ABSTRACT
When a person takes their own life, it is referred to as “suicide,” but when another person takes a life at the deceased’s request, it is referred to as “euthanasia” or “mercy killing.” The following paper aims to explain what euthanasia is and how it might be used in three different situations involving a person who has been alive since birth. What was the attitude towards elimination of life in different religions like Hindu, Muslim, Christian, and Sikh in ancient cultures of nations like India where the practise of self-destruction was a custom? Although self-destruction is the goal of both suicide and euthanasia, there is a definite difference between the two.
There are five categories in which euthanasia can be categorised, as well as several applications for it. In addition to them, the legal status of euthanasia in India in light of the Indian Constitution, Indian Penal Code, and other current laws, as well as the position of several other nations throughout the world, are all taken into consideration for discussion. Although the Supreme Court has already made a judgement on this matter, there are still some questions that need to be thoroughly examined. Finally, both reasons in favour of and against legalising euthanasia are presented, and this paper concludes with recommendation on passive euthanasia legality.
“Euthanasia is a topic that taps into deeply personal views of dignity and fear but, mostly, spirituality”. BY- Elin Hilderbrand,
Key words: Euthanasia, Mercy killing, Suicide, Voluntary euthanasia, Consent for killing, Passive euthanasia.
INTRODUCTION
In recent times, there has been a lot of progress in the field of medical research and its diverse domains, which has given rise to new challenges that demands the immediate attention of the legislators. Euthanasia and its effects on the lives of common people is one such sensitive issue
that is constantly evolving and needs careful consideration. In India, euthanasia involves legal, moral, and ethical questions, particularly regarding the right to life enshrined in Article 21 of the Indian Constitution. This right has been held to be the heart of the Constitution, the most intrinsic and progressive provision in our living constitution, serving as the very foundation of our laws. It has three important elements, namely life, liberty, and dignity. The right to life includes right to live with dignity and not just mere physical existence. In this context, dignity implies propriety i.e a sense that upholds the inherent worth and value as a human being. It means living a life where individuals are treated with respect and dignity by others, in a manner that is considerate of their cultural and personal beliefs.
Every humans has an inborn desire to fully embrace life, to cherish every moment and extend its duration as much as possible. However, often due to external factors or internal struggles, some situations arises, which eventually become an obstacle in the way of individual that they aren’t able to count the bountiful fruits of their existence. Such a situation can push the individual to an extent that people may feel trapped, torn between two equally distressing options: the agonizing contemplation of suicide which is both morally condemned and legally prohibited in India, or contemplation of euthanasia, which elicits differing opinions on its ethical and legal consequences as a means to end their suffering or lives.
RESEARCH METHODOLOGY
This is a form of doctrinal analysis and, thus, secondary research data is studied and critically analysed. In the study title “LEGALIZATION OF EUTHANASIA & ITS IMPLICATIONS ON HUMANS”, most appropriate. It is purely an interpretative and analytical study. It is concerned with the analysis of the legal doctrine and how it was developed and applied. Qualitative data is used in this research to demonstrate and explain the topic.
In this explanatory research, case studies and laws are also included. Primary resources referred to in the course of study include books, journals, law reports, cases and other open sources like articles that were derived from some legit websites that are all mentioned in the references.
EUTHANASIA: ORIGIN & ITS DEFINITION
The idea of euthanasia introduced a merciful and easy death which is set up beyond natural death. It involves the intervention of another person to end the life. In a layman’s language, Euthanasia simply means an easy or painless death, or the intentional ending of the life of a person suffering from an incurable or painful disease at his or her request. In short, it is the deliberate act or practice to cause ending someone’s life in order to relieve their suffering or
pain. This method is typically used for individuals who have a terminal illness, a severe and incurable disease, or are in a persistent vegetative state with constant pain.
Originally, The term “euthanasia” is derived from the Greek word EUTHANATOS, in which EU means GOOD and THANATOS means DEATH, putting it together means “Good Death1”. The concept of euthanasia was first proposed in the early 17th century, by an English philosopher and politician Sir Francis Bacon, which literally means mercy killing. However, According to the British House of Lords Select Committee on Medical Ethics2, Euthanasia is described as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering”. Professor Drape explained that any definition of euthanasia must have the following four components: an agent, a subject, a purpose, a causal relationship in which the agent’s actions influence the outcome, and an outcome. She then provided a definition based on this that included those components, stating that euthanasia “must be defined as death that results from the intention of one person to kill another person, using the most gentle and painless means possible, that is motivated solely by the best interests of the person who dies.” Therefore, the meaning of euthanasia can vary depending on specific nature and unique application of it.
