image by Zeyneeepl
The Supreme Court of India has ruled that it would be legal to withdraw life-support system to those in a permanently vegetative state. This ruling came in the judgement delivered by the court which turned down the petition seeking mercy killing of Aruna Shaunbagh, who has spent 37 years in a Mumbai hospital bed in a vegetative state.
While permitting the process, known as passive euthanasia, the court however held that active euthanasia, or actively ending a terminally ill person’s life by administering lethal injections or other means, would be illegal.
I find that a large majority of people have welcomed the judgement of the Supreme Court. I however disagree with the judgement – this is my season of disagreements with the court! In my opinion, the court has not only side-stepped the issue but has also dealt a body blow to the already suffering patients.
Passive Euthanasia Vs. Active Euthanasia
There are two types of euthanasia – active euthanasia and passive euthanasia.
In my opinion Passive Euthanasia is far worse than Active Euthanasia. If active euthanasia is murder, then passive euthanasia is the worst form of torture before murder.
Removing of life support systems is termed as passive euthanasia. Now what are life support systems? As per my understanding a life support system may supply air, water and / or food. A life support system may also help the patient deal with the body waste. So if a patient is not able to breathe on his own, he is put on a ventilator. Or if the patient can’t take in food or water on his own, then he is fed through tubes etc.
Removal of the life support systems will mean that you are authorising terminating the life of the patient by choking, starvation and or thirst.
In what way is this not murder?
Whom will the courts give more stringent punishment – a person who kills another by shooting him at point blank range in the head, or a person who tortures his victim and derives sadistic pleasure in his suffering which eventually results in the victim’s death?
Now one might argue that the patient in such a state is not feeling any pain and will not know when the end comes. If that be the case, then why euthanasia? If the patient is not suffering, then what is the good reason to ask for a “good killing?”
Another argument that I hear on Euthanasia is on the lines of “the quality of life” or “living with dignity.”
How do we define “quality of life” or “living with dignity”? And more importantly how can we decide if “another” person is living a dignified life. Whose benchmark are we going to use? Our or the patient’s? But patient’s benchmark we don’t know. So in effect we are imposing our benchmark on the patient.
We cannot eat, drink, and breathe on behalf of another person, however close he may be to us. So if we can’t do such basic things on behalf on another, how can we decide on behalf of another whether he should live or not?
It can also be argued that a person in a permanent vegetative state is “dependent” on others for most of his bodily and every day functions. And hence the person in such a state is not living with dignity. But so does a new born child.
A human child cannot do anything on his own and needs the constant attention of his parents for food, water and disposal of body waste. So does it mean that the child is not leading a life of dignity? Do we demand euthanasia for new born babies?
No, because the difference between an infant and a patient in vegetative state is the “higher hope” that one day the child will grow up to do things on his own. That the child will be able to “free us” of the caring that we need to give, and also that the child will “free us” of the financial investment that we have to make in bringing up.
In case of a patient in permanent vegetative state such hopes are non-existent. The demand therefore for euthanasia for such a patient is to save “ourselves” of the “emotional drain” and “financial loss”.
My take on euthanasia is simple:
- If a patient is in a vegetative state and cannot take decision on his own, then there should be NO euthanasia – passive or active. At least the state and the judiciary must not endorse passive euthanasia – though it frequently happens on the sly because of the financial reasons as mentioned above.
- If the patient is not in a vegetative state and is fully capable of deciding on his own, then in my opinion he has to decide what he has to do with his life. And that is a topic of another day’s discussion!
It is now your turn to express your views, agreements, disagreements…
I await your comments.
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Sanjeev I agree with you, no one has a right to decide on anyone’s death. Active or passive is a secondary issue. Every case is different in itself. However, SC coming out with such a decision might lead to misuse of its judgement especially in a country like India. Mytake on this…life is precious..and no one has the liberty to play with it…
Absolutely right Rachna. The court is also aware of the possible misuse permission for passive euthanasia.
On passive euthanasia, the court said: “In our opinion, in the case of an incompetent person who is unable to take a decision whether to withdraw life support or not, it is the court alone, as parents patriae (father of the country), which ultimately must take this decision, though, no doubt, the views of the near relatives, next friend and doctors must be given due weight.”
