Euthanasia

Sachdev Yadav

The word ‘euthanasia’ triggers a spate of controversy world wide redefining the meaning attributed to it and the context and the extent to which it could be legally practicable.

The debate raises a plethora of issues. While some oppose it, some are equally in favor. The concept of euthanasia strikes at the very root of human existence by allowing the right to end life. Like any other issue, euthanasia too has two sides. The current article explores the whole gamut of contentions regarding the subject.

Introduction

“No one is truly free to live until one is free to die.”  These were the words of Martin Luther King on the eve of his assassination. This seams to be the spirit behind all those millions of people whose support euthanasia.

The word ‘euthanasia’ triggers a spate of controversy world wide redefining the meaning attributed to it and the context and the extent to which it could be legally practicable. The debate raises a plethora of issues. There are heated debates, some strongly opposing it and some being equally in its favor. The concept of euthanasia strikes at the very root of human existence by allowing the right to end life. Like any other issue, euthanasia too has two sides. The current article explores the whole gamut of contentions regarding the subject.

What is Euthanasia?

The common man’s word for euthanasia is ‘mercy killing’. The word euthanasia originated from Greek language: eu meaning “good” and thanatos meaning “death”. One meaning given to the word is “the intentional termination of life by another at the explicit request of the person who dies”¹. That is the term euthanasia implies that the act must be initiated by the person who wishes to commit suicide. However some people define euthanasia to include both voluntary and involuntary termination of life. Like many moral/ethical/religious terms, “euthanasia” has many meanings.² It bears many names used synonymously .Nevertheless there is a slight distinction to each of the words. A brief discussion will abate the confusion.

Euthanasia

It means to help with a good death. Broadly speaking, on the basis of the right of an individual, it may be categorized as

• Right to die: It is the will, wish and decision of a person to terminate his own life and who therefore actively requests another person to  assist him to die; and
• Right to kill:The decision to terminate the life of a person suffering from terminal illness or who is in a permanent vegetative state is taken either by the doctor or the relatives of the patient in the absence of the consent from the patient.

Passive Euthanasia

Hastening the death of a person by altering some form of support and letting nature take its course. For example:

• Remove life support equipment (e.g. turning off a respirator), or
• Stopping medical procedures, medications etc., or
• Stopping food and water and allowing person to dehydrate or starve to death.
• Not delivering CPR (cardio-pulmonary resuscitation) and allowing a person, whose heart has stopped, to die.

The most common form of passive euthanasia is to give a patient large amount of morphine to control pain, in spite of the likelihood that the pain killer suppress respiration and cause death earlier then it would otherwise have happened. Such doses of pain killers have a dual effect of relieving pain and hastening death. Administrating such medication is regarded as ethical in most political jurisdictions and by most medical societies. But, the Pope says that this is nothing but #8216;euthanasia by omission’ and that nobody has the right to take away the life of another individual whatever may be the extent of pain or agony that an individual is suffering.

These procedures are performed on terminally ill, suffering persons so that death will occur sooner. It is also done on persons in persistent vegetative state-individuals with massive brain damage who are in a coma from which they can not possibly regain consciousness.

Active Euthanasia

It is the deliberate action to end the life of a dying patient to avoid further suffering.³

Active Voluntary Euthanasia

This involves causing the death of a person through a direct action, in response to a request from that person. A well known example was the mercy killing in 1998 of a patient with ALS (Lou Gehrig’s Disease) by Jack Kevorkian a Michigan physician. His patience was frightened that the advancing disease would cause him to die a horrible death in near future; he wanted a quick, painless exit from life. Kevorkian injected controlled substance into the patience, thus causing his death. Charged with first degree murder, jury found him guilty of second degree murder in March 1999. Presently the doctor is serving a sentence of imprisonment.

Active Involuntary Euthanasia

This term is used by some to describe the killing of a person who has not explicitly requested aid in dying. This is most often done to patients who are in persistent vegetative state and will probably never recover consciousness.

Physician Assisted Suicide

A physician supplies information and/or means of committing suicide (e.g. a prescription for lethal dose of sleeping pills, or a supply of carbon monoxide gas) to a person, so that he can easily terminate his own life. The term “Voluntary Passive Euthanasia” (VEP) is being commonly used. Prominent example of this kind of euthanasia again is that of Kevorkian, who has promoted VEP and assisted at the deaths of hundreds of patients. Originally he hooked his patient to a machine that delivered measured doses of medication, but only after the patient pushed the button to initiate the sequence. More recently, he provided carbon monoxide and a face mask so that his patient could initiate the flow of gas.

