INTRODUCTION
Death is an intriguing and inevitable thing. But the right to choose when and how you die has never been a decision that befalls upon man. Death, with its intricacies, complications, and consequences, bears significant importance not only in psychology but also in the legal field.
The stipulations and beliefs about death are manifold. Then comes another intricacy about dying voluntarily. Suicide has always been considered a cultural taboo, yet recently in the Western world, the idea of physicians suggesting Euthanasia as an acceptable alternative has been legitimized further with growing activism about individual’s right to choose. Parties from either side of the argument centred upon euthanasia’s validity have a myriad of both pragmatic and moral reasons. Notwithstanding the biases, this article aims to provide an equipoised view of the issue at hand.
What is Euthanasia? By definition, euthanasia is the practice of ending the life of a being, mostly a human, to limit their suffering. The being is typically terminally diseased or marred with excessive suffering and pain. There are several different types of euthanasia and their demarcations may sometimes appear slim but are indispensable:
Active euthanasia: killing a patient by active means, for example, injecting a patient with a lethal dose of a drug.
Passive euthanasia: intentionally letting a patient die by withholding artificial life support such as a ventilator or feeding tube.
Voluntary euthanasia: with the consent of the patient.
Involuntary euthanasia: without the consent of the patient.
Concurrently, only certain forms of passive euthanasia are legalised while active euthanasia remains unlawful. The three main clauses for performing euthanasia on human patients are: Their consent through a living will; and Their condition as either terminally ill or in a vegetative state.
SIGNIFICANCE
Since it pertains to both voluntary death and mercy killing, the topic of euthanasia and the right to die with dignity bears immense significance on multiple grounds. Several religions like Jainism and Hinduism have practices on the theme of ‘voluntary death’. The two chief practices being sallekhana and prayopavesa involve a person fasting till death. Though some argued that these practices should be protected under Right to Freedom of Religion’s Article 25(1). Notwithstanding the arguments, the Supreme Court ruled that these practices are not common and an essential element of either religion, and these fatal fasting rituals have been outlawed.
The Moral Question: Moralists claim varying interests on either side of the argument. Some believe that letting a person suffer with a terminal or incurable ailment is unnecessarily cruel to a patient. ‘Mercy killing’ is a euphemism used by such a cohort. Others think that death is not a thing to be given at a person’s behest but actually an act of God. Either way, the question of euthanasia’s legitimacy entails a wider discussion upon morality and human ethics. This includes the topic of abortion rights. The vast majority of the populace believes that withdrawing life support (passive euthanasia) is a much more righteous and humane way to ease one’s suffering than purposefully injecting lethal substances (active euthanasia). Another caveat comes with one being in a vegetative or a comatose state where the suffering cannot take a decision independently.
Mental Repercussions: The person performing euthanasia and the loved ones of the patient both have severe mental consequences of such a procedure. The patient may have left this earth but will leave their loved ones distraught. Although in most cases, the patient was fated to die anyway, the fact that the immediate cause of death was their own doing causes much mental agony to both the family and the euthanizing physician.
Aruna Shanbaug vs Union of India, 2011
The most notable case regarding euthanasia in India has been Aruna Shanbaug vs Union of India (2011). Aruna Ramchandra Shanbaug was a nurse working at the King Edwards Memorial Hospital, Mumbai when she was sexually assaulted by a sweeper on 27th November 1973. The attack, during which Aruna was even strangled by a chain, left her in a vegetative state that lasted for over 41 years until her death in 2015. Aruna had been kept alive with the help of a feeding tube. Pinki Virani, a social activist, lodged a plea in the Supreme Court arguing that Shanbaug's continuous existence constituted a "violation of her right to live in dignity". The Supreme Court denied the plea to remove Shanbaug's life support on March 7, 2011. The hospital team that cares for Aruna did not support euthanizing her, which was the basis for the Supreme Court's decision to reject the termination of her life support.
Common Cause vs Union of India, 2018
On February 25, 2014, while hearing a PIL filed by NGO Common Cause, a three-judge bench of the Supreme Court of India stated that the decision in the Aruna Shanbaug case was based on an incorrect interpretation of the constitution bench decision in Gian Kaur v. State of Punjab, which dealt with abetment in suicide. They concluded that the verdicts and decisions in each case were inconsistent, and following this, the case was forwarded to a bench of five judges. The Supreme Court's five-judge bench was tasked with assessing whether Article 21 of the Constitution contains in its ambit the right to die with dignity by executing a living will/advance directive.
In 2018, the five-judge panel ruled that "living wills" or advance medical directives permitting consenting individuals to be quietly terminated if they have a terminal illness or are in a vegetative state are legal. Before passive euthanasia became feasible in India, there was the option of signing a leaving against medical advice (LAMA) agreement, which transferred all responsibility for the withdrawal of live therapies from the physician to the patient.
In January 2023, the Supreme Court modified its guidelines in the Common Cause judgement, streamlining the process of preparing a valid advance medical directive.
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