In the contemporary era, the global community grapples with diverse illnesses, and ongoing technological and methodological advancements contribute to the field of clinical medicine. Unfortunately, a significant number of individuals succumb to various causes, including suicide or the inability to access essential medical treatment. Within societal structures, the provision of palliative care and addressing quality of life concerns for patients facing terminal illnesses, such as advanced cancer and AIDS, has become a crucial focus for healthcare professionals.
While suicide involves an individual voluntarily ending their own life, the deliberate act of ending someone else’s life with malicious intent constitutes a criminal offense, termed culpable homicide under Section 299 of the Indian Penal Code (IPC). The associated penalties range from death sentences to lifelong imprisonment. This paper aims to explore the concept of euthanasia, its legal standing, and the current scenario. Euthanasia, defined as mercy killing, refers to the practice of painlessly ending the life of someone suffering from an incurable disease who wishes to die.
The terms euthanasia and mercy killing are often used interchangeably, sparking deliberations on moral, ethical, religious, and social considerations, both nationally and globally. Despite the shared objective of self-destruction, a clear distinction exists between suicide and euthanasia. Advocates of physician-assisted suicide (PAS) argue that an individual’s autonomy grants them the right to choose a painless death, while opponents believe such actions contradict the fundamental principles of the medical profession.
Concerns about undiagnosed depression and the potential for social coercion in those seeking euthanasia raise ethical questions surrounding the practice. Consequently, stringent guidelines, including mandatory mental health assessments and the involvement of psychiatrists, are implemented to regulate PAS. The legal status of euthanasia varies globally, with some countries openly practicing it, while others deem it illegal and unethical. Sociological perspectives, along with an examination of India’s constitutional and legal framework, the IPC, and international laws, are crucial components of the discourse.
Governments worldwide have implemented laws and safeguards to prevent the abuse and misuse of euthanasia practices. These preventive measures include explicit consent from the individual seeking euthanasia, mandatory reporting by physicians, and consultation with a second medical professional.
Euthanasia, Terminal illness, Suicide, Indian penal code, Mercy killing, Counseling, Mala fide.
INTRODUCTION AND HISTORICAL BACKGROUND.
Understanding someone or something often requires delving into its past to gain a thorough understanding of the concept. Learning from past mistakes is a common practice, as individuals seek to avoid repeating errors and strive for perfection in an imperfect world.
The term “euthanasia” was coined by English philosopher Sir Francis Bacon in the early 17th century. Originating from the Greek words “eu,” meaning “good,” and “Thanatos,” meaning “death,” euthanasia initially conveyed the idea of a “good” or “easy” death. Essentially, euthanasia refers to the deliberate act, typically carried out by a physician, of ending a person’s life at their request. It involves the administration of a lethal agent to relieve the patient’s unbearable and untreatable suffering, with the physician’s motive being merciful and aimed at ending suffering.
The rapid advancements in medical science and technology have significantly impacted society, raising ethical questions and challenging established norms. The emphasis on human rights, autonomy, and freedom of choice prompts a reevaluation of societal and medical ethics. In physician-assisted suicide (PAS), the patient self-administers a prescribed lethal substance, distinguishing it from euthanasia where the physician administers the substance. Euthanasia is legally recognized in the Netherlands, Belgium, and Luxembourg, with PAS also permitted in the first two. In the United States, Oregon and Washington legalized PAS in 1997 and 1999, respectively, but euthanasia remains illegal. The situation in Montana is unclear, with a PAS bill passed in 2010 but subsequently rejected by the state’s senate judiciary committee.
The idea of the right to die or end one’s life is not new to human civilization. Ancient Greece and Rome deemed it acceptable to serve or put others to death in certain circumstances. Practices such as putting newborns with severe birth defects to death were observed in Sparta. Voluntary euthanasia for the elderly was a permitted custom in several ancient societies. Historical texts, including the Bible, the Koran, and the Rig Veda, mention suicide. In India, the Vedic age is replete with examples of religious suicides, as seen in the Mahabharata and the Ramayana. While some Hindus argue against euthanasia due to its impact on the separation of the soul and body, damaging the karma of both doctor and patient, others oppose it on grounds of violating the principle of ahimsa, or non-harming.