TYPES OF EUTHANASIA
Depending on factors such as a person’s perspective, level of consciousness, and degree of consent or involvement, there are various classifications of euthanasia which are as follows: 1. Voluntary Euthanasia: It is the classification of euthanasia, which occurs when a competent individual, who is suffering from a terminal illness or intolereable pain, actively seeks assistance from the doctor to end their life, and the doctor willingly
1 Kumar A, Mehra A, Avasthi A. Euthanasia: A Debate—For and Against. J Postgrad Med Edu Res 2021;55(2):91– 96, Retrieved on: July 9th, 2023.
2 Mishra Shikha, Singh Veer Uday, “EUTHANASIA AND ITS DESIRABILITY IN INDIA”, Published On: Summer Issue 2020, Retrieved On: July 10th, 2023, Retrieved From: https://ili.ac.in/pdf/sms.pdf
agrees to provide the necessary support. Here, the sick person and doctor both act willingly. As this type of euthanasia necessiates the explicit consent of the person involved. It is regarded as a form of patient autonomy, where individuals have the right to make decisions about their own life and death. Inshort, such euthanasia is done at the will of the individual and is legal in India.
2. Non Voluntary Euthanasia: Non-voluntary euthanasia involves the deliberate ending of a person’s life without their explicit consent of the sick person. This type of euthanasia is performed when the decision regarding the premature and merciful death is made by another person, because the person to be euthanised is unable to express their wishes due to factors such as coma, severe cognitive impairment, or a life
threatening disease in the new-borns. Non-voluntary euthanasia is often subject to ethical debates and legal restrictions, as it raises questions about decision-making on behalf of someone else and is therefore not permitted in India.
3. Active Euthanasia: Active euthanasia is also called “aggressive” euthanasia. In this, the patient is taken out of his suffering by active means. Active method here means the intentional administration of a deadly substance or the doing of any action with the direct intention of causing the death of a person. It may also include the use of drugs or procedures to actively end a person’s life, but only in response to their explicit request.
4. Passive Euthanasia: Passive euthanasia refers to the withholding or withdrawal of life sustaining treatment or medical interventions with the intention of allowing a natural death to occur. This can done by cutting off the life support system such as the discontinuation of ventilators, feeding tubes, or medications that prolong life. Passive euthanasia is often seen as allowing nature to take its course, rather than actively causing death. Due to its nature of facilitating a natural death, this approach is permissible and legally accepted in India.
HISTORICAL OVERVIEW OF EUTHANASIA LAWS IN INDIA
India has a long history of hotline concerns, that have encouraged the public to voice their opinions. And India being as a land of diversities, it deeply values the principles of individual and personal freedom to express one’s beliefs. It is noted that on the concept of euthanasia in India, many of these people from different religions and sects holds diverse views and beliefs. However, the idea of right to die or end one’s life is not something new and unknown to the
people of India. Since ancient times, many religious texts including Bible, Quran, Bhagavad Gita, Rigveda recognize self-destruction or suicide.
Traditionally, the Hindu Vedic age is replete with many examples of suicides committed on religious grounds. The sacred texts like Smritis, Shrutis, Vedas, Upanishads, Gita, Mahabharata and the Ramayana and Puranas etc seems to support euthanasia in the garb of the concept of self-liberation. It is believed that Lord Ram and his brother Lakshmana took Jal Samadhi in Surayu River, while Lord Mahavir met his death in search of it. Further, Prayopavesa i.e. fasting onto death was taken up by the Hindu leader Satguru Sivaya Subramuniyaswami in November 2001. Liberation under Hindu religion is permissible but is restricted as to when it shall be pursued. Hinduism seemed very much in favour of suicide and self-liberation. Indeed, even Manusmriti discusses accomplishing self-freedom while experiencing hopeless sickness.
