Anjana
The legality of mercy killing or euthanasia and its ethical and moral sides have been hotly discussed and debated in the Indian media and society for the last week or so.
Mercy killing is defined as the killing of one person by another. The victim of mercy killing is normally in the vegetable state or has an injury or illness that cannot be cured, as it is usually in its last stage. The victim experiences immensely painful last days just before his or her death.
For a voluntary case of mercy killing to take place, the killer must first obtain the consent of the victim, but there have been recorded cases of mercy killing against the wishes of the victim as well. This is known as involuntary mercy killing. The victim of a mercy killing dies a painless death after suffering an incurable ailment or serious injury. The term euthanasia, which means mercy killing, is derived from the Greek word for ‘good death’. Euthanasia has been legalised in some Western countries but is still considered to be an unethical practice in the Third World.
Also known as assisted suicide and mercy death, euthanasia is the intentional killing by act or omission of a dependent human being for his or her alleged benefit.
It is illegal in India and most countries of the world. Only ten odd countries have legalised the practice of mercy killing. Some social activists claim that euthanasia and assisted suicide are government mandated suffering for the terminally ill persons.
The DoctorNDTV.com survey on this issue has shown a mixed response. More than half the respondents feel that the decision should not be left to the doctors or the next of kin, while one third support the doctors / relatives right to take this decision. Two-thirds agree that euthanasia is the same as mercy killing . Though 71 per cent people feel that legal advice is necessary before taking a decision, most people (>88 per cent) feel that it may be misused in India.
The following are the pros and cons for allowing euthanasia.
Pros:
- It provides a way to relieve extreme pain
- It provides a way of relief when a person’s quality of life is low
- Frees up medical funds to help other people
- It is another case of freedom of choice
Cons:
- Euthanasia devalues human life
- Euthanasia can become a means of health care cost containment
- Physicians and other medical care people will get involved in directly causing death
- There is a ‘slippery slope’ effect that will occur.
- Stances, views and opinions on euthanasia vary greatly; it is called murderous by some and merciful by others. Such controversy arises generally from the serious social, cultural and moral issues attached to the subject.
A Matter of Life and Death – March 7th 2011
Bringing the issue into the limelight has been the case of Aruna Shanbaug, who has been in a vegetative state of 37 years. A nurse at Mumbai’s KEM hospital in 1973, she was sexually assaulted while working and the incident left her in a vegetative state, relying on life support systems since the incident.
On Monday the 7th of March 2011, the Indian Supreme Court ruled that passive euthanasia was legal in India and could be practiced in special circumstances, but struck down any hopes of active euthanasia in the country. The Supreme Court was responding to an appeal filed by a friend of Shanbaug. The Supreme Court stated that the plea from the friend was not a valid reason enough to grant euthanasia to the ex-nurse. The apex court also stated that if the hospital taking care of Shanbaug had filed a similar appeal, it would carry more weight and authenticity than the one currently filed. One of the reasons given by the court in rejecting the appeal was that the hospital and the nurses taking care of Aruna Shanbaug were opposed to euthanasia of the patient.
India has given the green light for passive euthanasia, a decision seen as welcome and progressive move by many doctors across the country. Passive euthanasia is administering euthanasia by removing the life support extended to a patient in vegetative condition. This is in contrast to active euthanasia, where an active chemical or agent is injected or delivered into the body of a patient in vegetative condition. The apex court observed that the country might not be ready for such radical and drastic ruling. The court stated that the only way active euthanasia could be legalised is if the Indian Parliament passed a law to that effect.
A Bench of Justices Markandey Katju and Gyan Sudha Misra, however, did not accept the plea of Pinky Viranai seeking permission to withdraw life support to her friend. Writing the judgment, Justice Katju said that there was no statutory provision in our country as to the legal procedure for withdrawing life support to a person in PVS or who is otherwise incompetent to take a decision. He agreed that passive euthanasia should be permitted in our country in certain situations.
The Bench pointed out that in the absence of a law against sexual harassment at work places, the Supreme Court in the Visakha case had laid down guidelines. Similarly he claimed that he was now laying down the law in this connection which will continue to be the law until Parliament makes a law on the subject. According to him, a decision has to be taken to discontinue life support [to a patient in PVS] either by the parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend. It can also be taken by the doctors attending the patient. However, the decision should be taken bona fide in the best interest of the patient.
