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The Choice of Dignity


Author: Jasmeet Makkar, Student of Bharati Vidyapeeth Deemed University, Delhi

INTRODUCTION


“The Choice of Dignity: Euthanasia and the Right to Die” delves into the profound and often contentious issue of end-of-life decisions, highlighting the belief that individuals should have the autonomy to make choices about their own lives, especially when confronted with terminal illness or unbearable suffering. Euthanasia, the act of intentionally ending a person’s life to alleviate pain, raises complex ethical, legal, and moral questions. The concept of the right to die advocates for the legal recognition of an individual’s choice to seek a compassionate end to suffering, emphasizing personal dignity and autonomy. The debate is enriched by diverse perspectives, including religious, philosophical, and medical viewpoints, and is shaped by the varying laws across countries and states that govern these practices. Personal stories often illuminate the emotional weight of these decisions, underscoring the importance of compassionate care. Ultimately, this topic encourages a thoughtful dialogue about autonomy, compassion, and the ethical dimensions of end-of-life care, prompting readers to reflect on what it means to live—and die—with dignity.

THE RIGHT TO DIE [EUTHANASIA] : CONCEPT AND MEANING
To fully engage with the topic of euthanasia, it is essential to first understand its meaning and implications. The Oxford Dictionary defines euthanasia as the act of facilitating a gentle death for someone suffering from an incurable or painful illness. Similarly, the *Encyclopedia on Crime & Justice* describes euthanasia as an action that brings about death to relieve an individual from a distressing or intolerable condition of life. Another perspective defines it as the intentional termination of life at the request of the person who wishes to die.

Roedy Green elaborates on the concept of euthanasia by categorizing it into four key components: the pursuit of a good and peaceful death, commonly referred to as mercy killing; physician-assisted suicide (PAS), which involves a medical professional aiding in the process; and the act of terminating the life of a terminally ill patient upon their own request. Additionally, the Select Committee on Medical Ethics of the House of Lords provides a more focused definition, stating that euthanasia involves a deliberate intervention with the express intent to end a life to alleviate pain and suffering.

Examining the legal frameworks in different countries offers further insight into the definition of euthanasia. In the Netherlands, euthanasia is characterized as the intentional termination of a patient’s life at their request to a physician. The Belgian Euthanasia Act of 2002 takes this a step further, defining euthanasia as an intentional act to end a life performed by someone other than the individual seeking to die, but done at their explicit request.

In essence, euthanasia can be understood in its simplest form as a term that signifies the concept of a painless death, reflecting a compassionate response to suffering and the desire for autonomy in end-of-life choices. As discussions around euthanasia evolve, they raise important ethical, legal, and moral questions that warrant careful consideration.

CLASSIFICATION OF EUTHANASIA
Euthanasia can be classified into several categories:

Active Euthanasia
Active euthanasia occurs when death is deliberately brought about by medical professionals or another individual through a specific action. This may involve administering a lethal dose of medication or overdosing the patient on drugs that, in normal circumstances, would not be fatal. The key aspect of active euthanasia is that these actions directly lead to the person’s death.

Passive Euthanasia
In contrast, passive euthanasia involves the cessation of treatment that is necessary to sustain life. Here, medical professionals may refrain from performing actions that would keep the patient alive or may withdraw existing treatments. Examples include disconnecting life support systems, halting medication, or removing feeding tubes. In passive euthanasia, the doctors are not actively causing death; rather, they are allowing the natural process to take its course by not intervening.

Voluntary Euthanasia
Voluntary euthanasia occurs when a patient explicitly consents to end their life. This form emphasizes the patient’s autonomy, allowing individuals suffering from incurable illnesses to make a conscious choice about ending their suffering.

Non-Voluntary Euthanasia
Non-voluntary euthanasia takes place when a person’s life is ended without their explicit consent, typically because they are unable to make such a decision due to mental incapacity, such as being in a coma. In these cases, the individual has not provided a living will or advance directives, often because they were either unprepared for such a situation or unable to foresee the possibility of it occurring.