In modern times, the greater part of the hindus says that a doctor shouldn’t accept a patient’s request for euthanasia because this would cause the soul and body to be separated at an unnatural time. And as a result, the karma of both the doctor and the patient will be affected. Euthanasia, according to other Hindus, is against the teaching of ahimsa (doing no harm), so it cannot be practiced. On the other hand, some Hindus believe that helping to end a painful life is a good deed and fulfils one’s moral obligations. In the commentaries on Manu, Govardana and Kulluka made the observation that, despite Vedic laws prohibiting suicide, a man who is suffering from an incurable illness or experiences a great misfortune may embark on a journey that results in death.
Other religions in India like Buddhism and Jainism are also supportive of the idea of euthanasia but with some reasonable restrictions. On the contrary, the religions like Muslims and Christians are against the practice of euthanasia. They strongly believe that life is a pious gift of their respective good (Allah & Jesus) and it is the god who chooses the life of any person that how long he/she will live. Like them, the Sikhs derive their ethics largely from the teachings of their scripture, Guru Granth Sahib, and the Sikh Code of Conduct i.e. (The Rehat Maryada). The Sikh Gurus rejected suicide (and by extension, euthanasia). They believe euthanasia interferes with God’s plan. Suffering, they said, was part of the operation of karma, and humans should not only accept it without complaint, but act so as to make the best of the situation that karma has given them. Therefore, no human being has the right to interfere in taking the life of any person. In short, they argued on the premise that one should not interfere with the natural process of death.
POSITION OF EUTHANASIA IN OTHER COUNTRIES
Internationally, the concept of euthanasia or right to die with dignity has gained a significant recognition and acceptance. The following is the lists of those few countries where it is permitted3:
NETHERLANDS: In 2001, the Netherlands legalised euthanasia. In the said year, the Parliament of Netherlands has passed a bill, which later became an act i.e “Termination of Life on Request and Assisted Suicide” (Review of Procedures) Act. This act formally relaxes the law’s ban on euthanasia and assisted suicide that had previously been upheld by a judicial decisions. Previously, accordingly to the penal code of the Netherlands killing a person on his request was punishable with twelve years of imprisonment or fine and also assisting a person in committing suicide was punishable with three years of imprisonment or fine. But after the guidelines, the law of Netherlands provides a defence of ‘necessity’ to the offence of voluntary euthanasia and assisted suicide. This defence of necessity is two main components:
The first one pertains to ‘psychological compulsion’ while the second one relates to ’emergency’. The grounds laid down by the court for deciding whether the defence of necessity applies or not is briefly elaborate herein below:
∙ The request for euthanasia must come from the patient only and the consent must be completely free and voluntary.
∙ The patient’s request must be done with careful approach, durable effectiveness, and persistent nature.
∙ The patient must undergo an experience of intolerable suffering, which may not be limited to physical pain.
∙ Euthanasia should be the last resort and there should be no prospect of improvement in their health.
∙ Other options should be considered and deficiencies found to alleviate the patient’s condition.
∙ Euthanasia must be perform by doctors only.
∙ The doctor should consult an independent medical colleague who has experience in this area.
3Srivastava Vinod, “Euthanasia: a regional perspective”, Published On: July 21st, 2014, Retrieved On: July 12th, 2023, Retrieved From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158780/
AUSTRALIA: Australia’s Northern Territory became the first country to legalize euthanasia by passing the Right to Terminally Ill Act, 1996. This was upheld as legal by the Supreme Court of the Northern Territory of Australia in the Wake v Northern Territory of Australia case. But afterwards it was rendered unlawful once more by the Euthanasia Law Act of 1997.
UNITED STATES : In USA, The practise of actively ending a patient’s life is illegal but doctors are not held accountable if they refuse or cease to providing life-sustaining care or life support system at the patient’s request or at the request of the patient’s authorised agent. In short, according to their laws, the passive euthanasia is allowed and permitted. Also in the legal landscape, the Supreme Court of the United States has completely banned euthanasia through landmark cases such as Washington v. Glucksburg and Waco v. Quill. In these cases, the ban on physician-assisted suicide was upheld, saying it was in consonance with constitutional provisions. However, in the state of Oregon, assisted suicide was legalized in 1994. Since then, 27 cases of assisted suicide have been reported in 1999, and this number is expected to rise further.
BELGIUM : In Belgium, the concept of euthanasia was made legal in the year 2002.
