Prelude- The essay contemplates various aspects of Right to Dignified Death , Euthanasia and Suicide .
Life Exists, therefore it has a right to exist ; Death exist, therefore it has a right to exist too
Introduction :-
Right to dignified death has been a one of the most debated issues across the world after abortion.Rightly so , it has been able to bring a philosopher out of a policy maker and few judges probably became poets after the deliberation on Life and Death. It is as much a matter of importance for religion as it is for any philosopher or for a man of science.
All our science stops at the doorstep of death. Philosophy and religion has taken a discourse life after death, but to test them is to die first , and death is where our communication stops with the living world.While life after death may remain a mystery for centuries to come , death strikes every now and then, the question remains how to get there peacefully, without suffering , without misery . From the discourse of peaceful exit and exit from suffering , born the philosophy of right to dignified death.
Save the religious and philosophical tenets of the matter at hand , it is essential to understand the different manifestation of right to dignified death such as – Euthanasia and Suicide.
Euthanasia – Objective Analysis of a subjective matter :-
- Active euthanasia involves taking specific steps such as injecting the patient with a lethal substance e.g. Sodium Pentothal which causes the person to go in deep sleep in a few seconds and the person dies painlessly in sleep, thus it amounts to killing a person by a positive act in order to end suffering of a person in a state of terminal illness. It is considered to be a crime all over the world(irrespective of the will of the patient) except where permitted by legislation,as observed earlier by Supreme Court.
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In India too,active euthanasia is illegal and a crime under Section 302 or 304 of the IPC.Physician assisted suicide is a crime under Section 306 IPC (abetment to suicide)
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Passive euthanasia, otherwise known as ‘negative euthanasia’, however, stands on a different footing. It involves withholding of medical treatment or withholding life support system for continuance of life e.g.,withholding of antibiotic where without doing it, the patient is likely to die or removing the heart–lung machine from a patient in coma
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Passive euthanasia is legal even without legislation provided certain conditions and safeguards are maintained (SC Judgement in Aruna’s case)
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Distinction between Active and Passive Euthanasia :-
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The core point of distinction between active and passive euthanasia as noted by Supreme Court is that in active euthanasia,something is done to end the patient’s lifewhile in passive euthanasia, something is not done that would have preserved the patient’s life.
- In passive euthanasia,“the doctors are not actively killing anyone; they are simply not saving him”, “while we usually applaud someone who saves another person’s life, we do not normally condemn someone for failing to do so”.
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The Supreme Court pointed out that according to the proponents of Euthanasia ,while we can debate whether active euthanasia should be legal,there cannot beany doubt about passive euthanasia as “you cannot prosecute someone for failing to save a life”.
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Passive euthanasia is further classified as voluntary and non-voluntary.Voluntary euthanasia is where the consent is taken from the patient. In non-voluntary euthanasia, the consent is unavailable on account of the condition of the patient for example,when he is in coma.In this regard the SC observed that –
while there is no legal difficulty in the case of the former, the latter poses several problems, which we shall address”. The Supreme Court was concerned with a case of non-voluntary passive euthanasia because the patient was in coma. -
A hundred years ago, when medicine and medical technology had not invented the artificial methods of keeping a terminally ill patient alive by medical treatment, including by means of ventilators and artificial feeding,such patients were meeting their death on account of natural causes.Today, it is accepted, a terminally ill person has a common law right to refuse modern medical procedures and allow nature to take its own course, as was done in good old times. It is well -settled law in all countries that a terminally ill patient who is conscious and is competent, can take an ‘informed decision’ to die a natural death and direct that he or she be not given medical treatment which may merely prolong life.There are currently a large number of such patients who have reached a stage in their illness when according to well -informed body of medical opinion, there are no chances of recovery. But modern medicine and technology may yet enable such patients to prolong life to no purpose and during such prolongation, patients could go through extreme pain and suffering. Several such patients prefer palliative care for reducing pain and suffering and do not want medical treatment which will merely prolong life or postpone death.