ACCEPTANCE OF EUTHANASIA IN SOCIETY AND RELIGION
To grasp the perspective of Indian medical professionals on euthanasia, it is essential to consider the various factors that influence individual viewpoints. Recent studies indicate that religiosity significantly impacts a doctor’s stance on euthanasia, with those who adhere more deeply to their religious beliefs often considering it morally wrong, as it conflicts with their faith.

Christianity
Different sects within Christianity have varying opinions on euthanasia. The Catholic Church categorically condemns the practice, viewing it as a crime against God and life. In contrast, many Protestant denominations are beginning to adopt a more liberal stance on euthanasia, influenced by the efforts of various advocates and a shifting societal framework.

Hinduism
Hindu perspectives on euthanasia are dualistic. On one hand, ending a painful life may be seen as a compassionate act; however, it also conflicts with the Vedic teachings about the cycle of life and death. Engaging in euthanasia could result in transferring the patient’s remaining karma to those involved in the act.

Islam
The Islamic faith is largely opposed to euthanasia, grounded in the belief that human life is sacred and originates from God. Therefore, it is viewed as beyond human authority to terminate one’s own life, with religious doctrine explicitly declaring euthanasia as forbidden.

Buddhism
Buddhism presents a spectrum of views regarding euthanasia. Compassion is a core tenet of Buddhism, and in some contexts, allowing death to relieve suffering is considered acceptable. However, in certain sects, facilitating death, even from a place of compassion, may be regarded as a failure on the part of a monk.

Jainism
Jainism supports the practice of Sallekhana, or “fast unto death,” which is a voluntary death that can be undertaken by both laypeople and ascetics. This practice is only encouraged when an individual has relinquished all passions and possesses the mental resolve to neither live nor die. It must be conducted in a state of consciousness, distinguishing it from suicide.

Overall, the acceptance of euthanasia varies widely across religious and cultural contexts, reflecting a complex interplay of ethical beliefs and societal norms.

LEGAL ASPECTS OF EUTHANASIA IN INDIA.
In India, the legal framework currently recognizes only passive euthanasia. A landmark judgment in the case of Common Cause (A Regd. Society) established that the “right to die with dignity” is a fundamental right. This right can be exercised by patients suffering from incurable and prolonged illnesses, particularly those in a permanent vegetative state (PVS) with little to no hope of recovery, who are kept alive through life-sustaining machines such as cardiopulmonary devices. In such circumstances, passive euthanasia is permissible.

Previously, passive euthanasia was not legally recognized in India. Medical professionals who facilitated euthanasia were subject to Exception 5 of Section 300 of the Indian Penal Code, which implies that their actions were considered intentional acts leading to death. In cases of voluntary euthanasia where valid consent was provided, the involved medical practitioners could still face charges of culpable homicide not amounting to murder under Section 304 of the Penal Code.

It is important to note that this legal protection applies only to voluntary euthanasia, where the patient is over 18 and has given explicit consent. Non-voluntary and involuntary euthanasia are not covered by these provisions and would fall under the prohibitions of the first proviso of Section 92 of the Penal Code. Additionally, active euthanasia remains classified as a criminal offense in India.

One significant argument for legalizing euthanasia was presented in the Supreme Court case of *Gian Kaur v. State of Punjab*, where it was contended that the “right to life” enshrined in the Indian Constitution implicitly includes the “right to die.” However, this argument was dismissed, with the Supreme Court ruling that Article 21’s right to life does not extend to a right to die, thus upholding the illegality of euthanasia as constitutionally valid.

In the case of *Aruna Ramchandra Shanbaug v. Union of India*, the court determined that for individuals who are unable to make decisions about withdrawing life support, the court itself, acting in a parens patriae capacity, must make that decision. However, the perspectives of close relatives and medical professionals should be given significant consideration. The court clarified that while active euthanasia is entirely illegal, passive euthanasia has been legalized to a degree, following guidelines established in this case.

