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RSTV- The Big Picture : Passive Euthanasia: Death with Dignity

  • IASbaba
  • March 20, 2018
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The Big Picture- RSTV
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Passive Euthanasia: Death with Dignity

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In News: The Supreme Court has given legal sanction to passive euthanasia in a landmark verdict, permitting ‘living will’ by patients on withdrawing medical support, if they slip into irreversible coma.

  • The directions and guidelines laid down by it and its directive shall remain in force till a legislation is brought on the issue.
  • Though there were four separate opinions of the bench but all the judges were unanimous that the ‘living will’ should be permitted since a person cannot be allowed to continue suffering in a comatose state when he or she doesn’t wish to live.

Mar 7, 2011: SC, on a separate plea on behalf of Aruna Shanbaug, allowed passive euthanasia for the nurse lying in vegetative state at Mumbai’s KEM hospital. Shanbaug had spent 42 years in a vegetative state after she was raped by a wardboy on November 27, 1973.

The Petition

Filed by: NGO ‘Common Cause’

  • Approached the court seeking a direction for recognition of ‘living will’ and contended that when a medical expert said that a person afflicted with terminal disease had reached a point of no return, then she should be given the right to refuse being put on life support.
  • Right to life includes right to die with dignity. A person cannot be forced to live on support of ventilator. Keeping a patient alive by artificial means against his/her wishes is an assault on his/her body

Passive euthanasia

  • Passive euthanasia is a condition where there is withdrawal of medical treatment with the deliberate intention to hasten the death of a terminally-ill patient.
  • Active euthanasia, which involves administering a lethal injection to the patient, is still illegal.

Living Will:

Written document by way of which a patient can give his explicit instructions in advance about the medical treatment to be administered when he or she is terminally ill or no longer able to express informed consent.

When: When the patient is in complete command of himself/herself, with right cognitive abilities and not under any coercion

When to be executed: Person who is the subject of treatment should spell out the specifics and circumstances in which the living will should be executed

Decision, if patient is not in a position: Can be taken by an identified guardian or the next friend

Rules in place to make sure that it is not misused: Subsequently, the hospital needs to constitute a medical board with Head of Department and 3 experts from the respective field of care with 20+ years of experience. Doctors would be bound only by the choice of self-determination made by the patient who is terminally ill and undergoing a prolonged medical treatment or is surviving on life support, subject to being satisfied that the illness of the patient is incurable and there is no hope of his being cured. Opinion of the hospital goes to the Collector, who then constitutes a separate medical board.

Significance:

Reduction in Emotional, Financial and Care-giving Investment: Favourable to patients who will now be able to avoid needless medical interventions, saving a lot of money and agony for patients and their families, and prevent unnecessary treatments for the terminally ill.

Encourage Organ Donation: This practice can see a rise wherein one person will be capable of saving lives of 10 others – gifting ‘Right to Life’ to others.

Issue of public good: In the case of Aruna Shanbag, one hospital bed was reserved for her for 42 years, which could have been used by thousands of patients, all legitimately claiming the right to live. A hospital bed is meant for patients who have a reasonable chance for recovery. For the rest, there are palliative care homes, hospices and residences. No person should be allowed to use taxpayers’ funds on the one hand, and on the other deny hospital beds to more deserving patients

Implications:

Fault line named palliative care services: A substantial number of patients die of illnesses in this country either because they don’t get care in time or can’t afford treatment. Those with terminal illnesses suffer needlessly because of poor palliative care services, including lack of access to painkillers. Against this background, “terminal illness” and “withdrawal of care” acquire a different context. Since the state can’t assure a right to dignified life, it cannot curb the right to die.

Legislation & Judicial Activism or Overreach: Whenever there is a need of law, the State needs to become proactive. SC will come into the picture if the fundamental rights of the citizens get affected. This directs the State that it needs to keep up with time and respond to the urgency of situations.

Mindmap – For Quick Revision

Connecting the Dots:

  1. What are the moral dilemmas raised by ‘Euthanasia’? How does Hindu philosophy place atman, karma and dharma in the context of Euthanasia? Elaborate.
  2. What are your views on Passive Euthanasia? Provide a reasoned argument.

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