Recently, there was a flood of articles in the international new agencies about ecologist David Goodall, who opted for euthanasia. He was not terminally-ill, however he felt he has lived beyond his prime and wished to end his life at the age of 103. As he ended his life through assisted suicide last month, a heated debate re-emerged in societies about the merit of euthanasia.
In the Indian Context, there have been various cases for euthanasia filed by activists on behalf of people suffering. The most famous case was filed by Pinki Virani, a plea for euthanasia for Aruna Shaubaug. Aruna Shaubaug was a nurse who was assaulted in 1973, at the KEM Hospital, Mumbai. She stayed in a vegetative state for nearly 42 years. The landmark judgment, which paved the way for euthanasia in the Indian legal system. On March 7 2011, The Supreme Court issued guidelines under which passive euthanasia could be legally conducted. According to these guidelines, the decision to withdraw life support must be taken by parents, spouse or by other close relatives. In the absence of the same, the decision could be taken by a ‘next friend’. This decision requires the approval of the concerned High Court.
In the current context, there are various groups propagating for euthanasia, not merely passive euthanasia. Passive euthanasia refers to withdrawal of life support and medical care, on the other hand euthanasia refers to conscious decision for death.
Another landmark decision was made on March 9 2018, The Supreme Court allowed living will in addition to passive euthanasia. Living will refers to a document, made by a healthy person at the time stating that he/she refuses extraordinary measures to be taken in the case of a medical condition. The proceedings took place post a petition filed by NGO The Common Cause in 2005. Justice Chandrachud held: ““Life and death are inseparable. Every moment our bodies undergo change… life is not disconnected from death. Dying is a part of the process of living.”
However, there is an ongoing debate regarding the misuse of living wills and passive euthanasia. During the proceedings of the case, Chief Justice Misra asked whether there was any mechanism to ensure that a living will is genuine. He highlighted an important issue. In a society like India’s, where the elderly usually possess the family wealth but continue to depend on the younger, there are heightened chances for fake living wills.
The Common Cause was represented by advocate Prashant Bhushan, who countered the arguments against euthanasia by recommending the setting up of medical boards and Supreme Court benches like in the case of Aruna Shaubaug.
From a medical perspective, euthanasia could benefit a large section of medical patients. Dr (Lt Gen) Varma, a doctor with 42 years of experience, said, “Euthanasia is permissible in situations where the patient is brain-dead and supported by a ventilator. Another case when euthanasia makes sense is when the patient is in a vegetative state.” When questioned about living wills, he stated, “If an individual has given a will, it should only be valid when the condition is irreversible. I would personally refuse ventilator support, if I ever reach that stage myself.” He advocated euthanasia, especially stressing the misery and monetary expenses involved.
Will euthanasia work in the Indian society? It might, only if the medical boards work alongside the legal boards. However, with the burden on both these sectors in our nation, it seems difficult for the boards to analyse each case in detail. Another important issue is the case of medical malpractice. Recently, the Dutch government was probing into five cases of euthanasia. The doctors allegedly conducted euthanasia on patients who were unable to express their views.
With countless cases of medical malpractice, the question remains the same. Is Indian society, doctors and the legal system ready for euthanasia?