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Article 21 states, “No person shall be deprived of his life or personal liberty except according to a procedure established by law.” This means that everybody has the right to have a dignified life which allows them to own it. Only a rightful procedure by the law has the right to contradict the same. This right is available to every person whether a citizen or not. Thus, even a foreigner can enjoy this right.
Article 21 has a much wider concept than living a basic life. It has the right to live with human dignity, right to livelihood, right to privacy, right to shelter, right to food, right to get pollution-free air and water, right to education, and some other rights which are essential to have a basic life. Hence Article 21 states 2 concepts:
1. Right to life
2. Right to personal liberty
Along with these provisions, this right to life may sometimes go to an extent wherein there would be endless suffering and self-destructive habits. In such a case death is seen as a solution to end a cause. The question then arises whether in such a situation, can death be seen as a moral solution or not. The right to die with dignity then exists. When death becomes a normal thought for a person whose suffering is incurable and chronic, then that voluntary embrace of death is known as euthanasia or mercy killing.
Euthanasia is an act done by a medical expert who ends a patient’s life painlessly, whose illness is untreatable, and who is suffering from prolonged disease. Euthanasia came from a Greek “eu” (good) and “thanatos” (death). word that literally would mean ‘good death’ by the practice of ending a life intentionally to avoid pain and misery. Euthanasia, although a modern word, has been practicing for ages through ‘samadhi’, which was a non-violent and silent death-causing way. It was practiced during the ancient times by the Hindus and the Buddhists when the person has achieved his aims and goals and ultimately chooses to end his life by starving oneself to death.
So, when a terminally ill person has no purpose to live due to his illness and is living in agony, can he morally free himself of his misery by ending his own life? It should be perfectly okay if that person willingly wants to take his cause of action by Euthanasia.
This practice can be twisted and will be coined as suicide, which can happen due to ongoing anger, frustration, and is left with no choice but to end it. Due to this, many religions are against practicing Euthanasia, as all human lives are sacred, and killing is considered a sin. But there’s a difference between suicide and euthanasia.
ASSISTED SUICIDE AND EUTHANASIA
Suicide in medical terms is approved in some parts of the world known as ‘Physician-assisted suicide.’ (PAS) However, assisted suicide can be differentiated from euthanasia. Both can have the same meaning but their means are different from each other. Assisted suicide is to intentionally provide that person a way to commit suicide. Physician-assisted suicide is done by the physicians who prescribe medication in a way to end their life by themselves i.e to commit suicide. However, this type of practice is not legalized in many countries.
Euthanasia on the other hand involves a physician who actively participates in the cause of death to a person who is suffering from an incurable disease or condition. Euthanasia by the physicians is provided by directly injecting that person with a type of drug which leads to the death of that person. This brings relief to the patient as he will no longer suffer from his illness. Euthanasia is mainly considered when the person suffers from physical and psychological factors which are mainly directed from the illness the person is suffering from. Physical factors can mainly include unbearable pain, paralysis, breathlessness, nausea, and difficulty in swallowing. Psychological factors can include depression, lack of having control in general, and constantly depending on the other person even for their basic needs. Euthanasia is mainly specified in 2 categories:
a) Voluntary euthanasia- If the person is taking his conscious decision to end his life, it is known as voluntary euthanasia. The person must give consent and should prove his awareness about the consequences which will happen.
b) Non-voluntary euthanasia- The decision which is taken by some other person, especially by the patient’s family member, and not by the patient himself is known as non-voluntary euthanasia. This generally happens when the patient is not in a capacity to make this decision so the other member has to lead indirectly.
Further, euthanasia has 2 types through which it can be conducted:
i) Active Euthanasia
ii) Passive Euthanasia
Active euthanasia- It mainly occurs when the medical professionals perform a direct action that has a quick result. They inject a patient with a drug which contains a lethal dose of sedative that leads to immediate death. Active euthanasia should be carried out by the voluntary means of a patient. Although active euthanasia has a direct and quicker impact on the patient leading them to death, it is strongly opposed in many countries as it is considered as killing them with a lethal drug. Many countries of the world have made it illegal to have this kind of procedure for conducting euthanasia.
Passive Euthanasia- Passive euthanasia is done when the doctors do not do anything which is necessary to keep the patient alive, i.e by slowly withdrawing the things which keep the patient alive. They can also completely stop administering the medication at once, which would allow that person to die.
a) Discontinuation of the drugs that would otherwise help them to extend their life,
b) Disconnecting the feeding tube,
c) Switching off life support machines.
Passive euthanasia is legalized in most countries as it does not intend to kill the patient directly. But not all life prolonged diseased patients can have euthanasia.