Mercy Killing

It is a term loosely used to describe all acts of euthanasia. It may be defined as ending another person’s life without explicit request in the belief that it is the only compassionate thing to do.

Why Shun Euthanasia

Because the law says so. But it is not as simple as that. Otherwise it would have been implied in the fundamental ‘right to life’ of every individual. Does the right to life carry with it the implied right to end it, just as the right to speech also includes the right to remain silent? Apparently the answer is no. It is so because the law has usurped the individual’s right to end his life. Termination of an individual’s life is allowed only if it is sanctioned by the state, in a prescribed manner. The law has been so framed in the public interest for the public good. Suicide has been penalized for the reason that highest importance is given to human life. It violates one’s natural desire to live and harms other people. It was considered against the morals and norms of the society. It was more a disgrace then a crime or a sin and categorized as mental illness. It was equated to murder and in many western countries the persons who committed suicide were buried along with the criminals or sometimes were not given the burials.

Initially attempt to commit suicide was a punishable offence in all the legal systems around the world. The changing world with more emphasis on individual rights considered suicide as personal choice, a human right and a rational option under certain circumstances. Gradually many western countries have removed suicide from their list of offences. Now, it is no longer a punishable offence. But ironically assisting/abetting suicide is a punishable offence attracting heavy punishment. Suicide euthanasia in the Indian perspective is altogether a different matter and is dealt separately. Suffice to say at this point that it is still an offence punishable under the Indian Penal Code.

Causes of Euthanasia and Suicide

Suicide is a permanent solution to a temporary problem. The reason for a person to end his life may be anything. That may be a mere admonition, insult, lack of will to live or  depression, prolonged illness, chronic pain, poverty, inability to afford medication, specific beliefs… the  list is long. There is a marked difference between the mental and physical factors which incite a person to commit suicide. Suicide caused due to emotional reasons like depression, humiliation, insult etc which mentally torment a person does not require the extreme step of ending one’s life. It can be solved through treatment by way of counseling or medication. Such treatments can bring many more years of joyous life. Likewise a person undergoing unbearable pain due to ill health can be cured through proper pain management through medication. It is in this particular sphere that euthanasia differs from suicide.

Euthanasia is also a kind of suicide; but by people who are chronically ill or are in a vegetative state. They are afflicted with some serious disease or disorder or diagnosed with some degenerative progressive illness like the AIDS, Huntington’s disease, Multiple Sclerosis, Alzheimer’s etc. They have to constantly depend on others for the most trivial tasks. It is demoralizing for them which cause an unacceptable loss of personal dignity. They want their property to be utilized in a better way rather then for the medication of an illness which can never be cured. The physical unworthiness of the individual to a point of no return incites him to put an end to his life. The difference between euthanasia and suicide is well brought by Ralph Miro⁴.He said that the difference between a pain plugged terminally ill patient taking a legally prescribed lethal dose of pharmaceuticals and the suicide of one depressed is analogous to the difference between love making and rape. What the people campaigning in favor of euthanasia want is to legalized euthanasia and not suicide.

The causes for euthanasia/suicide may be summed up as:

• Financial: This is often seen in poor and developing countries where as a result of unemployment or otherwise the person is unable to make both ends meet and hence decides to end his life rather, some times along with the whole family.
• Pathological:Some persons owing to some diseases or deviant health conditions tend to be suicidal. For example alcoholism, tumor etc., are pathological factors which arouse suicidal tendencies in some persons. The person is very well aware of the suicidal act that he is attempting but, it is something beyond his control to stop.
• Religious: No religion in the world advocates for the right to die. It rather looks upon taking one’s life as a sin .Termination of life is in the hands of Him who gives life. This is the Principle of life in all religions.
• Medical: This is the factor which forms the basis for the grant of right to die. When a person is hopelessly ill and can not recover in his lifetime, death is preferable to a mere animal existence. It is on this ground alone and none else that euthanasia is sought for.
• As a threat:  This is used by person attempting suicide for emotionally blackmailing others for whom he wants an act to be done. Fasting unto death, consuming poisonous substances etc., are instances of this kind of suicides.

