only maintain status quo, at best.
In March 2018, the Supreme Court of India gave a landmark judgment, allowing passive euthanasia, and thereby taking the legal debate with regards to Euthanasia forward.
Before moving further, it is important to understand the various categorizations of Euthanasia. Each of these forms has a very different recognition in law as, despite the common end, each of them involve varying degrees of intent and knowledge on part of the person administering the process- usually doctors and next of kin.
Euthanasia is categorized in different ways. The first categorization yields the difference between active and passive euthanasia. Active euthanasia involves deliberately undertaking certain steps in order to end the person’s life. This could be in the form of giving an overdose of painkillers, administering morphine, etc. It is an act on part of the medical institution. Passive euthanasia, on the other hand, would be an omission on part of the institution, where medical professionals “either don't do something necessary to keep the patient alive, or when they stop doing something that is keeping the patient alive”. For instance, they could turn off the ventilator or disconnect the feeding tube, etc. Most people often argue that this would be a false dichotomy and that there is no real difference between the two. Both, giving a drug and turning off the ventilator, would require an act on part of the medical institution. However those accepting of the distinction tend to favor active euthanasia as it is considered to be quick and less painful for the individual.
Another distinction can be made among voluntary, non-voluntary, and involuntary euthanasia. Voluntary euthanasia is an assertion of a willingness to die on part of the individual concerned. This is usually asserted by a refusal of food, medical treatment, etc. Non-voluntary euthanasia involves a situation where the will of the person concerned cannot be ascertained. Such a situation arises in cases where patients are in a coma or a vegetative state. A non-voluntary euthanasia morphs into an involuntary euthanasia when the person is euthanized against their wishes. This is different from murder inasmuch as an intention to kill cannot be imputed- a lack of mens rea (intention or knowledge of wrongdoing) at the time of the act.
Global Positions on Euthanasia. Source: News 18.
The History: From Gian Kaur to Aruna Shanbaug
The trajectory that the laws on Euthanasia have followed is long and unwieldy. The debate around this began in 1996 in the case Gian Kaur v State of Punjab, where Justice J.S. Verma of the Supreme Court had held that both assisted suicide and euthanasia were unlawful.
In the Gian Kaur judgment, the Court argued that there may be certain cases where the absences of a certain right may be permitted (eg. the freedom of speech and expression also includes the freedom not to speak), but the right to live was not one such right. “The 'right to die', if any, is inherently inconsistent with the 'right to life' as is 'death' with 'life'. Overturning the decision in the P. Rathinam case, the apex court held that the right to life must certainly include “death with dignity” but must not be confused with “unnatural extinction of life curtailing (the) natural span of life”.
Further, the court held in Naresh Marotrao Sakhre And Anr. vs Union Of India And Others (1994) that “Euthanasia or mercy killing is nothing but homicide whatever the circumstances in which it is effected.”
The debate around euthanasia widened in 2011 in the famous case- Aruna Ramachandra Shanbaug v. Union of India. Here the court legalized passive euthanasia in the country and granted its application only in exceptional circumstances and under the strict monitoring of the Supreme Court. At the time, the centre opposed the idea of voluntary euthanasia as well, claiming that those who availed such an option were probably making an uninformed choice without knowing much about medical advancements. They denied granting euthanasia to Aruna; the nurses of the KEM hospital had filed a counter claim stating that they were happy taking care of her.
The March Judgement
In 2018, in Common Cause v. Union of India. Chief Justice Dipak Misra, and Justices A. K. Sikri, D. Y. Chandrachud, and Ashok Bhusan held that passive euthanasia would be allowed hereon. Primal importance was given to one’s individual autonomy and dignity. It further permitted the drafting of a “living will” by the person concerned, wherein he or she can specify in advance about wanting to remain on a ventilator or not when under dire circumstances.
The decision also hails as its important facet the idea of consent. This judgment has prioritized some of the arguments made by medical ethicists and the like, who have for years wished for some amount of justice for those suffering for years. The time had come for India to take this step. We can now safely say that the debates surrounding this issue may slowly die down and Aruna Shanbaug’s spirit is, somewhere, resting in peace.
About The Author
Kamya Vishwanath is extremely passionate about her political opinions and reads extensively about the subject. A strong advocate of mental health and combating stigma around the same, she has interned with the Spastics Society of Karnataka and the Center for Law and Policy Research and continues to write passionately about mental illness.