The bench said that the issue of mercy killing for such patients cannot be left solely in the hands of patient’s relatives or doctors treating them as such a provision will be prone to misuse by those who want to appropriate an ill person’s property.
“Considering the low ethical levels prevailing in our society today and the rampant commercialisation and corruption, we 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,” the court added. So, the apex court ordered for the mandatory judicial approval in the cases of passive euthanasia.
It asked the high courts to decide such cases expeditiously in the prescribed manner. When such issue comes before it, the Chief Justice of the High Court should constitute a bench of at least two judges who should decide to grant approval or not.
I truly agree with you Sanjeev. As the matter is highest level of sensitivity and also varies with case to case. the decision to take should also vary. I am not sure of how many such cases are there but it would be great if each case is carefully scrutinized and correct decision is taken.
I personally think that no one, including the courts should be allowed to decide if a person can be administered euthanasia. Courts are for disputes between two parties – in case of a person who is in a permanent vegetative state, the “dispute” does not exist between two parties because one of the parties is incapable of any dispute -so how can even the courts decide something which directly involves such a person?
Hi Sanjeev,
Wow, what a subject matter I happen to visit for the first time on your blog.
I don’t know, this topic kind of ranks up there with religion and politics for me. Two subjects I prefer not discussing because I firmly believe what I believe. I know that people are entitled to their opinions, but I prefer not being involved in a debate over them.
The only thing I will share is that toward the end of my father’s life, we knew he would never regain consciousness. He was not on life support but he was on a feeding tube. He had a living will and the entire family knew how strongly he felt about wanting to have quality of life instead of quantity. After getting the devastating results from his doctor’s that he would never be able to function fully on his own any longer, we respected his wishes and put him in hospice care. The way that works is they are made comfortable but that’s it. A person can go for a long time without food but they can’t go for a long time without water. So basically, my father died from dehydration. He was given pain medication so that he didn’t suffer, but again, these were his requests so I don’t look at this along the lines of murder. That’s why everyone should have a living will so it’s their choice whether they want to be kept alive or not. It shouldn’t be up to the court or anyone else for that matter.
So that’s my input on this subject but I can appreciate what you are saying. I pray I never am put in that position but I have had a living will for 10 years now. My family is aware of how I feel about quality of life verses quantity as well!
Thanks Sanjeev for this very compelling post.
Adrienne
Adrienne, first I am really sorry to read about your dad. I can understand your thoughts about the issue as well.
In your dad’s case he had a living will and he had decided how he wanted to be treated in the unfortunate event of being so unwell as to have no reasonable chance of recovery. The key difference here is that he had decided about how he wanted to live his life. Not anyone else and no court.
That is exactly how I feel. In the article towards the end I have mentioned that “If the patient is not in a vegetative state and is fully capable of deciding on his own, then in my opinion he has to decide what he has to do with his life.”
The problem arises when there is no such guideline given by people when they are well and conscious about what course of treatment should be adopted when they are in no position to take decisions about it. Do we let courts decide? Or the family? Society? And more importantly on what criteria?
I am very happy to see you here and hope to see you again and often.
Hi Sanjeev,
I know it’s a tricky topic but I also mentioned that I don’t believe it should be up to the courts to decide about a person’s life. I truly believe that your family would have your best interests at heart, although I know not all families do. I can only speak from my experience and I know that my family would always do what is best for me and also go with what I have made clear in my living will as well.
You are right though, very debatable topic indeed. I can only speak from my own experience regarding this which is why I always tell ALL of my friend, no matter what their age, to get a will in place. This is YOUR life we are talking about and it’s not guaranteed.
Thanks for the reply and for you visiting my blog as well. Enjoy meeting you. Best of luck.
Adrienne
I agree Adrienne. I think if people were to have a living will the moral issues will not be so complicated since living will is a legal document that a person uses to make known his or her wishes regarding life prolonging medical treatments. It can also be referred to as an advance directive, health care directive, or a physician’s directive. It is important to have a living will as it informs your health care providers and your family about your desires for medical treatment in the event you are not able to speak for yourself.
The reason why I have mentioned this here is that in India I do not think there is yet a concept of living will – at least I have not come across it. And even in the western countries I do not know to what extent people actually make a medical directive while they are able.
I would also like to thank you for tweeting this article.,