- From the above discourse it is clear that refusing treatment is one’s right so is welcoming natural death is one’s right , but as far the argument stands , till now it holds active euthanasia or positive intervention of death as illegal and Passive euthanasia or negative intervention is allowed.
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The Larger debate of Active Euthanasia and Suicide :-
- It is well understood by the now the stand of jurisprudence on Passive Euthanasia, However the debate is far from conclusion unless the active euthanasia is taken in to legal discourse for debate, deliberation and discussion .Without it the right to dignified death is incomplete.
- In so far, the Honorable SC , and multiple commissions has contemplated the passive euthanasia and shied away from the larger question on active euthanasia. In Aruna’s case it was a selective judgement in the sense that , though the SC held active euthanasia as illegal , yet it had not delved in to the larger question of right to dignified death or right to death as a fundamental right.
- The general fear that entails over active euthanasia is that – if it is made illegal , it will be used as an weapon. And given our socio-political milieu , it would be much difficult a task to manage and carry out it judiciously.When the society is wrecked in corruption, it does make everyone anxious of a law that allows ‘assisted suicide’. Especially when the large body of medical practitioners as acting as mere commercial agents, it would take no time for them to make active euthanasia a viable business proposition and the danger of it in Indian society looms large.
- Another fear hovers on the active euthanasia is of the medical ethics, Doctors are taken pledge to save lives, hence it directly contradicts with the medical ethics to let one die.However , if we use the same analogy , a state’s duty is also to protect its citizens, but it does executes one of its own when there is a need be in accordance with the legal procedures.
- So it makes clear that Indian society is not ready as yet to legalize active euthanasia. More so, India is a deeply religious society, thus to take any adventurous run in this path for any politician or policy maker is dangerous and thus their rather unusual shyness on this matter is understandable.They are supposed to make the society ready for change, but as long as this issues is concerned , everyone is just so silence, even the judiciary as pointed out above.
- Keeping the fears , views of policy makers, politicians, Judiciary , religious and philosophical questions aside, If one encounters the suffering and pain endured by terminally ill patients , one would be humbled . With the person, suffers his whole family , the misery associated with it leads many to take psychological care and breaks the family economically.The terminally ill person just awaits for death , but death is not to avail.It is not the death that he fears, it is the journey that he is incapable of enduring.With his illness , he brings many under stress, pain and misery.Therefore , he appeals, appeals for a dignified death, wants his family to remember by the good he has done, not by the the suffering that he has brought them .In this context , right to dignified death or so to say active euthanasia holds true.It’s the pain of the non-recoverable terminal ill , who awaits get in to the deep sleep and make preparation for it so as not to just, exit this world but exit it with dignity.
- Suicide : – When the assisted suicide is not allowed for terminally ill, it makes no sense to argue in favor of general suicide. However the oddity of our law is that , we have provisions where if someone jumps off a cliff and unfortunately survives , he/she gets imprisonment . It makes no sense to imprison a person who just tried death .Hence better course of action in this regard would be to decriminalize the suicide clause from IPC and create trauma care infrastructure and counseling centers to assist the needy and a fund to help them start or carry on with their lives.
Conclusion :-
- The dilemma of right to dignified death looms large on anybody who has seen people suffering and has seen the commercialization of medical industry.To conclude , it would be non judicious to legalize active euthanasia . However , Supreme Court , can come up with solutions such as a special bench on Euthanasia , where they can very well judge the case on its merit and give the directions accordingly.But this has to be done on a case by case basis and justice must be given as fast as possible , becuase the time is the only luxury the terminally ill can’t afford.Moreover, The SC can frame guidelines to consider the cases and it would be a better discourse than just outrightly denying the right to dignified death by a mere generalization not on a case by case basis.
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Steve Ovett, the famous British middle-distance athlete, won the 800-metres gold medal at the Moscow Olympics of 1980. Just a few days later, he was about to win a 5,000-metres race at London’s Crystal Palace. Known for his burst of acceleration on the home stretch, he had supreme confidence in his ability to out-sprint rivals. With the final 100 metres remaining,
[wptelegram-join-channel link=”https://t.me/s/upsctree” text=”Join @upsctree on Telegram”]Ovett waved to the crowd and raised a hand in triumph. But he had celebrated a bit too early. At the finishing line, Ireland’s John Treacy edged past Ovett. For those few moments, Ovett had lost his sense of reality and ignored the possibility of a negative event.