1) It can be only applicable for those whose health condition is so severe that it is worse to have a life than death.
2) It requires a category as it is not very cost-effective for everyone to have this type of medication.
3) There are chances where the treatment can be withdrawn as it can be burdensome and harmful. In such cases conducting passive euthanasia will not succeed. The main aim of the health professional is not to provide death as an ultimatum but to provide relief to the patient from his suffering. The patient might change his decision about conducting euthanasia as they have the right to decide about their life. Hence, with such possible circumstances, passive euthanasia cannot be conducted as it requires thorough decisions and conditions.
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EUTHANASIA IN INDIA
In India, only passive euthanasia has been made legal since 2018. This means that it is only applicable only to those who are in a Permanent Vegetative State by the means of withdrawal of the life support. This verdict came into existence only because of the case involving Aruna Shanbaug who was in a Persistent Vegetative State (PVS) for more than 40 years.
In 2011, Supreme Court provided two conditions for which passive euthanasia can be conducted:
A) With the brain dead, the life-supporting system can be switched off.
B) For those who are in Persistent Vegetative State (PVS), their pain managing palliatives can be controlled.
Active euthanasia has been made illegal in India as consuming lethal drugs to end one’s life can be highly dangerous.
ARUNA SHANBAUG CASE
Aruna Shanbaug was a nurse and was working in Kings Memorial Hospital. On the 27th of December 1972, she was strangled with a chain by a hospital sweeper. Her oxygen level was deprived and due to this, she was in a vegetative state for many years. For almost 40 years, she showed no signs of improvement and was kept in the same condition. Her activist friend Pinki Verma, filed a petition seeking euthanasia as her right to live with dignity has been violated.
Although the court rejected the plea of Pinki Verma, guidelines were made regarding this, and passive euthanasia was legalized in India.
The rejection of the plea was not only regarding conducting a death on a living person but was also rejected due to the nurses who were taking care of her and were unsupportive of conducting Euthanasia on her. The guideline for conducting Passive Euthanasia was as follows:
i) The discontinuation of the life support should either be decided by the patient’s family or their spouse or any other family member. It can also be conducted through the presence of a doctor who was attending to the patient.
ii) The reason should be certified and should be in the interest of the patient.
iii) The decision should be approved by the medical board of the hospital and along with this, it requires two witnesses before the conduction and it should be countersigned by the first-class judicial magistrate.
THE LIVING WILL
In March 2018, The Supreme Court of India passed a law for the right to die with dignity. The law is considered in the fundamental rights of the Constitution.
The living will, is a legal document wherein the person will state his desire to die in advance. They can express there freely how they want to die. It is an advanced statement done by the patient not to put them on a ventilator if they are in a vegetative state or in a coma.
The will gets activated when the person is not able to communicate or is in a vegetative state or in a coma. The person’s right to die with dignity will be protected with the living will. It will protect the patient from going through any painful procedures or sufferings due to their illness. It will also help the family members to cope up smoothly as they won’t be having any guilt since the decision was made beforehand. Lastly, it will help to save up having endless hospital bills for treating the illness. Due to this, their financial burden will also be relieved. It should be kept in mind that the living will should only be done by the patient or the person who wishes to do this for themselves. There should be no forceful act or coercion to making this will.
MERITS OF CONDUCTING EUTHANASIA:
a) It can be the easiest way to die to those who are suffering from a chronic and painful illness.
b) It provides the right to die with dignity as the patient won’t be living with agony until he dies naturally.
c) It provides release to mental and physical tension with the ongoing treatments and illness.
d) The ongoing medical bills can be avoided once euthanasia is conducted.
DEMERITS OF CONDUCTING EUTHANASIA:
1) As India highly believes in religious aspects, conducting such type of treatment is considered as killing in their particular religion.
2) This treatment can be highly disadvantageous for those whose family members are considering them as a burden and conducting euthanasia would be an easy way to get rid of them.
3) It is not very cost-effective for everyone for those who seek euthanasia.
4) This type of treatment can be organized in making money i.e in the form of corruption.
The decision to conduct Euthanasia should completely depend upon the terminally ill patient. They have every right to perform things that are bound by the law which can be beneficial for them and for their other concerned relatives. Due to the religious factor, death with ease is discouraged and the suffering of that person will continue to exist.
But with the Supreme Court legalizing Passive Euthanasia, the right to die has been constituted as the fundamental right as death by virtue should hold significance.
Author: SHRADDHA AJIT MULGUND
Editor: Kanishka Vaish, Senior Editor, LexLife India.