The causes of euthanasia/suicide are crucial in determining whether the attempt at terminating one’s life can be punishable or not. When suicide is attempted as a threat, it should certainly be dealt with severely by admonition or reprimand. If the attempt to end a life was pathological, the court should send the person to an institute to recover his health. If medical reasons forms the basis of terminating one’s life, steps should be taken to initiate pain management. It is for this reason that the court in most of the cases of assisted suicide, mete out minimal punishment to the perpetrators of the offence.

Issues Surrounding Euthanasia

The debate over euthanasia is raging worldwide with no signs of an early abatement. Statistics point to the fact that the pro-euthanasia is gaining a positive momentum with more and more people from all communities seeming to agree for a painless death in circumstances of their choice. At the same time, religious groups and orthodox sections of the society are up in arms against the idea of legalizing euthanasia. A look at the view point of people for and against euthanasia will through light on the various issues that are linked to euthanasia/physician assisted suicide (PAS).

Pro-life/Anti-Euthanasia

‘The relief of human suffering is the primary goal of the medical profession’. The same slogan has been adopted by some section of the society who strongly opposed euthanasia or physician assisted suicide or even suicide in its plain form. They are moral absolutist, politically conservative and religious fundamentalists. The   main opposition comes from the hierarchy of Roman Catholic Church and other religious institutions. According to them, suffering ennobles a person; a man is but a steward of life, which is a gift of God which only He can take away. Another group which strongly opposes euthanasia is the medical associations whose members are dedicated to saving and extending life. They feel uncomfortable with the idea that the death can be chosen by the patients themselves and do not want to be involved in assisting such unnatural death.

The pro-life groups believe that people are giving away their existential choices and responsibilities to the doctors. The patient would be frightened that their physicians might kill them without their permission. (There have been the instances where the doctor considered it best to put an end to the suffering of the patient without consulting him). The medical fraternity believes that legalizing euthanasia will destroy the traditional bond between the doctors and the patients. Also the commercialized medical practices will prefer to get rid of long term patient who are short of insurance funding. They basically believe that doctors should not kill patience but should be helping them. There are no sufficient laws to punish errant doctors who cause breach of trust. The analogy of a lawyer defending a criminal once he takes up the case is applied to the doctors. It is the doctor’s duty to preserve life; whether it is valuable or not is none of his concerns.

Doctors are unsure of how to carry out euthanasia treatment and most of them are ill-informed. Attempts by doctors to help people suffering from fatal illness take their own lives failed to give an ‘easy’ death in one in five cases, researchers say. People recover from comas after taking supposedly fatal drug doses and suffer side effects such as vomiting and gasping. Patients who tried to kill themselves by taking the drugs prescribed by a doctor failed in 16% cases as the medication did not work as expected.

In a further 7% of cases there were technical problems or unexpected side effects. Problems surfaced so often that doctors felt compelled to intervene in 18% of cases, according to a report in New England Journal of Medicine. Even when the doctor directly performed euthanasia, complication occurred in 3% of the cases. In 6% of the cases patient took longer to die then expected or woke from a drug-induct coma that was supposed to be fatal. They feared that from terminally ill euthanasia will spread over to sick infants, adults in coma, in vegetative state and to those who think that life is unbearable.⁵

Advances in palliative care could eventually rule out one of the arguments given in favor of euthanasia-that it should be an option to the patient whose quality of life is negligible. Whereas euthanasia aims to end the sufferings palliative care aims to alleviate it.⁶Palliative care seeks to relieve the patient of his sufferings. It seeks to relieve the effects of illness rather then cure the disease itself. But the issue is, how many from the public can afford palliative care. Those who have seen their loved and dear ones die in appalling circumstances due to lack of treatment or sub-standard care would opt for euthanasia. The key objectives of palliative care are:

• To affirm life and regard death as normal process.
• To neither hasten nor postpone death.
• To provide relief from pain and other distressing symptoms.
• To integrate physiological and spiritual aspects of care.
• To offer a support system to the family cope during the patience’s illness, and afterwards in bravements.⁷

The science of pain relief within the hospice movement provides the opportunity for dignified death rather then starving and dehydrating to death via the so-called passive the passive euthanasia. (This was the sad fait of Taylor’s patient Mary Ormerod. She died of thirst after 40 days of neglect). Where euthanasia kills the patient when unable to cure the pain, palliative care kills the pain itself.

