Watching loved ones decline in their old age can be heartbreaking – the once strong, independent, capable and loving people are reduced to mere shadows of their former selves. Watching a loved person deteriorate and linger without hope of recovery brings home the importance of being able to die with dignity. Speaking practically, the sort of drain this places on a family’s emotional and financial resources may be very significant too. The Indian Supreme Court’s enlightened and humane judgement on the matter of euthanasia and living wills would change at least some of this.
Often referred to as mercy killing, this is the practice of making a choice about ending life intentionally to relieve pain and suffering. In the UK it means “deliberate intervention” to end a life to “relieve intractable suffering”. In some European countries this is understood as the “termination of life by a doctor at the request of a patient”.
Also known as physician assisted suicide, euthanasia is of several types: active euthanasia where death is actively accelerated. Voluntary euthanasia is where a person asks for their own life to end. Non voluntary euthanasia is the ending of the life of a person who is unable to make a decision (such as when in a coma). Passive euthanasia is the withdrawal of life extending treatments or life support treatments to let a person pass away.
In a landmark judgement by the top court, a bench led by CJI Dipak Misra made certain pronouncements on living wills and passive euthanasia. Passive euthanasia, which is the withdrawal of medical treatment or life support to a terminally ill patient with the intention to hasten death, was allowed by way of an order of 7 March 2011 in the Aruna Shanbaug case. At the time, the concept of living will was rejected by the SC; now however by the order dated 9 March 2018, living wills are to be legal and enforceable in India.
The SC now speaks of honouring of a person's living will and has laid down procedures and guidelines for this. A living will is an advance health care directive made by a person about their own end of life medical care wishes. All the judges of the bench were unanimous in the view that a person in a comatose state should not have to continue suffering if they have no wish to live.
Medical professionals and others have welcomed the judgement which will permit people to refuse aggressive life prolonging treatments for terminally ill patients who would rather spend the time they have left, with loved ones. While the medical community’s efforts to prolong a person's life may be laudable, such efforts may only delay the inevitable, while causing immense suffering for the patient. It can also be financially draining and emotionally exhausting for all concerned.
An argument often used against legalising euthanasia is that there is the apprehension of misuse. However by differentiating between active and passive euthanasia and deciding to honour the living will of a patient, this apprehension is largely taken care of. Active euthanasia, which is the administering of a lethal injection or such assisted suicide is still illegal. It is the recognition of a persons’ right to live, but also to die with dignity that makes the latest SC judgement an enlightened one.
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