Should Active Euthanasia be allowed in India?

By Suryansh Beohar

Introduction

To understand the legality of euthanasia in India or whether it should be allowed, we must first understand the standard information regarding Euthanasia. The term ‘Euthanasia’ is derived from the Greek language. The original word was “euthanatos”, which means “good death” which refers to a person ending their pain and suffering by a prideful death. Now one can classify Euthanasia in three spheres: Voluntary Euthanasia where consent is provided, Non-Voluntary Euthanasia where consent is not provided by the patient, most of the time due to being not in a state where consent can be provided like coma or a persistent vegetative state, etc. Third and last, Involuntary Euthanasia, where the procedure is performed against the will or permission of the patient. There are two more sub-spheres that branch out from these original 3 spheres, which are passive and active euthanasia. In Passive euthanasia, generally, the patient is stopped being provided the essential medications like pills, injections, etc. which are essential for the patient to stay alive at the time. In active euthanasia, lethal ways or methods are used to put the patient to eternal sleep. The laws regarding active euthanasia differ from country to country. In the Netherlands, Active Euthanasia being legal is regulated by the “Termination of life on request and assisted suicide” Act 2002. The Netherlands was the first country to legalize active euthanasia, and after it comes Belgium where it is regulated by Belgian Act on Euthanasia, 2002. Other countries where active euthanasia is legal are- Luxembourg, Switzerland, Germany, the United States of America, and Colombia. Interesting point- In Switzerland foreigners can be legally provided with euthanasia! It should be noted that passive euthanasia is legal in India and other countries like the United States of America etc. Another term called ‘Assisted suicide’ is also used in the place of euthanasia.

Euthanasia in India

As I have already mentioned that Euthanasia is legal in India, passive euthanasia to be specific. Supreme Court on the 7th of March 2011, legalized it but the patient must be in a ‘permanent vegetative state’. Active euthanasia, on the other hand, is still illegal in India. This judgment came in the Aruna Ramchandra Shanbaug v. Union of India & Ors case, where Aruna was basically a living skeleton, enduring immense pain while not being able to carry out any activity at all, she stopped seeing and hearing anything, she was not conscious of her existence, and her bones were so brittle that if grabbed in a wrong way, would instantly break. Since there was no law around at that time regarding euthanasia, Supreme Court had to step in. Few guidelines were given by the Supreme Court on passive euthanasia by stating: ‘A decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend. It can also be taken by the doctors attending to the patient. However, the decision should be taken bona fide in the best interest of the patient.’

‘Even if a decision is taken by the near relatives or doctors or next friend to withdraw life support, such a decision requires approval from the High Court concerned.’

‘When such an application is filed the Chief Justice of the High Court should forthwith constitute a Bench of at least two Judges who should decide to grant approval or not. The Bench will nominate a committee of three reputed doctors, who will give reports regarding the condition of the patient. Before giving the verdict a notice regarding the report should be given to the close relatives and the State. After hearing the parties, the High Court can give its verdict.’

The debate on whether Euthanasia should be completely legalized in India has been up for a long time now. There have been various points put forward by both sides, those who are in favor of euthanasia and those who are against euthanasia. Let’s take a quick glance at the arguments of both sides.

Argument in Favor of Euthanasia

One of the points that the people in favor of euthanasia bring up is Article 21 of the Indian Constitution. It talks about the right to protection of life and liberty, under which the Right to live with dignity also comes. People in favor claim that as they have the right to live with dignity when they are old and weak and are forced to take the help and assistance of people around them to carry out even the most basic chores, the dignity in living such life no longer exists. Then at such a moment, every citizen should have the right to decide when to take away their own life. Because denying a patient who is already suffering due to their pain and injuries, to put an end to their life, against their will can be considered to be a grave and outright violation of the human rights of a person. This claim highlights that the people both in the society and the healthcare industry must respect the individual’s personal decision. The argument regarding logic is also brought up, in which the people in favor say that why should the government spend precious resources on people who do not even have any chance
of surviving any further if they are denied access to the medical treatments or any medication which is essential for their survival. All these resources which are spent on such people can be used on other medical patients who are in dire need of them and who actually have a chance of surviving. For example, an old couple residing in Maharashtra wrote a letter to the
The President of India requested him to grant them permission to be provided with active euthanasia. The name of the husband is Narayan Lavate and the name of the wife is Iravati Lavate. Both are aged 86 and 79 years old respectively. The couple’s reasoning behind requesting the President of India to get active euthanasia was that since the President holds a wide range of powers where he can even pardon life sentences, then he should also hold the power of allowing the permission to ‘right to death’. The couple claims that they are satisfied with the life that they have lived so far and do not wish to continue it. They also do not suffer from any kinds of physical or mental illnesses, in fact, they both have healthy physical bodies (by the standards of old people). They claim that since at such an old age they cannot offer any service by which they could be proven to be a valuable source for the country, the government of India is basically putting its wealth and resources to waste by spending and exhausting the resources on them. They said that they decided to have no children in the first year of their marriage, and all their siblings and close family members who used to check up on them are dead, they fear that if one of them passes away then another one would have to spend the rest of their lives alone which they do not want. That is why they requested the President to allow them to get active euthanasia. Thus, in the end, it all comes down to the medical authorities choosing to spend their time or resources, and money between a patient who will most probably die soon, and a patient who has a greater chance of recovery. People against euthanasia claim that the right would be abused by people, to counter this the people in favor often claim that almost every right enjoyed by us risks being abused, due to which various laws and statutes are introduced by the government to properly define such rights and set boundaries to prevent such abuse. Also, the risk of mere abuse of any right cannot be a sensible explanation to deny someone from accessing that right. Even more so, when the question is about someone’s life.

