END OF LIFE CHOICES: EXPLORING THE ETHICAL AND LEGAL IMPLICATION OF EUTHANASIA IN INDIA

Author: ANJANA BYJU A, BHARATA MATA SCHOOL OF LEGAL STUDIES, KERALA

ABSTRACT:

Euthanasia is one of the most debated issues in the legal arena because it lies between the ethics of doctors, institutions, and people’s self-determination. The Supreme Court has always sought to interpret the constitutional provisions as broadly as possible to ensure the maximum welfare of the people. In parallel, the Supreme Court has incorporated the right to die into the Indian Constitution as an important aspect of the right to life. The Supreme Court analyzed the applicability of euthanasia in various rulings and finally legalized passive euthanasia in the Aruna Shanbhag case, bringing great relief to terminally ill patients. It is illegal to treat a conscious, sane adult without their consent. Patients in a permanent vegetative state (PVS) who are unlikely to improve cannot make decisions about the treatment they receive. Ultimately, the court will decide in the patient’s best interest.

Keywords: Euthanasia, Physician-assisted, Voluntary, Non-Voluntary, Vegetative State, Suicide

INTRODUCTION 

The entire human being is a complicated process, having evolved to be who we are and how we live after a complicated web of events. Animals cannot decide on simple or difficult matters in life; we can choose, and we may achieve our goals through hard work. Imagine living a life in which you are breathing, heart rate, body temperature, and sleep cycles, but you are unable to talk or act, and you are unaware of your surroundings and yourself. You may even lose conscious intention. This clarifies why someone would be in a vegetative condition. When the brain stem and hypothalamus continue to function but the cerebrum stops working, this is known as a vegetative state. Everyone aspires to lead a fulfilling life.

HISTORICAL BACKGROUND 

In ancient Greece and Rome helping others die or putting them to death was admissible in some situations. For  illustration, in the Greek  megacity of Sparta, babe with birth  blights were put to death. The father of drug, the Greek croaker Hippocrates opposed this act of killing as an  manacle between the croaker and the cases.  numerous ancient textbooks including the Bible, the Koran, and the Rig Veda mention tone- destruction or self-murders committed on religious grounds. The Mahabharata and the Ramayana are also full of cases of religious self-murders. Govardana and Kulluka, while writing narrative on Manu, observed that a man might take over the Mahaprabhu( great departure) on a  trip that ends in death when he’s incurably diseased or meets with a great  mischance, and that, it isn’t opposed to Vedic rules which  prohibit  self-murder.  Muslims are against euthanasia. They believe that all mortal life is sacred because it’s given by Allah and that Allah chooses how long each person will live. Christians are substantially against euthanasia. Sikhs decide their ethics largely from the tutoring of their  Book, Guru Granth Sahib, and the Sikh Code of Conduct. The Sikh Gurus rejected self-murder as an hindrance in gods plans. In Jainism, voluntary death is rehearsed by Jains where a person freely gives up on food and drink so that he’s starved till death.

JUDICIAL TRENDS IN INDIA

In India, the contention whether the ‘right to live’ includes within its  dimension the ‘ right to die’ came for consideration for the first time in the time 1987. It was in the case of the state of Maharashtra. Maruti Shripati Dubal, wherein the Bombay High Court held that everyone should have the freedom to dispose of his life as and when he desires.There had been clashing  opinions of  colorful courts  each over India where the Andra Pradesh High Court in Chhena Jagadesswerv v. State of Andra Pradesh held that an attempt to commit  self-murder is legal and  naturally valid.

But also in P. Rathinamv. Union of India, the Supreme court of India for the first time formulated fifteen questions and raised the issue “whether an Indian citizen abiding in India has a right to die?” at the end of judgment, it was held that “attempt to commit self-murder” is outdated, cruel and an illogical provision .Thus it’s violative of composition 21 of the constitution of India and it’s void and unconstitutional.

The ruling in P. Rathinam’s case was overturned in Gian Kaur v. State of Punjab, a significant ruling in the history of euthanasia. The Supreme Court ruled that a person’s “right to life” does not include their “right to die,” adding that article 21 forbids reducing a person’s normal life expectancy. Providing a decent existence till death, including a dignified manner of passing away, was part of it.

The case of Naresh Marotrao Sakhre v. Union of India established that the Indian penal code’s section 309 does not apply to acts of euthanasia, suicide, or attempts at mercy killing. There are factual and legal distinctions between the two ideas. Whatever the circumstances surrounding its commission, euthanasia, sometimes known as mercy killing, is nothing more than homicide.

In the landmark case of Aruna Ramachandra Shanbaug v. Union of India and Ors, passive euthanasia was legalized under stringent guidelines, revolutionizing the field of medicine. India now allows passive euthanasia thanks to this historic ruling.

RECOMMENDATIONS OF THE LAW COMMISSION OF INDIA

M. Jagannadha Rao served as chair of the law commission that produced the 196th report on “Medical Treatment to Terminally Ill Patients” (protection of patients and medical professionals). This report was created with patients with terminal illnesses or those in a prolonged vegetative state in mind, giving them the opportunity to pass away naturally.