COLOMBIA: The status of euthanasia in Colombia is uncertain because Congress never validated the Constitutional Court in 1997 decision to legalise it. On the other hand, physician assisted suicide is considered illegal.
LANDMARK CASES
CASE NAME: Aruna Ramchandra Shanbaug vs Union of India4
Facts Of The Case: Aruna Ramchandra Shanbaug worked as a staff nurse at the Mumbai based King Edward Memorial Hospital. On November 27, 1973, she was attacked by a hospital sweeping employee. He used a dog chain to wrap around her and strangle her, preventing her from moving in an effort to rape her. He sodomised Ms. Aruna after noticing she was
4 MANU/SC/0176/2011
menstruating. On November 28, 1973, the very following day, Ms. Aruna was discovered on the floor covered in blood. She was discovered unconscious by one of the maids. The dog chain strangulation severely damaged the cortex of her brain by cutting off the oxygen flow. She also suffered a contusion to the brain stem and a cervical cord damage. A friend of Ms. Aruna filed a plea for the matter under article 32 of the Indian Constitution in 2009, after 36 years of the incidence. Ms. Shanbaug has been in a “Permanent Vegetative State” for a very long time. She has grown incredibly frail and weak.
Respondent’s Arguments: The hospital’s dean argued that Ms. Shanbaug had received care and food from the nurse and other hospital employees for as long as 36 years. The staff took excellent care of her and did it with the utmost responsibility and willingness. As a result, they object to and dislike the concept of killing Ms. Shanbaug. Given that the patient is approaching
60 years old, she may naturally pass away.
They pleaded with the court to forbid the murderous act. All of her basic requirements and needs have been met by the personnel with diligence and respect. In the unlikely event that this is accepted, euthanasia has a strong propensity for abuse. .In order to prevent family members, relatives, and other close friends from abusing the legalisation of passive euthanasia, they pleaded with the court to deny the practice’s acceptance. One of the nurses is willing to care for Mrs. Shanbaug for the rest of her life without payment because the hospital staff has an emotional connection to the patient.
Ms. Shanbaug has a right to life, thus taking her life would be immoral and cruel. Also important to note is the outstanding and selfless service provided by the hospital staff. Further, since the patient is unable to consent herself to being removed off the life support system, the issue of who would consent on Ms. Shanbaug’s behalf arises.
Petitioner’s Arguments: A petition was submitted under article 32 of the Indian Constitution by Ms. Shanbaug’s acquaintance. According to the petitioner’s attorney, article 21’s protection of the right to life also encompasses the right to live in the highest degree of dignity. Therefore, it must also encompass the right to a dignified death. Any person with a terminal illness or who is permanently vegetative must fall under the definition of the “right to die” in order to put an end to their excruciating pain and suffering. She has been bedridden for the past 36 years with no chance of change. She is completely unaware of her surroundings, lacks the ability to chew her food, is unable to speak on her own, and has no knowledge of her surroundings.
Judgment: The difference between active and passive euthanasia was drawn by the court. Active euthanasia is the intentional and positive ending of a person’s life through the injection or administration of a fatal drug. Except if sanctioned by law, it is regarded as illegal everywhere. Active euthanasia in India is a clear violation of sections 302 and 304 (3) of the IPC. Moreover, section 309 (4) of the IPC makes physician assisted suicide a crime. On the other side, passive euthanasia involves the removal of medical care or life-supporting mechanisms.
The primary difference between active and passive euthanasia is that during “active” euthanasia, a purposeful action is taken to end life, but during “passive” euthanasia, no such action is taken. The supreme court rejected the petitioner’s argument and instead outlined an appropriate procedure and set of standards for approving passive euthanasia in the “rarest of rare circumstances.” The High Court would have the power to decide whether to turn off the life support system under the provisions of article 226. When an application is submitted, the Chief Justice of the High Court must convene a bench and refer a committee of three well respected doctors to them.
EFFECTS OF EUTHANASIA ON HUMANS5
Ethical Concerns: Euthanasia raises deep ethical concerns regarding the value of human life, personal liberty and the right to a dignified death. These difficult ethical conundrums are made easier to understand and deal with by research on euthanasia, which enables individuals and society to form well-informed opinions on the subject.
