Legalising Euthnasia in India

Modern medical science has attained great heights in its quest to find a cure for diseases. But as the Chinese proverb goes, “Medicine can only cure curable diseases, and then not always!” In spite of these advances, there are times when a disease becomes incurable. The quality of life of a person deteriorates to the extent that death alone appears to be the best doctor, capable of relieving the suffering.

The late Aruna Shanbaug, a nurse at the King Edward Memorial Hospital, went through something similar following a sexual assault by a ward boy in November 1973. 

It left her largely brain-dead, cortically blind and unable to walk or speak, eat or evacuate. She stayed in a vegetative state for more than three and a half decades – a pain shadow of someone who was once known as Aruna Shanbaug.

On 24th January 2011, the Supreme Court of India responded to the plea for euthanasia filed by Aruna's friend journalist-activist Pinki Virani, by setting up a medical panel to examine her. The court turned down the mercy killing petition on 7th March 2011. However in its landmark judgement – the law ironically is named after Aruna – it permitted passive euthanasia in India which “places the power of choice in the hands of the individual over government, religious and medical control… and allows him / her to die with dignity.”

Following the rejection by the Supreme Court of Virani’s plea, her colleagues, the nursing staff at the hospital, who had opposed the petition, and who had been her caregivers since she had lapsed into coma, distributed sweets and cut a cake to celebrate what they termed as her "rebirth". A senior nurse at the hospital later said, "We have to tend to her just like a small child at home. She only keeps aging like any of us, does not create any problems for us. We take turns looking after her and we love to care for her. How can anybody think of taking her life?”

Paradoxically, we, the living, define death. If only the likes of Aruna had a say, the definitions would be stranger than fiction.

At this point, though, it is pertinent to define euthanasia and go over what it means to the common man. Euthanasia, literally, means the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma. The origin of the word is from the Greek words for “easy death”, namely eu = well + thanatos = death. Thus, euthanasia – also called ‘mercy killing’ – may be described as the act or practice of painlessly putting to death those suffering from a painful and incurable disease or incapacitating physical disorder.

Euthanasia and Physician Assisted Suicide (PAS) have been legalised in certain countries and states, with clear cut conditions. In November, 1994, the State of Oregon in the USA passed the Death with Dignity Act. This act allows qualified terminally-ill patients with a life expectancy of less than six months to request medication to end their lives. It did not permit euthanasia. With that, Oregon became the first place in the world to legalise PAS. In the same year, the Dutch Supreme Court ruled that in exceptional cases, PAS might be justified for patients with no physical illness but intolerable mental suffering. The Northern territory of Australia legalised active euthanasia under careful controls in June 1995. The Australian Senate disapproved the law two years later. Netherlands enacted a law in April 2001 to allow euthanasia and assisted suicide in patients suffering unbearably with no hope of relief.

Clearly, it is a tough call to take away something that human beings, in a sense, cannot give – life. But hopefully we are moving towards more nuanced expressions such as making a distinction between the right to die and euthanasia; and life which must be necessarily underpinned by freedom.

The right to take away life – one’s own or of someone else – has its legal and other repercussions. But Indian thought takes a gentler view on death – and doesn’t pitch it as an antithesis of life. Indian law, however, albeit understandably, has been mostly uncertain in the matter of euthanasia.

Euthanasia and Indian Law

The intent to kill qualifies euthanasia as a crime under the Indian Penal Code, 1860. A physician who practices euthanasia can be charged under Section 299 or Section 304A, IPC depending on the method used. All people, including relatives who participate or are aware of such intent on the part of the physician may be charged under Sections 107 and 202 of the IPC. In cases where the entire process is undertaken at their behest, relatives may be charged under Sections 299 or 304 as well.

The question whether euthanasia should be legalised in India can be argued on the following grounds:

1. Euthanasia conforms to the biomedical ethical concept of autonomy.

2. Since it represents the wishes of a competent person, it should be respected.

3. Where the State guarantees personal freedom of choice in principle, it cannot refute it in certain issues like on the question of voluntary euthanasia.

4. Euthanasia is an act of compassion. Hence, it is called “mercy killing”.

5. Like abortion, its ultimate aim is beneficial.

6. Non- voluntary euthanasia, as for example, in the case of severely disabled newborn infants is justified.

7. In voluntary euthanasia the State should not interfere with the free, informed choices of its citizens in matters that do not harm others.

8. Euthanasia relieves a person from a life that has become unbearable. It can relieve the terminally ill from lingering death.

9.  Euthanasia is letting die - it is not killing. The motive is to help and not harm. Hence, it is distinct from murder.

Legalising euthanasia simply means granting an individual his natural right to die or terminate his life owing to non-normalcy or bad quality of life due to medical reasons. While attempt to suicide under mental coercion is punishable under law, asking for death to be given due to continual suffering of an individual is not punishable. In most cases of an individual suffering from Persistent Vegetative State (PVS), courts grants physician-assisted suicide with a standing consent from the patient if he has expressed his willingness to die and is not externally influenced in his decision to do so. This willingness should stem from the grounds that there is no hope in the improvement of the quality of life.

Euthanasia is a way of ending a person’s life who has been suffering from excruciating, permanent pain and indignity in what is a hopeless life. Various countries have legalised it. The debate on euthanasia has been on since long. After the landmark judgement given by the Indian Supreme Court in Aruna’s case, passive euthanasia has now been allowed in India with conditions set out in the judgement. The ambiguity with regard to euthanasia, however, remains.

Medical science has outwitted death inasmuch as it has found partial or complete cures for many malignancies that blight human beings. But there are times when the remedy is worse than the illness, where death is the only arbiter. An urgent need to legislate on euthanasia is the need of the hour.

Advocate Mansi Bajaj