Recently, the Supreme Court of India rejected a petition by an elderly couple seeking passive euthanasia for their comatose son, who has been bedridden for 11 years due to a fall.
This decision has reignited the debate on the legal and ethical dimensions of euthanasia in India.
Background of the case:
The Supreme Court, while ruling against the plea of the parents of the patient, said that the case does not fall under passive euthanasia as the patient is not on any life support system and is receiving nutrition through a feeding tube.
The court said that allowing him to end his life would not be passive euthanasia but active euthanasia which is illegal in India.
Euthanasia:
Euthanasia is the practice of ending a patient’s life in order to limit their suffering.
Types of euthanasia:
Active euthanasia:
Active euthanasia is when a medical professional or another person intentionally does something that causes the patient’s death, such as administering a lethal injection.
Passive euthanasia:
Passive euthanasia is the act of stopping or withdrawing medical treatment, such as turning off or withdrawing life-supporting devices, for the purpose of allowing a person to die.
Euthanasia in India:
The Supreme Court of India, in a landmark judgment in Common Cause v. Union of India (2018), recognised a person’s right to die with dignity, stating that a terminally ill person can opt for passive euthanasia and execute a Living Will for denial of medical treatment.
It also laid down guidelines for ‘living will’ made by terminally ill patients who are already aware that they are likely to go into a state of permanent anaesthesia.
Earlier in 2011, the Supreme Court had recognised passive euthanasia for the first time in the Aruna Shanbaug case.
The court specifically said that “dignity in the process of death is a part of the right to life guaranteed under Article 21.” To deprive a person of dignity at the end of life is to deprive the person of a meaningful existence.”
Different countries with euthanasia:
The Netherlands, Luxembourg, Belgium allow both euthanasia and assisted suicide for anyone who suffers “unbearable suffering” and has no prospect of recovery.
Euthanasia is banned in Switzerland, but death is allowed with the presence and assistance of a doctor or medical professional.
Since 1942, Switzerland has allowed assisted suicide, with a focus on personal choice and control over the dying process. According to the law, the mind of individuals should be healthy, and their decisions should not be motivated by selfish motives.
Australia has also legalised both types of euthanasia. This applies to adults who have perfect decision making and are suffering from an incurable disease that is likely to die within six or twelve months.
The Netherlands has a well-established legal framework for euthanasia, which is regulated by the Ending of Life on Request and Assisted Suicide (Review Procedure) Act of 2001.
Recent changes in guidelines by Supreme Court on Passive Euthanasia:
In the year 2023, the Supreme Court revised the Euthanasia Guidelines of 2018 to simplify the process of providing passive euthanasia to critically ill patients.
In 2018, the Supreme Court recognised the right to die with dignity as a fundamental right and laid down guidelines for terminally ill patients to implement this right.
Amendments to the Supreme Court Guidelines:
Verification of Living Will:
The Court has done away with the requirement of verification by a Judicial Magistrate on a Living Will (a document in which a person states what kind of treatment he wants to undergo in case of serious illness in future). Now, verification by a notary or gazetted officer is enough, making the process easier for individuals to express their choice to end their lives.
Integration with National Health Digital Records:
Earlier, the Living Will was maintained by the District Court. The revised guidelines mandate that these documents be part of the National Digital Health Record. This ensures easy access to hospitals and doctors across the country, facilitating timely decision making.
Appeal procedure for denial of euthanasia:
If the medical board of a hospital refuses to allow removal of the life support system, the patient / patient’s family can appeal to the concerned High Court. The court will then constitute a new medical board to reassess the case to ensure a thorough and fair review of the case.
Moral aspects associated with euthanasia:
Autonomy and informed consent:
Euthanasia involves respecting individual autonomy, which means that people should have the right to make decisions about their lives, especially to end suffering if they are mentally competent.
It also requires informed consent, in which the person must fully understand his or her situation, the process of euthanasia and its consequences, to ensure that he or she is not being pressured or manipulated in any way.
Quality of life versus purity of life:
Discussion on euthanasia often focuses on quality of life versus purity of life. In quality of life, it is argued that it may be ethical to end suffering and preserve one’s dignity during serious illness, while the purity or sanctity of life often reflects religious or philosophical beliefs that hold that life is intrinsically valuable and should not be prematurely terminated.
Legal and Social Implications:
The legal framework relating to euthanasia varies depending on the jurisdiction, reflecting different cultural perspectives and ethical discourses on end-of-life issues.
Its social impact includes questions related to the role of medical professionals, social responsibility and the need for equitable access to palliative care and psychological support to address the underlying causes of the demand for euthanasia.