Legal Framework: In India, the legal environment pertaining to euthanasia is still developing. The Supreme Court of India issued a major decision in 2018, generally referred to as the “Aruna Shanbaug case,” that recognised the idea of “passive euthanasia” and established clear rules for its use. Assisted suicide and active euthanasia are still prohibited. Policymakers, legal experts, and academics may build thorough and complex rules and regulations governing end
of-life choices by studying euthanasia.
5 Roy Caeser,”POSITION OF EUTHANASIA IN INDIA – AN ANALYTICAL STUDY”, Published On: July, 2011, Retrieved On: July 11th, 2023, Retrieved From:
https://www.researchgate.net/publication/259485727_POSITION_OF_EUTHANASIA_IN_INDIA_- _AN_ANALYTICAL_STUDY
Social Implications: Euthanasia is a subject that affects the society as a whole. Studying euthanasia helps to understand its impact on families, caregivers, health care professionals, and society at large. This allows exploration of the possible social, emotional and psychological consequences for the individuals involved, as well as the wider moral and ethical implications for society.
Patient Rights and Autonomy: The study of euthanasia helps to examine the concept of patient autonomy and the right to make decisions about one’s life, including the option of a dignified death. India is a diverse country with different cultural, religious and social perspectives on death and dying. An exploration of these perspectives, along with individual rights, can help shape health care practices that respect and uphold patient autonomy while considering the broader social context
Comparative Analysis: Studying euthanasia in the Indian context allows comparative analysis with other countries that have legalized euthanasia or have a stronger legal framework for end of-life decisions. By examining international practices, researchers and policy makers can learn from the experiences of other countries and evaluate the potential benefits, risks, and safeguards associated with legalizing euthanasia.
As an overall, the study of euthanasia in India is important for promoting informed discussions, developing an appropriate legal framework, shaping health care policies, and addressing the ethical dilemmas associated with end-of-life decisions. It facilitates a wider understanding of the subject, leading to a more compassionate and holistic approach to end-of-life care and the rights of persons experiencing intolerable suffering.
SUGGESTIONS
Although there has been progress in terms of legal recognition and rights, there is still a long way to go in achieving real acceptance of the process of euthanasia in India. Here are some suggestions:
∙ Public Awareness: Launch a massive public awareness campaign to educate the public about euthanasia, its benefits and the need for its legalization. Providing factual information should be a part of this, and it should be done across a variety of channels, including social media, radio, and television. This will help in removing misconceptions and promoting an informed and empathetic society
∙ Need of Oversight authority: Establish a commission or independent authority to be in charge of monitoring the application of euthanasia laws. This body is in charge of ensuring that the procedure is strictly followed, overseeing its execution, and responding to any issues or complaints.
∙ Create stringent qualifying requirements: Create a strict list of requirements that patients must satisfy in order to qualify for euthanasia. This may involve having used up all available medical therapies, having a terminal illness, experiencing excruciating pain or suffering, or having illnesses that are irreversible.
∙ Involve a multidisciplinary approach: Seek input from medical professionals, ethicists, legal experts and religious leaders to ensure a holistic approach on euthanasia. This will help address concerns related to medical ethics, religious beliefs and possible legal repercussions.
∙ Implement rigorous safeguards: Incorporate multiple layers of safeguards to prevent any potential misuse or abuse of euthanasia. These safeguards may include mandatory second opinions from independent medical professionals, psychological counseling and a cooling-off period to ensure that the patient’s decision is well informed and voluntary.
CONCLUSION
No such law could be guaranteed to be free of abuse, which would primarily focus on the lives of other sick people who did not want their lives stolen. The ease with which such abuse can be made invisible makes it exceptionally hazardous. Therefore, even if mercy killing seems morally acceptable, it seems virtually impossible to carry out in practise. But so is every law without proper implementation or strict and well established guidelines.
Therefore, euthanasia would need to be legalised with appropriate protections. When a legislation on the subject is being drafted to combat unethical practises and the improper use of euthanasia, it must take into account the recommendations made in the legislation Commission of India’s reports and the guidelines outlined in the Aruna’s case. Additionally, the likelihood of euthanasia being used inappropriately would be significantly decreased if the aforementioned proposals were to be put into practise.
NAME: SHRELY SINHA
COLLEGE: LOVELY PROFESSIONAL UNIVERSITY, JALANDHAR, PUNJAB