The term euthanasia comes from the Greek word ‘euthanatos’ meaning good death. It is an act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition. It is also known as ‘mercy killing’ which is an act where the individual who has no chance of survival as he is suffering from painful life, ends his life in a painless manner. It is a gentle, easy and painless death. It is basically to bring about the death of a terminally ill patient or a disabled. Euthanasia is thus practiced so that a person can live as well as die with dignity. There are two types of euthanasia namely, active euthanasia and passive euthanasia. Active euthanasia or positive euthanasia refers to causing intentional death of a human being by direct intervention. It is a direct action performed to end useless life and a meaningless existence, e.g., by giving lethal dose of a drug or by giving a lethal injection. On the other hand, passive euthanasia or negative euthanasia is intentionally causing death by not providing essential, necessary and ordinary care or food and water. It implies discontinuing, withdrawing or removing artificial life support system. Passive euthanasia is usually slower and more uncomfortable than active.
Before moving further, it is important to note that there is a difference between Suicide’ and ‘Euthanasia. In a suicide, a man voluntarily kills himself by stabbing, poisoning or by any other means. It is an act of intentionally killing oneself due to depression or other reasons. On the other hand, euthanasia is an action of a person to bring to an end the life of another person. Another difference to be studied is between ‘assisted suicide’ ‘euthanasia’. Assisted suicide is an act which intentionally helps another to commit suicide, e.g., by providing the means to do so. When it is a doctor who helps a patient kill himself by providing a prescription for lethal medication, it is a physician assisted suicide.
On the other hand, euthanasia may be active such as when a doctor gives a lethal injection to a patient or passive when a doctor removes life support system of the patient. Now, the matter of concern is the legalisation of euthanasia. In countries like Belgium, the Netherlands and Switzerland, active euthanasia is legal. Passive euthanasia is allowed in the UK, the USA and Canada.
In India, the question of legalising euthanasia came during the case of state of Maharashtra v/s Maruti Shripathi Desai. After the decision of Supreme Court in 2011 in Aruna Shanbaug case, a nurse who was in a vegetative state for 37 years as a result of sexual assault, India allowed passive euthanasia in exceptional cases on 7th march, 2011 after a review by medical experts, while ‘active euthanasia is not allowed. Aruna’s condition forced the court to consider passive euthanasia. This landmark decision legalised passive euthanasia, giving thousands of patients living in a persistent vegetative state all over the country, the right to have artificial life-support system withdrawn so as to enable them to end a life of misery. The court held that there is no right to die under Article 21 of the Constitution but causing the death of a person who is in a permanent persistent vegetative state, with no chance of recovery, by withdrawing artificial life support is not a ‘positive act of killing’. Terming this ‘passive euthanasia’, a bench of justices Markandey Katju and Gyan Sudha Mishra held that this could be permitted on a case-by-case basis.
The court also laid down guidelines for passive euthanasia such as that the matter must be referred to the High Court for a decision and that the doctor or the parents or the parents or spouse of the patient must be one of the petitioner for the withdrawal of life support system. A special two-judge bench will be formed in every High Court to decide applications seeking permission for euthanasia. A committee of three reputed doctors from a panel constituted by the High Court in consultation with the State Government will examine the patient and submit its report to the High Court bench. Notices will be issued to all those concerned with the doctor’s report attached. After hearing everyone, the bench will give its verdict. The matter must be dealt with speedily as delays prolong the agony of the patient.
But in a historic decision (2018), the Supreme Court declared passive euthanasia and the right of persons, including the terminally ill, to give advance directives to refuse medical treatment permissible. The Supreme Court in its judgement upheld that the Fundamental Right to a “meaningful existence” includes a person’s choice to die without suffering.
It is in consonance with the Article 21 of the Constitution which provides for living with dignity and if that standard is falling below that minimum level then a person should be given a right to end his life. It not only relieves the unbearable pain of a patient but also relieves the relatives of a patient from the mental agony. It provides a way to relieve the intolerably extreme pain and suffering of an individual. On the other hand, many people are against legalising euthanasia. They believe that the human life is a gift of God and taking life is wrong and immoral. Human beings cannot be given the right to play the part of God. Acceptance of euthanasia as an option could exercise a detrimental effect on societal attitudes and on the doctor-patient relationship. Miracles do happen when it is a matter of life and death; there are examples of patients coming out of coma after years. It is feared that if euthanasia is legalised then other groups of more vulnerable people will be at risk of feeling like taking that option themselves.
To conclude we may say that it has now been realised that this method to end unbearable pain and suffering of a being is no crime but it sometimes may lead to a crime if not monitored properly. As far as possible, efforts should be made to reduce the pain and suffering by means of treatment i.e., both physical and mental. Euthanasia has to be resorted to only when all the other options have been exhausted.
The decision should be a collective one, based on the consent of doctors and the patient’s closest relatives. After all, the right to live would not be complete if the right to die with full dignity is not available to an individual.