There are two Hindu perceptions of euthanasia:
Assisting in the termination of a person’s painful existence is perceived as a virtuous act, fulfilling one’s moral obligations. By aiding in the end of a suffering life, an individual disrupts the natural cycle of death and rebirth, a morally objectionable action that results in assuming the residual karma of the patient involved in euthanasia.
Similarly, proponents of this viewpoint argue that artificially prolonging a person’s life through life-support machines is also an undesirable practice. However, employing such machines as a temporary measure for healing purposes is considered acceptable. The concept of an ideal death emphasizes consciousness, making palliative treatments problematic if they diminish mental alertness.
Within the Muslim perspective, euthanasia is vehemently opposed. Muslims believe that all human life is sacred, a gift bestowed by Allah, and it is Allah’s prerogative to determine the duration of each person’s life. Taking steps to interfere with this divine plan is considered unacceptable. Islamic teachings explicitly forbid suicide and euthanasia, emphasizing the sanctity of life and prescribing that one should not take the life that Allah has made sacred.
Similarly, many Christians reject euthanasia based on the belief that life is a divine gift from God, and humans are created in the image of God. Birth and death are integral parts of the divine life process, and humans are called to respect and honor them. Consequently, Christians argue that no individual possesses the authority to intentionally end the life of an innocent person, even if that person expresses a desire to die.
Sikh ethics, primarily derived from the teachings of the Guru Granth Sahib and the Sikh Code of Conduct (The Rehat Maryada), discourage suicide and, by extension, euthanasia. Sikh Gurus rejected these actions as interference with God’s plan, asserting that suffering is an inherent aspect of the karmic process. Sikhs are encouraged to accept suffering without complaint and strive to make the best of the situations determined by their karma.
This paper is descriptive and the research is based on secondary sources for the deep analysis of the concept of euthanasia. Secondary sources of information like newspapers, journals, and websites are used for the research.
TYPES OF EUTHANASIA
The term ‘euthanasia’ is commonly mischaracterized as representing a singular practice, but a more accurate understanding treats it as an umbrella term encompassing various practices. These practices can be classified into different forms of euthanasia, including:
- Passive voluntary euthanasia: This occurs when medical treatment is withdrawn or withheld from a patient at the patient’s request, to end their life.
- Active voluntary euthanasia: In this case, medical intervention takes place at the patient’s request to deliberately end their life.
- Passive involuntary euthanasia: Medical treatment is withheld or withdrawn from a patient, not at the patient’s request, to end their life.
- Active involuntary euthanasia: Medical intervention takes place, not at the patient’s request, with the intention of ending the patient’s life.
EXPERIENCE AND DEVELOPMENT OF EUTHANASIA IN DIFFERENT COUNTRIES
The Voluntary Euthanasia Society, also known as Exit, was established in the UK in 1935, marking the first recognized euthanasia society globally. It advocated for the legalization of euthanasia, sparking increased public debate. However, the onset of World War II stifled discussions on euthanasia, particularly due to the Nazis’ ‘euthanasia program.’ This program, initiated in 1939, led to the silent cessation of euthanasia debates.
The euthanasia discourse resumed in the 1970s, especially in the Netherlands, becoming a prominent academic and public debate. Significant cases, court decisions, and legislative acts shaped the global development of euthanasia. Notably, the Netherlands is the only country openly practicing both euthanasia and physician-assisted suicide, albeit subject to criminal law. The United States witnessed debates on withholding and withdrawing life-sustaining treatment in the 1970s and 1980s, evolving into discussions on physician-assisted suicide in the 1990s.