There is a fear that legalizing euthanasia may kill disabled people against their will resulting in undignified and unmerciful killing. It may enhance the situation where some people may be pressurized or coaxed into accepting assistance in dying by their families. Though euthanasia stands by the choice of the patient in wishing death, it is particularly difficult to regulate such cases.

Legalizing euthanasia would send wrong signals to the society that it is right, like giving the seal of approval. What is currently a crime would be transformed into medical treatment. Giving it a legal sanctity may be interpreted as compelling old citizens to die. The right to die may escalate into ‘duty to die’. It will encourage people to take the easy way out or make it easy for people to give up life whenever they face adverse situation.

Pro-choice/Pro-euthanasia

‘It is not the death but dying which is most frightening’. This is an old truism which has found favor with the pro-choice group of activists. The people who favor euthanasia are moral relativists who are also politically liberal. Their foremost contention is that dying patients like the normal human beings have the basic human rights and the right to die is a most personal and intimate choice of an individual which has to be respected by one and all. Death is inevitable and can not be evaded. It is not the death which people dread to face but the circumstances in which they have to die. They do not wish to dye a horrifying death, gasping for breath or thirsting for water or food supplements. They wish to control the way they die. They would rather die a painless and dignified death. They argued that the desire to have control over their lives is a fundamental part of humanity and not asking for the moon.

Loss of dignity and personal quality of life is much sought after reason for people who favor euthanasia or PAS. People who are terminally ill or whose body is afflicted by an incurable disease lose all hope of any fruitful life, they refuse to impose themselves on others or reduce themselves to a life of misery, pain and suffering. Such a situation would result in loss if dignity. To be at the mercy of others for the most trivial task is demoralizing to an individual. A life devoid of quality is not worth living when the situation can not improve as in the case of a terminally ill patient or a person in a vegetative state. Moreover the funds that go into the medication of the hopelessly ill or terminally ill patient can better be utilized for other necessities; may be for pre-natal and post-natal care etc.

The pre-choice people sling the accusation of ‘stone age ethics or space age medicine’ against pro-life groups. They do not favor any concession to religious rites. Their only interest lies in what is best for the patient. Any method which would eliminate the misery of the patient is deemed ethical. They do not tolerate when opinion of some religious sects dictating the terms of life and death are sought to be imposed. They do not force any person to go against their morals or ethics while resorting to euthanasia or PAS. The advancement of science and technology has provided numerous means to live better life. When all the means have been exhausted and the individual is left high and dry, euthanasia should not be considered as crime.

Another argument put forward by the pro-choice people is that the knowledge of having an option of how and when to die gives great comfort to the patient. The patient can negotiate terms relating to the execution of his death. It provides the peace of mind and the patient can relax and enjoy the time left till he dies. Since the time of death is known beforehand there is scope to be with the family and friends and bid farewell or let their intentions made known to all regarding all matters. In many cases the knowledge of time of death has rejuvenated family reunions and helped bridge the indifferences by healing the past wounds. It also gives an opportunity to the dying person to resolve pending issues and absolve him from any guilt.

The term ‘assisted –suicide’ according to the pro-choice people is misnomer. They would rather address it as ‘self-deliverance’. Some people are so sick or bed ridden that they have to take the assistance of physician to induce death. For this reason suicide should not be termed as physician assisted suicide. Going by the analogy, if one buys the rope to hang oneself can be termed as ‘merchant assisted suicide’? Euthanasia was and always will be only the choice of a person wishing to die and not otherwise. The countries which have legalized euthanasia/PAS also go by the same footing. They recognize as valid any doctor’s right to refuse to involve himself in assisting suicide if it goes against his ethics.

Finally the pro-choice group voices that death being an irreversible act is permanent and inevitable; but suffering need not be. They say that death is a choice that terminally ill patience should be able to make for them. In the words of Diana Barnard of Middlebury, USA, ”We must remember here we are taking about people who are dying- who have a terminal illness-who have less then  six months to live-death is certain-suffering need not be-peace of mind should be.”⁸

After considering the pros and cons of the effects of euthanasia, a picture emerges as to when to resort to euthanasia and when not to.

Yes to Euthanasia

• For the advanced terminally ill patients; patience who are undergoing unbearable pain and suffering, both physical and psychic, despite good medical care.
• For people who feel life is not worth living owing to intractable pain.
• For people who face loss of dignity/loss of capability/total loss of quality of life due to medical reasons.

