Insights into Editorial: Should euthanasia be allowed?


Insights into Editorial: Should euthanasia be allowed?


 

Context:

Elderly Mumbai couple seeks Presidential nod for ‘active euthanasia’.

The couple, Iravati Lavate, 79, a retired school principal, and her husband Narayan, 86, a former government employee, have no major health problems. However, the fear of falling terminally ill and of not being able to “contribute to society” has pushed them to write to the President to seek permission for “doctor-assisted death”.

Lavate said he wrote to the president because the latter has the constitutional power to pardon life sentences, and should also have the power to allow ‘right to death’.

Both the petitioners are in reasonably good health, not afflicted by any serious ailment as on the date of this petition.

National discourse on euthanasia

It started in India in 2011, when the Supreme Court, while hearing the case of a nurse from KEM Hospital, Aruna Shanbaug, who was in a vegetative state for nearly 30 years, legalised passive euthanasia. Shanbaug was in a vegetative state since 1973 after she was sexually assaulted in the hospital premises. However, she herself couldn’t benefit from the case as the petitioner in the case was not her kin. The nurses of KEM, who were caring for her after her family stayed away refused to allow euthanasia. Shanbaug died in 2015, while on a ventilator for several days after suffering from pneumonia.

There have been applications, including one in 1997 from CA Thomas Master, a Kerala teacher, before Indian courts seeking permission for active euthanasia. The Kerala high court rejected the teacher’s plea. He subsequently killed himself in April 2004.

Why does old couple’s request unlikely to be heeded?

The 2011 judgment helped to push the debate to the extent of permitting passive euthanasia for terminally ill patients under the strict supervision of the High Court, in consultation with a team of doctors treating the terminally ill patient.

Passive euthanasia means withdrawing life support to induce death in a natural way. In contrast, active euthanasia means injecting legal drugs to induce death. This is not permitted in India and so the Lavates’ request is unlikely to be heeded as India is not comfortable with the idea.

The chances of its (active euthanasia) misuse is a major cause of concern

In the Aruna Shanbaug case, which generated a lot of debate, we have to bear in mind that Shanbaug was not in a position to take any decisions herself.

In the case of terminally ill patients who are provided with expensive health care, whose families know that the patients are unlikely to return to normalcy and given the economic burden on the family and on society to treat these patients, euthanasia could be debated. But euthanasia for those who are mentally alert, though physically disabled, is a big no.

Euthanasia in that form cannot be allowed or legalised because the probability of its misuse is very high. The decision in favour of euthanasia is far more complex when a person is mentally alert.

The right to life

The right to life was made more sacrosanct and, over the years, has been seen as a basic feature of the Constitution, thereby making it both fundamental and permanent.

The significance of this is that if one relinquishes the right, one can do so only in accordance with procedure established by law. Imposing death by way of capital punishment is an example of the right to life being terminated in accordance with the procedure established by law.

To terminate life, even one’s own life, were it to be done without the authority of law, would amount to an unlawful act. In certain cases, it may even be a criminal act. In fact, an attempt to commit suicide is a crime under the IPC.

There exists no legislation laying down the procedure to permit a person to take her own life. Now the courts are called upon to decide, without having the benefit of legislation to guide their decision-making.

Way forward

The right to life under Article 21 has been interpreted by the Supreme Court as the right to live with dignity. The debate now is whether the fundamental right to life extends to the right to choice.

The Lavates (Old couple) are physically fit. Nobody should or can allow them to die. Even the courts have ruled that life support can be withdrawn only when the chances of return to life are negligible.

But their letter to the President has opened up a new debate in this area. So far, the debate has been confined only to people who are terminally ill. Countries like Canada have given legal recognition to the concept of a “living will”, where people lay down directives in advance on how they should be treated if they end up in a vegetative state.

Now an important question before the courts is whether the law should allow living wills.