LEGAL ASPECT OF EUTHANASIA IN INDIA
In India, euthanasia is presently illegal, falling under Section 300 of the Indian Penal Code, 1860, which pertains to culpable homicide. Voluntary euthanasia, with the patient’s consent, may be considered under Exception 5 to Section 300. The right to die is not recognized as a legal right in India, and the Indian Medical Council Act, 1956, allows the Medical Council of India to prescribe standards for professional conduct and ethics.
The case of Aruna Ramchandra Shanbaug marked a significant development, allowing for the legalization of passive euthanasia in exceptional circumstances. The Law Commission has recommended the repeal of Section 309 of the Indian Penal Code, which criminalizes suicide attempts. However, the legal position remains complex, with ongoing debates and recommendations for legal reforms.
LAW COMMISSION OF INDIA AND ITS RECOMMENDATIONS.
In its 42nd Report, the Law Commission recommended the elimination of Section 309 from the Indian Penal Code. The Indian Penal Code (Amendment) Bill, 1978, which included the removal of Section 309, was approved by the Rajya Sabha. Unfortunately, the bill lapsed as it couldn’t be passed by the Lok Sabha due to its dissolution. Following the judgment in Gian Kaur v. State of Punjab, the Commission, in its 156th Report, suggested retaining Section 309. Subsequently, in its 210th Report, the Law Commission proposed considering attempted suicide more as a manifestation of mental illness deserving treatment and care rather than an offense warranting punishment.
In the case of Gian Kaur, the Supreme Court focused on the constitutionality of Section 309 but did not find cause to retain or uphold it in the statute. The Commission has resolved to urge the Government to take steps toward repealing the outdated law in Section 309, IPC, to alleviate the distress faced by individuals. The 196th Report of the Law Commission on Medical Treatment for Terminally Ill Patients (Protection of Patients and Medical Practitioners) is regarded as one of the most significant subjects ever addressed by the Law Commission of India in a comprehensive study. This report pertains to the legal aspects applicable to terminally ill patients, including those in a persistent vegetative state, who wish to undergo a natural death without resorting to modern life support measures such as artificial ventilation and artificial food supply.
SUGGESTIONS AND CONCLUSION.
In India, much like in other parts of the world, advancements in medical science are evident, with the availability of devices capable of artificially prolonging life. While this technological progress holds the potential to extend life, it inadvertently raises ethical concerns regarding the prolongation of terminal suffering, coupled with the considerable financial burden it may place on the families involved. Consequently, end-of-life considerations have emerged as significant ethical dilemmas within contemporary medical science in India.
Supporters and opponents of euthanasia and physician-assisted suicide (PAS) are actively engaged in debates in India, mirroring the global discourse on these issues. Despite this active discourse, the Indian legislative system appears less receptive to these matters. Although a landmark Supreme Court judgment has provided impetus to pro-euthanasia advocates, the journey towards enacting it into law within the parliamentary system is extensive. Furthermore, apprehensions regarding the potential misuse of euthanasia laws remain a major concern that needs to be addressed before formalizing such legislation in the country.
The ongoing debates between proponents and opponents of euthanasia and physician-assisted suicide (PAS) in India reflect the broader global discourse on these issues. However, the responsiveness of the Indian legislative framework to these debates appears somewhat limited. Although a landmark Supreme Court judgment has provided momentum to pro-euthanasia advocates, the transformation of this momentum into parliamentary law is a protracted process. Moreover, the persisting apprehensions about the potential misuse of euthanasia laws stand out as a significant concern that warrants thorough consideration before the enactment of such legislation in the country.
- https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/yonsei4 HYPERLINK “https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/yonsei4§ion=8” HYPERLINK
- Gian Kaur v. State of Punjab
- The Oregon Death and Dignity Act was passed in the Oregon general election in 1994.
- The Law Commission in its 42″ Report * recommended the repeal of section 309 of Indian Penal Code.
- In 1984, the Royal Dutch Medical Association stated that physicians performing euthanasia and assisted suicide would not be prosecuted if they met some requirements.
- Indian constitution article 21.
GURU NANAK DEV UNIVERSITY AMRITSAR.