Other conditions to be considered:

• The above categories of persons should repeatedly, expressly and actively ask for help in accelerating death.
• The patient must be mature adult of sound mind.
• They must not be suffering from depression.
• The decision to terminate life must be a considered and informed decision
• The request for the termination of life must be expressed; repeatedly and actively made by the patient.
• It must be the choice of the patient and nobody else, neither the doctor nor the relatives of the patient.
• All other avenues for the patient to live must be exhausted.
• The treating physician and the relatives must be consulted with.
• The doctors and the patient involved in euthanasia process should have had a long term relationship.
• The physician/doctor should consult other independent physician regarding the matter.
• Finally the death must be informed and reported to the law enforcing authorities.

No to Euthanasia

· Euthanasia must not be the solution where the patients do not expressly ask for assistance.

· For a healthy person who is going through bouts of depression, consulting and medication would be the appropriate remedy.

· When palliative care can cure the person of his feeling of loss of dignity or loss of quality life.

· At the first knowledge of a terminal illness or a degenerative disease; medical care or cure to slow down the disease should be taken.

· For disabled people who in the opinion of the authorities of the state are no longer useful to the society.

· For patient who are tired of life.

A few illustrative cases would throw light on the circumstances when euthanasia is or is not allowed.

When the patient argues for his right to live⁹

Leslie Burke 44, a Britisher, dying from a degenerative brain condition filed a case against London’s High Court against UK’s General Medical Council rules which allow doctors to withdraw artificial feeding from terminally ill patient, possibly leading to their death. Under the guidelines, doctors could decide to take such course of action even if the patient and his family want artificial feeding to continue. This goes against the right to life. The law permits a patient to refuse medical treatment recognizing his right to die but the GMC guidelines imply that he can not in the same way choose to live. This is a clear case where euthanasia should not be resort to.

Where the Husband of the Patient Sued for Right to Die whereas Her Parents Sued for the Right to Life¹⁰

The Florida legislature in USA has introduced legislation that would require incapacitated people who never made written end-of-life plans to be kept alive regardless of their family’s wishes. The bill is a direct response to the case of Terri Schiavo, a brain damaged woman. Terri had a heart attack in 1990. Since then she has been on life supporting system, kept alive by the feeding tube in a nursing home. Her husband Michael Schiavo argues that his wife would not want to keep living in her condition and requested her feeding tube to be removed. Consequently the court allowed the same. This was challenged by Terri’s parents who say that their daughter is responding to them and should be kept alive. The court ordered the tubes to be reinserted. The bill is yet to be enacted and the controversy continues.

Where the Patient is not Terminally Ill/Close to Death/in a Vegetative State¹¹

A man has been in the wheelchair since 1941 as a result of polio. He has led a wonderful life till twenty years ago. From then on he has been experiencing the post polio syndrome and has lost strength. He is constantly fatigued. Right now he is at the point of being very close to not being able to do much of anything. He is struggling to accomplish his regular daily living activities. His question is, “What is the plight of persons like me?” He can not restore to euthanasia and the law can not help him either. He has to suffer till death.

Where the patient is tired of life¹²

In December 2002, the highest courts in Netherlands ruled on a case involving physician, Philip Uxorious, who had helped former senator, Edward Brongersma, to commit suicide in 1998. Brongersma had suffered from inconsistence, dizziness and immobility. He said he was tired of life. The court ruled that the Brongersma’s condition was not sufficiently critical to justify a mercy killing: “The question in this case was whether euthanasia was justified also in circumstances where a patient is tired of life.

Where the Patient did not Express His Wish to Die¹³

On March 28, 1995 the District Court in Yokahame found a doctor guilty of murdering a terminally ill cancer patient who was expected to die within a few days. The court held, “The doctor’s action did not meet all the conditions under which mercy killing would be permitted. The patient had mad no clear expressions about his physical pain nor about his will to approve euthanasia. The doctor’s action can not be viewed as euthanasia and represents illegal termination of patient’s life.”

Status of Euthanasia Worldwide

The modern voluntary euthanasia movement started in 1935 in Britain, in 1938 in USA and in 1980 in Canada. The euthanasia movement gained monument only in 1976 when the ‘right to die case’ of Karen Ann Quinlan was brought to the notice of general public by huge publicity. This case was an eye opener for the public who became aware of the advancement the medical science has mad to extend life indefinitely in a persistent vegetative state. Consequent to this case the Hemlock society was formed in 1980 to campaign for law reform on assisted suicide. The recent trend in the countries worldwide is in favor of euthanasia or PAS. Not only the citizens but also the doctors and nurses are in favor of euthanasia. Active canvassing is on in many States to make euthanasia legal. The present status of euthanasia can be gauged from a look at the situations in various countries¹⁴.