Argument against Euthanasia

The argument against euthanasia basically revolves around active euthanasia. People in favor of euthanasia claim that even if euthanasia is legal in countries like Belgium, it is only allowed in the cases of children who are terminally ill. Another example can be Switzerland, where euthanasia is only performed when it is clear that the person will not be able to recover from pain and suffering in the future. This clearly tells us that euthanasia is only allowed in specific types of cases, and cannot be performed on everybody. It is also stated that the probability of the abuse or misuse of such a right can cause a lot of problems in the society, for example, if a person is in a coma, then the decision about performing euthanasia on the said patient can be taken by the relatives of the patient since consent cannot be obtained from that person. If the relatives hold any malicious intents towards that patient, or if the death of that patient would result in them acquiring land, or gaining monetary profit, then those relatives would definitely give their consent for euthanasia to be performed. If euthanasia gets completely legalized then the probability of people abusing this right in such a manner would increase by a large degree. One of the major problems here is that there has been no proper ‘procedure’ established on how the process of someone legally taking their life would take place. This would create ambiguity regarding the whole process. People would have to go to the courts to file petitions to seek ‘permission’ to initiate the process of euthanasia due to the absence of a proper procedure. Such petitions would also majorly consist of people who do not wish to live anymore and want to end their lives, along with the petitions by the relatives of a person they do not wish to keep alive due to them constantly going through excruciating pain and suffering and do not have any chance of recovering. The main problem which arises here is that this would make the courts and their judges the sole deciding authority over the life of someone else, without the ‘benefit’ of any litigation. This would drastically reduce the ambit of the thinking of the judges and would decrease their efficiency in deciding on the matter since various points of both sides would not be kept in front of them. They would be forced to guide themselves only on the basis of facts. Such factors when considered would make the end decision a bit unreliable or even arbitrary. Another argument is that due to the rapid pace of advancement in medical science, and the cures of various diseases and ailments being discovered, it is highly possible that those people who are ill today have a good chance of being cured in the near future. That is why it would be wrong to kill someone by stating that they cannot be cured ‘today’ and killing their chances of recovery in the future. It is always not clear whether the patient actually has the desire to end his or her life.
If euthanasia becomes an option for everybody, then there is a major risk of the patient being coerced into giving his/her consent. Since physical coercion would in all probabilities not take place, chances of mental coercion taking place are very high. The patient might get emotionally blackmailed into giving his/her consent to ending the life. The patients who already have a history of suffering depression, anxiety, or any other kinds of mental illnesses, would be even more prone to such mental coercion. Even if a patient’s family members do not force, but the patient and the family are financially weak, then the patient might be forced to choose euthanasia considering it is an option available to him/her so that the patient does not become a financial burden on the family. Such factors may force the patient to ‘choose’ euthanasia, which is wrong. Also, the decision to end one’s own life is a very big one, and it is highly probable that the patient at one time might get emotionally frustrated for a brief period due to the pain suffered by him/her, and in that brief period, the patient might consent to euthanasia, even if the patient might not want it. So, there is a very high chance of decisions being influenced by emotions and various other factors which would interfere with the rationale and reasonable thinking of the patient, which would only be possible if the patient takes the decision with a cool mind while keeping all the various factors in mind.

Opinion of the Author & Justification

I would like to base my opinion on various factors. Should euthanasia completely be legalized and be made available to everybody? No. Why? Because euthanasia can be considered a very important and potentially life-changing decision for both the patient and their relatives. It requires a very well-thought-out and informed decision, and such decisions should only take place when it is an absolute requirement. The patient must be in such a crippling condition and must be so reliant on technology to keep him/her alive, leaving the relatives being incredibly hurt by watching their loved ones in such constant pain. Otherwise, all kinds of people might start asking for euthanasia, majorly suicidal people, which would create a huge problem. Coming to passive vs active forms of euthanasia, I personally do not hold any negative opinions about both of them, especially passive euthanasia, since it is now a ‘legal reality in India. In a judgment in 2018 by a bench comprising of Justices A.K. Sikri, A.M. Khanwilkar, D.Y. Chandrachud and Ashok Bhushan on a PIL filed in 2005 by an NGO the Supreme Court issued guidelines in terms of the “living will”’ made by terminally-ill patients. In the judgment, Justice D.Y Chandrachud stated that ‘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.’ This statement clearly highlights how the right to life is interlinked with the right to end one’s own life with dignity. Active euthanasia although still illegal in India, is also an appropriate option that can be taken by patients in foreign countries where it is legal. In Active euthanasia, instead of disconnecting the patient from life support in a passive method, generally, lethal injection is given to the patient to instantly kill them, sure, it is a bit aggressive, but rather a more painless way to end someone’s life, as disconnecting someone from life support in passive euthanasia would definitely cause a lot of pain for a few seconds. So overall, I am not against Euthanasia but it must be performed under specific circumstances.