The Law Commission of India has also recommended the legalization of euthanasia in its 241st Report. In the notable case of Common Cause (A Regd. Society) vs. Union of India (UOI) and Ors., the Supreme Court reaffirmed that the “right to die with dignity” is indeed a fundamental right. It ruled that a sane adult can refuse medical treatment and choose to die naturally instead of pursuing life-prolonging interventions.

The court has recognized passive euthanasia, wherein the physician does not actively cause death but rather allows the patient to die by withdrawing treatment or disabling life-support systems. Conversely, active euthanasia, defined as administering a lethal dose of medication or an overdose that would otherwise not be fatal, remains illegal under Indian law.

The legal stance emphasizes that a doctor cannot be punished for failing to save a patient, as their inaction does not equate to a crime. However, legal obligations also encompass omissions, meaning that a person can be held accountable for failing to perform duties mandated by law. Thus, the legal nuances of euthanasia in India continue to evoke significant ethical and moral considerations.
financial regulation and corporate governance, highlighting the ongoing evolution of legal frameworks in response to financial misconduct.

Conclusion
The issue of euthanasia and the right to die embodies a complex interplay of ethical, legal, and societal factors. As medical technology advances, the capacity to prolong life raises critical questions about the quality of that life and the rights of individuals to make autonomous decisions regarding their own end-of-life care.

In many societies, the discussion around euthanasia challenges traditional views on morality and the sanctity of life, pushing for a more compassionate understanding of suffering and dignity. While legal frameworks vary, the growing recognition of the “right to die with dignity” reflects an evolving societal perspective that prioritizes patient autonomy and informed consent.

In India, the legal acceptance of passive euthanasia marks a significant step toward acknowledging these rights, yet active euthanasia remains a contentious and illegal practice. This ongoing debate calls for continued dialogue among lawmakers, healthcare professionals, ethicists, and the public to address the nuanced implications of euthanasia. Ultimately, the conversation surrounding euthanasia and the right to die is not just about legality; it is about honouring human dignity and recognizing the profound complexities of life and death decisions. As society grapples with these profound issues, it is essential to strive for a compassionate approach that respects individual choices while ensuring ethical safeguards are in place.


Frequently Asked Questions

QUES 1. What is euthanasia?
Euthanasia is the intentional ending of a person’s life to relieve suffering, classified as either active or passive.

QUES 2. What is the difference between active and passive euthanasia?
– Active Euthanasia: Directly causing death (e.g., lethal injection).
– Passive Euthanasia: Withholding or withdrawing life-sustaining treatment.

QUES 3. Is euthanasia legal?
Legality varies by country. In India, passive euthanasia is recognized, while active euthanasia is illegal.

QUES 4. What is the ‘right to die’?
The ‘right to die’ advocates for an individual’s autonomy to choose how and when to end their life, especially in cases of suffering.

QUES 5. What are the ethical considerations?
Key ethical debates include the sanctity of life, patient autonomy, and potential for abuse.

QUES 6. How does religion view euthanasia?
Views differ:
– Christianity: Generally opposes it, especially Catholicism.
– Hinduism: Mixed views on alleviating suffering vs. karma.
– Islam: Generally prohibits it.
– Buddhism: Varied, focusing on compassion.
– Jainism: Supports voluntary death (Sallekhana) under specific conditions.



QUES 7. What safeguards are in place?
Safeguards may include psychological evaluations, waiting periods, documented consent, and oversight by authorities.

QUES 8. How does the process work?
Involves patient requests, assessments for legal criteria, and administration of lethal substances or withdrawal of treatment.

QUES 9. What alternatives exist?
Alternatives include palliative and hospice care, focusing on improving quality of life without hastening death.

QUES 10. How can one support the conversation?
Engage in discussions, educate oneself, and advocate for policies respecting patient autonomy and dignity.



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