This analogy works well for the India story and our policy failures , including during the ongoing covid pandemic. While we have never been as well prepared or had significant successes in terms of growth stability as Ovett did in his illustrious running career, we tend to celebrate too early. Indeed, we have done so many times before.
It is as if we’re convinced that India is destined for greater heights, come what may, and so we never run through the finish line. Do we and our policymakers suffer from a collective optimism bias, which, as the Nobel Prize winner Daniel Kahneman once wrote, “may well be the most significant of the cognitive biases”? The optimism bias arises from mistaken beliefs which form expectations that are better than the reality. It makes us underestimate chances of a negative outcome and ignore warnings repeatedly.
The Indian economy had a dream run for five years from 2003-04 to 2007-08, with an average annual growth rate of around 9%. Many believed that India was on its way to clocking consistent double-digit growth and comparisons with China were rife. It was conveniently overlooked that this output expansion had come mainly came from a few sectors: automobiles, telecom and business services.
Indians were made to believe that we could sprint without high-quality education, healthcare, infrastructure or banking sectors, which form the backbone of any stable economy. The plan was to build them as we went along, but then in the euphoria of short-term success, it got lost.
India’s exports of goods grew from $20 billion in 1990-91 to over $310 billion in 2019-20. Looking at these absolute figures it would seem as if India has arrived on the world stage. However, India’s share of global trade has moved up only marginally. Even now, the country accounts for less than 2% of the world’s goods exports.
More importantly, hidden behind this performance was the role played by one sector that should have never made it to India’s list of exports—refined petroleum. The share of refined petroleum exports in India’s goods exports increased from 1.4% in 1996-97 to over 18% in 2011-12.
An import-intensive sector with low labour intensity, exports of refined petroleum zoomed because of the then policy regime of a retail price ceiling on petroleum products in the domestic market. While we have done well in the export of services, our share is still less than 4% of world exports.
India seemed to emerge from the 2008 global financial crisis relatively unscathed. But, a temporary demand push had played a role in the revival—the incomes of many households, both rural and urban, had shot up. Fiscal stimulus to the rural economy and implementation of the Sixth Pay Commission scales had led to the salaries of around 20% of organized-sector employees jumping up. We celebrated, but once again, neither did we resolve the crisis brewing elsewhere in India’s banking sector, nor did we improve our capacity for healthcare or quality education.
Employment saw little economy-wide growth in our boom years. Manufacturing jobs, if anything, shrank. But we continued to celebrate. Youth flocked to low-productivity service-sector jobs, such as those in hotels and restaurants, security and other services. The dependence on such jobs on one hand and high-skilled services on the other was bound to make Indian society more unequal.
And then, there is agriculture, an elephant in the room. If and when farm-sector reforms get implemented, celebrations would once again be premature. The vast majority of India’s farmers have small plots of land, and though these farms are at least as productive as larger ones, net absolute incomes from small plots can only be meagre.
A further rise in farm productivity and consequent increase in supply, if not matched by a demand rise, especially with access to export markets, would result in downward pressure on market prices for farm produce and a further decline in the net incomes of small farmers.
We should learn from what John Treacy did right. He didn’t give up, and pushed for the finish line like it was his only chance at winning. Treacy had years of long-distance practice. The same goes for our economy. A long grind is required to build up its base before we can win and celebrate. And Ovett did not blame anyone for his loss. We play the blame game. Everyone else, right from China and the US to ‘greedy corporates’, seems to be responsible for our failures.
We have lowered absolute poverty levels and had technology-based successes like Aadhaar and digital access to public services. But there are no short cuts to good quality and adequate healthcare and education services. We must remain optimistic but stay firmly away from the optimism bias.
In the end, it is not about how we start, but how we finish. The disastrous second wave of covid and our inability to manage it is a ghastly reminder of this fact.