The Uses and Abuses of Euthanasia

Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering. It is also thus known as ‘mercy killing’. However, in many countries, there remains a public controversy regarding the moral, ethical and legal issues relating to euthanasia. ‘Right to life’ including the right to live with human dignity implies the existence of such a right, till the end of natural life, which may include the right of man to die with dignity. But the ‘right to die with dignity’ should not be confused with the right to die an unnatural death curtailing the natural span of life. Euthanasia is indeed a controversial topic since it involves deliberate termination of human life. Patients suffering from certain diseases are often faced with a great deal of pain as the disease gradually worsens, until it kills them, and this may be so excruciating that they would rather end their life than continue suffering.

Euthanasia can be categorized into three types; voluntary, non-voluntary, or involuntary. Voluntary euthanasia is conducted with the consent of the patients and is legal in some countries, including Netherlands, Colombia, Belgium and Luxembourg. Non-voluntary euthanasia is conducted when the consent of the patient is unavailable, and is illegal in all countries. Involuntary euthanasia is conducted against the will of the patients and is thus usually considered akin to murder. In contrast, non-voluntary euthanasia is conducted when the patient’s will is not accessible or sound, such as in the case of children or patients in a vegetative state, and may be ethically permissible, varying on the basis of cases and regions. Euthanasia can also be classified on the basis of its active or passive forms.  Active euthanasia entails the use of lethal substances or forces, such as administering a lethal injection to kill, and is the most controversial means of carrying out euthanasia. It is causes death quicker in comparison to other means and all forms of such euthanasia are considered illegal. Passive euthanasia essentially implies causing death intentionally, by not providing essential, necessary and ordinary care or food and water. It thus involves discontinuing artificial life support.

People must have the right to self-determination, which implicates that they should be able to choose their fate. ‘Right to life’ is a fundamental right mentioned in Article 21 of the Indian Constitution. However, euthanasia is an unnatural termination of life. Refusing medical treatment is well recognized in law, including medical treatment that sustains life. For example, a patient suffering from blood cancer can refuse treatment or deny the passage of food through a nasogastric tube. In this manner, recognition of the right to refuse treatment gives a way for passive euthanasia. Euthanasia in terminally ill patients provides an opportunity to advocate for organ donation. This in turn may help patients with organ failure waiting for the transplantation. Not only could this help many patients and grant the ‘right to die’ for the terminally ill, but also the ‘right to life’ for the former.

Though there is a positive side to euthanasia, people still believe that this weakens the society’s respect for the sanctity of life, and belies the belief in God’s miracle of curing the terminally ill or any prospects of the discovery of a possible cure for the disease in question, in the near future. Proper palliative care would render euthanasia unnecessary. There is no appropriate way of  regulating euthanasia. On the one hand, it gives too much power to the doctors. However, it can also become a cost effective way to treat the terminally ill.

Passive euthanasia was legalized in India on March 7 2011, when the Supreme Court legalized it by means of allowing the withdrawal of life support to patients in a permanent vegetative state. The decision was made as part of verdict in a case involving Aruna Shanbaug, who spent 42 years in a vegetative state after a brutal sexual assault.

The Parliament should however, lay down some circumstances under which euthanasia is lawful- the consent of the patient should be imperative, where there is the failure of all medical treatments or the financial condition of the patient or his/her family is not satisfactory to sustain treatment. Suitable safeguards must be implemented to avoid its abuse by doctors, and the intention of the doctor must never be to cause harm. Euthanasia can be regarded as a viable option when all life care interventions fall short of ensuring a better life for terminally ill patients. There could be the presence of a will, that is, a written document allowing the patient to give instructions in advance about the medical treatment to be administered when he/she is terminally ill or no longer able to express informed consent. Withdrawing life support if a medical board declares that all lifesaving options have been exhausted, can also be considered. Despite such valid arguments, the government had opposed the concept as there was a risk of misusing it.

Medical science is progressing in India as in the rest of the world, and currently we possess devices that can even prolong life by artificial means. Hence, euthanasia has become an ethical issue of major contention. Moreover, concerns for its misuse remain as another major issue which ought to be addressed, which is why it should be used judiciously and only under legal conditions.

Picture Courtesy- The Ethics Centre

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