Die another day, or today?

The recent statement of Union Health Minister Harsh Vardhan that there should not be any rush to decide on euthanasia and efforts should be made for a national consensus on it has kickstarted a debate in medical scopes that whether euthanasia should be made legal in India? Vardhan emphasised that ‘a consensus should be developed on whether to allow killing of terminally-ill people with no chances of revival. It is a complex issue. There should not be any hurry to decide on this highly emotive subject.’

In a writ petition filed on behalf of Aruna Ramachandra Shanbaug, a former nurse from Haldipur, Uttar Kannada, Karnataka in India, in 1973, while working as a junior nurse at King Edward Memorial Hospital, Parel, Mumbai, she was sexually assaulted by a ward boy, Sohanlal Bhartha Walmiki and has been in a vegetative state since the assault. On 24 January 2011, after she had been in this status for 37 years, the Supreme Court of India responded to the plea for euthanasia filed by Aruna’s friend journalist Pinki Virani, by setting up a medical panel to examine her.

The Apex court held that euthanasia is one of the most perplexing issues which the courts and legislatures all over the world are facing today. The court observed that in this case, the court is facing the same issue, and we feel like a ship in an uncharted sea, seeking some guidance by the light thrown by the legislations and judicial pronouncements of foreign countries. The court turned down the mercy killing petition on 7 March 2011. However in its landmark judgment, it allowed passive euthanasia in India.

Article 21 of the Constitution guarantees protection of life and personal liberty.

While interpreting Article 21 of the Constitution, the courts have held that every person is entitled to a quality of life consistent with his human personality. The right to live with human dignity is the fundamental right of every Indian citizen. Protagonist of euthanasia on the view that existence in persistent vegetative state (PVS) is not a benefit to the patient of a terminal illness being unrelated to the principle of ‘sanctity of life’ or the right to live with dignity’ is of no assistance to determine the scope of Article 21 for deciding whether the guarantee of right to life’ therein includes the right to die’.

The right to life’ including the right to live with human dignity would mean the existence of such a right up to the end of natural life. This also includes the right to a dignified life up to the point of death including a dignified procedure of death. In other words, this may include the right of a dying man to also die with dignity when his life is ebbing out. But the right to die with dignity at the end of life is not to be confused or equated with the right to die an unnatural death curtailing the natural span of life.

The general legal position all over the world seems to be that while active euthanasia is illegal unless there is legislation permitting it, passive euthanasia is legal even without legislation provided certain conditions and safeguards are maintained.  Euthanasia in the Netherlands is regulated by the ‘Termination of Life on Request and Assisted Suicide (Review Procedures) Act’, 2002. In none of these countries such as UK, Spain, Austria, Italy, Germany and France euthanasia or physician assisted death is legal.

In January 2011 the French Senate defeated by a 170-142 vote a bill seeking to legalize euthanasia. In England, in May 2006 a bill allowing physician assisted suicide, was blocked, and never became law. In United States of America Active Euthanasia is illegal in all states but physician assisted dying is legal in the states of Oregon, Washington and Montana.

Now the question arises in the context of a dying man, who is, terminally ill or in a persistent vegetative state that he may be permitted to terminate it by a premature extinction of his life in those circumstances. This category of cases may fall within the ambit of the ‘right to die’ with dignity as a part of right to live with dignity, when death due to termination of natural life is certain and imminent and the process of natural death has commenced. These are not cases of extinguishing life but only of accelerating conclusion of the process of natural death which has already commenced.

The debate even in such cases to permit physician assisted termination of life is inconclusive. It is sufficient to reiterate that the argument to support the view of permitting termination of life in such cases to reduce the period of suffering during the process of certain natural death is not available to interpret Article 21 to include therein the right to curtail the natural span of life.

The debate continues, life sometimes means more than animal existence. The state has failed to provide quality universal healthcare to half of its population. The healthcare conditions in the so called government hospitals and dispensaries are pathetic with complete antipathy of the administration including the doctors and nursing staff towards the poor patience leaving them in vegetative state and giving them very few options but to end their lives.

The author is an advocate
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