EUTHANASIA

TAG: GS-2: POLITY & SOCIAL JUSTICE

THE CONTEXT: The Ministry of Health and Family Welfare (MHFW) recently issued draft guidelines for the withdrawal of life support in terminally ill patients, aligning with the Supreme Court’s 2018 and 2023 rulings on the right to die with dignity.

EXPLANATION:

About the Euthanasia:

• • Euthanasia is defined as the hastening of death of a patient to prevent further sufferings.
  • This involves a physician directly administering a lethal substance to end a patient’s life. Euthanasia can be voluntary, or involuntary, if the patient cannot consent, such as in a coma.
  • As Mahatma Gandhi said, “The highest moral duty is to alleviate suffering.” Striking a balance between ethical concerns and individual rights is crucial to maintaining dignity in end-of-life care.

Types of Euthanasia:

Legal Status of Passive Euthanasia in India:

The legal landscape of euthanasia in India has evolved significantly over the past few decades.

• • Gian Kaur v. State of Punjab (1996): The Supreme Court of India held that the right to life under Article 21 of the Constitution does not include the right to die, distinguishing between euthanasia and suicide.
  • Aruna Shanbaug v. Union of India (2011): This landmark case permitted passive euthanasia for the first time in India. The Supreme Court allowed the withdrawal of life support for Aruna Shanbaug, a nurse who had been in a persistent vegetative state for decades. The Court laid down detailed guidelines for passive euthanasia, emphasizing the need for judicial oversight.
  • Common Cause v. Union of India (2018): This case further solidified the legal status of passive euthanasia in India. The Supreme Court recognized the right to die with dignity as a Fundamental Right under Article 21. It allowed individuals to draft a ‘living will,’ enabling them to refuse medical treatment or opt for the withdrawal of life support under specific conditions. The Court’s judgment highlighted the importance of patient autonomy and dignity in end-of-life care.

Case Study

Sarco Pod The Sarco Pod, a ‘suicide pod’ developed for assisted death, recently gained attention after a 64-year-old American woman with an autoimmune condition reportedly used it in Switzerland in September 2024. Operated without medical involvement, the pod allows the user to self-administer nitrogen gas, leading to a painless death within minutes.

Legality in other parts of the world:

• • Euthanasia is legal in several countries. Euthanasia is legal in the Netherlands, Belgium, Luxembourg, and Spain.
  • Switzerland allows assisted suicide.
  • Canada permits both euthanasia and assisted suicide, while certain U.S. states, such as Oregon, Washington, and California, allow assisted suicide under strict regulations. Colombia has legalized euthanasia.
  • Each country or region has specific criteria, such as terminal illness or unbearable suffering, that must be met for euthanasia or assisted suicide to be performed legally.

Draft guidelines on passive euthanasia:

Defined terminal illness

• • The draft has defined terminal illness as an irreversible or incurable condition from which death is inevitable in the foreseeable future.

Based on four conditions

• • The guidelines for withdrawing or withholding medical treatment in terminally ill patients are based on four key conditions:
  • The individual has been declared brainstem dead.
  • There is a medical assessment that the patient’s condition is advanced and unlikely to improve with aggressive treatment.
  • The patient or their surrogate has provided informed refusal to continue life support after understanding the prognosis.
  • The procedure follows the directives set by the Supreme Court.

Allow patients to decide on life support and resuscitation

• • Developed by AIIMS experts, these guidelines allow patients to decide on life support and resuscitation.
  • They also permit the withdrawal of supportive care such as ventilation or dialysis if a patient is brain dead, unlikely to benefit from further intervention, and if the patient or surrogate refuses care.

Provisions related to advance medical directives

• • The guidelines also mention advance medical directives, where individuals document their treatment preferences in case they lose decision-making capacity.
  • The physician, upon deeming life-sustaining treatments inappropriate, will refer the case to a primary medical board for review.
  • If the board agrees, a shared decision is made with the family, and a secondary medical board’s approval is required before withdrawing support.

Source:

https://indianexpress.com/article/explained/explained-law/experts-explain-how-passive-euthanasia-works-in-india-9639043/