Though suicide is no longer a crime in England or Wales, assisting suicide is a crime attracting up to 14 years of imprisonment. The law even bans the publication of any kind of matter which might incite or abet suicide.

Scotland does not recognize suicide as illegal. However, killing another person, with or without consent is murder,as consent is irrelevant in such case. It is for this reason that a person assisting another person to end his life by way of giving advice or by giving provisions for committing suicide is criminally liable on a number of other grounds such as manslaughter, reckless ending of human life, culpable homicide or wicked recklessness.

France and Luxemburg do not have a positive law banning suicide but a person can be made liable for failure to assist a person in danger. Germany criminalized direct killing by euthanasia though it does not penalized assisted suicide. While in Denmark there is no specific law banning or permitting assisted suicide, in Italy it is legally forbidden.

Belgium (2002), Switzerland (1941) and Netherlands (2002) are the three countries which openly and legally authorized assisted suicide of dying patients. Regulations have been carved to be strictly adhered to while assisting suicide. The involvement of at least two doctors is the norm. In case of the doubts as to the patient’s competency reference is to be made to a psychologist. The patients should have been residents for at least six months before resorting to euthanasia. Police are to be always informed.

The position in Switzerland is slightly different in as much as it does not stipulate the involvement of doctors or that the patients should be resident only. Thus there is no bar to foreigner provided they are critically terminally ill. Death by injection is banned though voluntary euthanasia has been made lawful since April 2002.

In Sweden assisted suicide is not banned specifically but a person assisting suicide might be charged with manslaughter. Norway likewise has criminal sanctions against assisted suicide by leveling the charge of “accessory to murder”. However in these cases the nominal sentences are passed on compassionate grounds. Finland has no provision in its criminal code about assisted suicide. It is done very informally with the assister sometimes informing the authorities of having assisted a person to die. No action is taken provided the action seems justified.

In Japan medical voluntary euthanasia was approved by a High Court in 1962. However the instances of euthanasia are rare because of the taboos on suicide and death. It is expressly forbidden in New Zealand under the New Zealand Crimes Act, 1961. In the rare cases that occurred, penalties were lenient. Canada has the same law as that of Britain and makes assisted suicide a crime through suicide per se is not an offence. A senate committee recommended in 1995 that a new category of ‘compassionate suicide’ be created under the Criminal Court to cover the cases of non voluntary euthanasia. The State of Oregon has a physician assisted suicide law since 1994 which was implemented from 1997. It is the only State in USA having such law. Many efforts to repel the law were successfully thwarted by the citizens.

Colombia’s constitutional Court approved medical voluntary euthanasia in 1997 for terminally ill patients who have clearly given their consent. But it has not been ratified by its parliament. Hence assisted suicide remains crime till it is legally challenged. In Uruguay the assister has to appear in the court. But he is not punished if he can prove that he assisted in the dying of a person upon the repeated request of that person on compassionate grounds. The assister should have a commendable reputation.

Euthanasia was legalized in the northern territory of Australia in june1995¹⁵. It provides for active euthanasia subject to certain prerequisites. The Act is called the Rights of Terminally Ill Act and cane into force in July 1, 1996. However the Australian Federal Government overturned the Rights of Terminally Ill Act on March 27, 1998 consequent to the state’s legislation being strongly condemned by opponents including church leaders and Aborigines.

South Africa currently criminalized physician assisted suicide. However with the global trend shifting towards pro- euthanasia, a bill (Bill on the Rights of terminally Ill) is under active discussion in the parliament. On the other hand, South Africa Medical Association and other pro-life groups are campaigning against passing of the bill.