The guidelines outlined in this study are international in nature, as courts in the United Kingdom, the United States of America, Ireland, Scotland, Canada, Australia, and New Zealand all apply the same standards to competent patients.

The study established the following rules for patients who are incompetent and unable to make decisions for themselves:

It is not at the discretion of the doctor to withdraw or withhold the medical treatment of the terminally ill patient unless they have obtained the opinion of three experts and if required a ‘Bolam Test’   could also be conducted to justify the condition of the patient.

  1. The experts must be chosen by the doctors from the panel established by the directors of medicine in the states and the director general of medical services for union territories. The doctors are not allowed to choose the expert at their own discretion. The expert panel’s decision binds the doctor, and they cannot be followed.
  2. Incompetent patients’ age, sex, name, address, what is in their best interests, and the justifications for stopping their medical treatment must all be recorded in a register kept by the doctors who care for terminally ill patients. Additionally, the physician must notify the patient’s family of his decision to stop providing medical support. If the patient’s family requests it, they have 15 days to file a motion in the High Court to get additional orders; if no order is issued, the physician may proceed as before.
  3. 3. Finally, a copy of the register, which contains information about terminally ill patients and must be kept confidential even after the case is closed, must be served to the appropriate authorities, such as the Directors of Medicine and the Director General of Medical Services for Union Territories.

ARUNA’S CASE: A REVOLUTIONARY DEVELOPMENT IN THE INDIAN LEGAL LANDSCAPE

The recent ruling in Aruna Ramchandra Shanbaug v. Union of India by our Supreme Court cleared the path for the practice of passive euthanasia to become lawful. Aruna Shanbaug is in a persistent vegetative state (PVS), essentially lifeless, with no awareness and a nearly dead brain. In this case, a petition was submitted to the highest court requesting permission for euthanasia.

According to what was said, Aruna, the petitioner, worked as a staff nurse at Mumbai’s King Edward Memorial Hospital. She was assaulted on the night of November 26, 1973, at the hospital by a sweeper who put a dog chain around her neck and pulled her back. When he discovered she was menstruation, he sodomized her instead of trying to rape her. It was claimed that the brain suffered damage as a result of the dog chain strangling the victim, cutting off the brain’s oxygen flow. It had been thirty-six years since the tragedy. It was claimed that she was totally reliant on KEM hospital in Mumbai and that there was no chance for her condition to get better. Because the hospital’s caregivers opposed euthanizing this nurse, the court did not support passive euthanasia. Pancreas caused her death afterwards.

The Supreme Court formed a team to examine the patient medically in order to determine the problem. In conclusion, the court denied Shanbaug’s petition and noted that while active euthanasia is illegal, passive euthanasia is allowed in certain extraordinary cases when supervised by the law.

The court in this connection has laid down the guidelines which will continue to be the law until Parliament makes a law:

  1. 1. The decision to remove life support must be made by the patient’s parents, spouse, or other close relatives. If any of them are not present, a person or group of people acting as a next friend may also make this decision. The physicians who are caring for the patient may also take it. But the choice must to be made honestly with the patient’s best interests in mind.
  2. Therefore, even if close family members, medical professionals, or a close friend decide to stop life support, the High Court must approve the decision, as established in the Airedale case .This is especially important in our nation because it is impossible to completely rule out the possibility that family members or others will mistreat the patient in order to inherit their property.

COMMON CAUSE V. UNION OF INDIA

Concerning the right to die with dignity, Common Cause, a registered society, wrote to the State governments as well as the Ministries of Law and Justice, Health and Family Welfare, and Company Affairs in 2002.

In an attempt to get the ruling that the right to pass away with dignity is a basic right under article 21 of the Constitution, common cause petitioned the Supreme Court in 2005 under article 32. According to common cause, individuals with chronic illnesses or those who are terminally ill shouldn’t be forced to cruel medical procedures.

CONCLUSION

Euthanasia, sometimes known as “mercy killing,” is a sensitive and divisive topic in India. Section 309 of the Indian Penal Code, which forbids attempted suicide and aiding and abetting suicide, presently forbids active euthanasia in India. However, passive euthanasia which is refusing or ending life support or medical treatment is permissible in some situations.

Overall, the legal and ethical implications of euthanasia in India are complex and require careful consideration and discussion. It remains to be seen whether euthanasia laws will evolve in the future to reflect changing attitudes and beliefs. 

FAQ

Q. What is euthanasia?

     The deliberate taking of a person’s life to stop their suffering is known as euthanasia. 

Q. Types of euthanasia?

Active euthanasia, Passive Euthanasia, Voluntary Euthanasia, Involuntary Euthanasia.

Q. How is euthanasia different from palliative care?

The goal of palliative care is to enhance the quality of life for patients and their families by relieving the symptoms and stress associated with a serious illness.

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