Euthanasia and Its Category
The term Euthanasia finds its origin in the Greek word “euthanatos” translates to “easy death” in which “eu” means “easy” and “thanatos” means “death”. As per the Black Law Dictionary, euthanasia is defined as “the act of killing a person or causing the death of a person who is in a permanent vegetative state or who is suffering from an incurable disease”.
Euthanasia is categorized into active euthanasia and passive euthanasia based on practice:
Active Euthanasia -It is also referred to as “aggressive euthanasia”. It involves the use of lethal medication, such as a fatal injection, to end a patient’s life. This type of euthanasia involves a commissioning act. For instance, administering sodium pentothal which results in a profound slumber followed by instantaneous death.
Passive Euthanasia – In passive euthanasia, a terminally ill patient is intended to die by the withdrawal of life-prolonging care. For instance, if a terminally ill patient intends to die, one could purposefully refuse to provide kidney dialysis if that patient needs it to survive.
In addition to the above categories, euthanasia is further classified into three major categories based on who makes the decision:
1. Voluntary Euthanasia – When a patient is suffering with intolerable pain due to his terminal condition which is medically recognized and he makes a conscious choice to end his own life, it is known as “voluntary euthanasia”.
2. Non-Voluntary Euthanasia – Non Voluntary Euthanasia is a subcategory of “voluntary euthanasia. When a terminally ill patient is not in a condition to express his preference and he has to depend on someone else to make a proxy plea to end their life, it is known as Non-Voluntary Euthanasia.
3. Involuntary Euthanasia – When a terminally ill patient suffers from unbearable pain for a prolonged time, and there is no clear choice has been made by the patient directly or indirectly. For instance, the patient might be in a coma or protracted sleep and there is a lack of consent due to the patient’s inability.
Article 21 and Right to Die
There has been much discussion on a patient’s right to end his own life if he is terminally ill and already dying. Under such circumstances, death is inevitable and close at hand. Permitting the ending of life would just shorten the duration of pain because the process of natural death has already begun and life is already diminishing.
In “physician-assisted suicide,” the patient delivers the pills with guidance from a physician, whereas in euthanasia, the drug is administered by a doctor or another third party. The only way to legitimize active euthanasia is through law; it is not covered by Article 21. Active euthanasia is illegal while Passive euthanasia is covered under Article 21 of the Indian Constitution. Due to the inherent nature of Article 21 which provides the right to a dignified death, the courts have the authority to rule on this matter. A decision as parens patriae may only be made by the court. In the case of P. Rathinam vs. Union of India (1994) 3 SCC 394, the Supreme Court declared that Article 21 encompasses the “right to not live a forced life”. Similarly, in the case of Gian Kaur vs. State of Punjab (1996) 2 SCC 648, it was clarified that the right to die is included in the right to life but that it does not justify someone dying intentionally by unnatural means.
Landmark Judgments
Aruna Ramchandra Shanbaugh vs. Union of India (2011) 4 SCC 454
In 2011, the Supreme Court of India rendered this significant decision, which greatly accelerated the legalisation of passive euthanasia in India. Aruna Shanbaug, the petitioner in this case, suffered a severe assault at the hands of a sweeper at the hospital where she worked as a nurse, leaving her in a vegetative condition for 36 years. Ms Pinki Virani, a journalist, submitted the petition, pleading with the court to grant her the right to die under Article 21 of the Indian Constitution since she was terminally ill and wanted to pass away peacefully and with dignity.
As per the Transplantation of Human Organs Act, 1994, and the medical report provided, the court concluded that Aruna was not brain dead. She was also capable of producing the required stimuli, feeling, and breathing without the need for a machine. Hence, it was not justified to end her life. The hospital personnel, not Pinki Virani, had the authority to make decisions on behalf of Aruna. Since she was only surviving on mashed food, leaving her on a ventilator would not be legal in India. Therefore, allowing her to be put to sleep would mean stopping her food supply. Consequently, the court denied the petition.
The court conducted a thorough investigation into passive euthanasia and established rules that must be adhered to until legislation on the practice is passed by the parliament. The supreme authority over the topic was also granted to the high courts to prevent any potential bad intentions behind ending the life of a particular person. The prescribed process began with the petitioner making an application, upon which the Chief Justice of the relevant High Court was required to take action and appoint a bench consisting of a minimum of two judges, who would then be in charge of giving the euthanasia order. In addition, the bench ought to consult with a committee consisting of three physicians, who will be nominated after contacting the relevant physicians and medical professionals. Following the committee’s appointment, the bench is required to provide notice to the State, the patient’s parents, spouse, siblings, and, in their absence, a friend. The Supreme Court will render the ultimate decision following the conclusion of this procedure.
The medical committee’s report on Aruna’s case stated that she was not brain-dead and would respond to stimuli in her unique way. Based on this information and the personnel of the Hospital’s commitment to care for her, the committee concluded that the euthanasia of Aruna is not necessary. The Supreme Court instituted this approach to ensure that the euthanasia process is free from the wills or any ulterior motivations of the petitioner’s family members.
Common Cause vs. Union of India (2018) 5 SCC 1
In this case, the Supreme Court rendered a historic decision, recognizing passive euthanasia as a lawful practice and allowing the execution of advanced medical directives or living wills. This case goes by several titles, including “euthanasia case,” “living will case,” and “passive euthanasia case.” A “living will” is a written declaration made by a patient who is competent and of sound mind, understanding the implications of their actions. A patient must voluntarily make it, free from coercion or force.
In this ruling, the Court found that it is harsh to make someone endure such a terrible condition, and that person ought to have the freedom to determine whether or not they receive medical care. India has taken a legal stance in this debate over euthanasia. It was decided that a person has the right to live with dignity till the end of his life and that this right is included in Article 21. The process involved when a patient wishes to carry out a living will is outlined by the Apex Court’s instructions, which must be adhered to while administering euthanasia. They offered an analysis of the ongoing discussion surrounding the “right to life,” which includes the “right to die.”
The ruling supports a dignified end to human life and is constitutionally lawful. When a person is subjected to passive euthanasia, their death is unavoidable; therefore, if life-sustaining equipment is used to keep them alive, it will only make their death more drawn out.
Conclusion
The concept of euthanasia comes from the desire for a dignified death. The distinction between active euthanasia and passive euthanasia reflects the intricate nuances of choice and highlights the ethical obligation to relieve the suffering of a patient suffering from a terminal illness. Cases like Aruna Ramchandra Shanbaugh vs. Union of India (2011) 4 SCC 454 and Common Cause vs. Union of India (2018) 5 SCC 1, have given legal recognition to passive euthanasia in India. The significance of the right to make informed choices about their own lives encompasses the right to die with dignity. The guidelines and procedures have been instituted for passive euthanasia. In addition to this, it aims to prevent the misuse of these procedures while considering the autonomy of the patient.
The developing discourse provides hope and empowers the patients and families to make choices. To conclude, it is a significant issue ensuring compassionate care during end-of-life.