Euthanasia in Indian Perspective

Indian culture rests on ‘karma siddhanta’. It is believed that our actions and their results are the causes of re-birth to settle our account with destiny that was born out of our past deeds. God deeds beget good dividend and bad deeds produce malefic results. This is the theory of karma. Realization or liberalization (Moksha) striven through material endeavour (Artha and Karma) and spiritual efforts “(Dharma-right conduct and Moksh-Liberation) blend to form the basis or purpose of life as per the Indian thought. There is no escape without experiencing the fruit of these actions. During the course of life, the past pre conditions defines the emergence into the present and the present influence of both action and environment shapes what is going to be met in the future.¹⁶

Based on this theory, a person has to repent for his sins before attaining moksha. Till he attains moksha the process of rebirth does not ceases. Committing suicide is considered as a sin rather then a crime. It is one of the panch maha pataks. For the repentance of this sin, a man has to take birth again and endure all the sufferings of human life. Hence, committing suicide is against the basic belief of life. If a person is afflicted with some incurable illness and is undergoing unbearable pain and misery, it is credited to his past ill deeds for which he is repenting in the present. Therefore, a person who is terminally ill/has a degenerative disease believes that suffering the same would absolve him of his sins. For them, suffering is a divinely appointed opportunity for learning or purification.

The other side of the coin shows the human life, which is god-given, to be the highest form of life on earth. Life is considered a gift of God which He alone has the power to take back. It is his decision and not man’s to decide when and how to die. Therefore, suicide is considered an offence.

Medical Council of India and Euthanasia

Under the regulations of medical council, practicing euthanasia shall constitute unethical conduct. However, on specific occasion, the question of withdrawing supporting devices to sustain cardiopulmonary response shall be dealt with by the treating physician alone. A team of doctors shall declare withdrawal of support system. Such team shall consist of the doctor in charge of the patient, Chief Medical Officer/ Medical Officer in charge of the hospital and doctor nominated by the in-charge of the hospital from the hospital or in accordance with the provision of the Transplantation of Human Organ Act., 1994.

Conclusion:

With modernization having its impact on the society and with increasing western influence which is materialistic in nature, cases of suicide are increasingly manifold. Man seems to have lost the zeal for survival. But this forms only a miniscule of the vast fabric of the society. On ground of public policy and morality the offence of abetment of suicide should be kept alive in the penal statutes lest the unbridled freedom results in more harm then the benefit to the individual and the society. Euthanasia on the other hand is understandably not a vice, if not a virtue. Euthanasia can never be implemented in a country where there is a clash of ideologies. There has been a lot of debate over this topic over the past few decades. The right to life of an individual is certainly the most fundamental right. Yet in the extreme cases it should not be binding on the individual to exercise the right in case of agony. Suicide should not be confused with euthanasia. The former is a narrow term when compared with euthanasia. In conclusion it can be said that euthanasia is an act of mercy rather then an act of murder provided it is legalized within the strictures prescribed by law. Every act has both positive as well as negative aspects. Where the positive aspects overshadow or outweigh the negative consequences, it would be beneficial for the act to be allowed, as was the case of abortion.

References:

1. Definition of euthanasia by the Netherlands State Commission on euthanasia.
2. http://www.religioudtolerance.org/euth.1.html.
3. From lawful exit: The limits of freedom for helping in dying by Derek Humphry, Norris Lane Press, 1993.
4. In an argument in a public lecture at Trinity University (October 13, 1995).
5. http://news.bbc.co.uk
6. http://news.bbc.co.uk
7. European Association for Palliative Care Constitution, Milan 1988.
8. Channel 3 TV news in Vermont, USA, report dated February 4, 2004.
9. www.thisisguernsey.com; published 2/3/2004 Guernsey Press and Star.
10. An associated press report cited by ERGO Newsletter.
11. Ethical eye: Euthanasia-volume II, national and European perspectives (30/1/2004); ERGO website.
12. www.religioudtolerance.org
13. Ibid
14. www.finalexit.com ERGO website.
15. www.nt.gov.au/lant/rotti/amend.html
16. www.explocity.com

About Authors:

Sachdev Yadav

M.Pharm. (Pharmacology), Senior Lecturer, Department of Pharmacology, Rajiv Academy for Pharmacy, Mathura, Delhi-Mathura Highway, Chhattikara. 281006, India Corresponding Author – sachdev_y@yahoo.com
Phone Number - (+919410446348), Fax Number – 0565 -2530766

Tarun Virmani
M.Pharm (Pharmaceutics), Lecturer, Department of Pharmaceutics, Rajiv Academy for Pharmacy, Mathura, Delhi Mathura bypass, Chhattikara 281006, India email – tarun2feb@rediffmail.com, Phone number - (+919896785874)

Hemendra gautam

M.Pharma (Pharmacy Practice) Lecturer, Department of Pharmacology Rajiv Academy for Pharmacy, Mathura, Delhi Mathura bypass, Chhattikara 281006,