The Bench believes that if they leave it solely to the patient’s relatives or to the doctors or the next friend to decide whether to withdraw life support to an incompetent person, there is always a risk in our country that this may be misused by some unscrupulous persons who wish to inherit or otherwise grab the property of the patient. Considering the low ethical levels prevailing in our society today and the rampant commercialisation and corruption, they cannot rule out the possibility that unscrupulous persons with the help of some unscrupulous doctors may fabricate material to show that it is a terminal case with no chance of recovery.”
In the present case, the Bench declared that Aruna Shanbaug’s parents are dead and other close relatives had not been interested in her ever since she had the unfortunate assault on her. It is the KEM Hospital staff, who has been amazingly caring for her day and night for so many long years, who really are her next friends, and not Ms. Pinky Virani, who has only visited her on a few occasions and written a book on her. Hence it is for the KEM Hospital staff to take that decision. The KEM hospital staff has clearly expressed their wish that Aruna Shanbaug should be allowed to live.
The nurses and doctors at the hospital were jubilant over the Supreme Court ruling. A few nurses at the hospital remarked to the media that the ruling was the best women’s day gift the top court could have given them. The nurses even went on to question the authenticity of Ms. Pinky Virani, Shanbaug’s friend who appealed to the Supreme Court to grant euthanasia. The nurses at KEM hospital claimed that Shanbaug was like family to them. They claimed that Shanbaug was not completely vegetative and that she responded to touch and food. Nurses were of the opinion that Ms. Virani, who had not taken care of Shanbaug through the 37 years of being comatose had no right to ask for the withdrawal of life support systems.
“India is not mature enough to handle euthanasia,” senior Bangalore-based cardiologist Devi Prasad Shetty said while expressing his happiness over the verdict on a mercy killing plea on behalf of 60-year-old Aruna Shanbaug. Dr. Shetty’s view was shared by Chief Cardiologist of Bombay Hospital B.K. Goyal, who said euthanasia is an emotional issue which can be “misused.”
There was joy among Aruna’s former colleagues and nurses in local KEM hospital who have been tending to her. Nurses distributed sweets at the hospital after the Supreme Court ruling.
While comparing euthanasia with MTP, senior doctor Goyal said that in such a case they should ensure the safety of people at large because when in India, MTP is allowed, it was misused right and left. In the same way, he feels euthanasia can be misused too.
Dr. Shetty said that financial constraints and inability to look after cannot be the reason to ask someone to terminate life. This is unacceptable.
He believes that this country is not mature enough to handle this major legal issue. It is not possible.
March 9th 2011
No parent would like to see their children killed, even if disabled, but watching the nightmarish existence of their physically challenged sons has prompted a couple from Bihar to seek euthanasia from them. Mukesh Kumar, a marginal farmer from Ratwada village of Muzaffarpur district filed a mercy death plea for his sons, Nitin, 15, and Anshu, 13, both living with muscular dystrophy (MD), a terminal and degenerative condition that has crippled the two brothers.
Muscular dystrophy is not just a disability, but a genetic and inherited disorder that gradually deteriorates killing muscle cells and tissues until the patient finally dies.
According to the parents, the boys were born healthy and were like normal children till age two when they got the muscular disorder. The boys cannot talk or stand on their feet and are completely dependent on their parents. They are also paralysed below their chests and are unable to move or eat without assistance.
Although, MD has no cure, some treatments are available in US. However, these are expensive, something to the tune of over Rs. 30 lakhs which are far beyond the poor farmer means.
The financial resources of the couple have been exhausted completely. They have sold off their few valuables and ancestral land to meet the expenses for their sons’ medical treatment.
Mukesh stated that they have been pleading for their mercy killing because we cannot continue costly medical treatment, which anyway will not cure them, only prolong their unhappy lives. He believes that the state government should either grant permission or provide us help for treatment.
Watching the discomfort, torturous pain, indignity and utter helplessness of the two sons virtually turn into vegetables over the last 10 years is distressing for the parents.
With doctors giving up hope, the parents feel death is the only solution that can put an end to the tyranny of their fate.
The dignity of life and the right to live without pain and discomfort are the major issues in the limelight. If active euthanasia is implemented in India, there is a considerable chance that it could be misused, especially in areas that are rural and withdrawn from the mainstream. The Supreme Court seems to have made a sensible decision on the issue. May be, India will have to wait a few more years until the nation is ready for legal active euthanasia.
Dream Dare Win
www.jeywin.com
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