1. Simone de Beauvoir in her book describes plight of her dying mother in hospital as “death by intensive care”
  2. The plight of a dying patient can only be understood by their closest family members, relatives and friends. Additionally, the debate cuts across various ethical, legal, political, social and individual human rights.
  3. Arun Shanbaug Case: The long vegetative state [42 years] of beloved nurse Aruna Shanbaug and a plight to the Supreme court to allow carrying out euthanasia for her had led to the opening of debate on Euthanasia in India.
  4. Arguments Against:
    1. Neglect of Healthcare by State:
      1. The Court noted that euthanasia may encourage or incentivize state to not take care of critical patients. In fact, in Holland, the legalization of euthanasia has led to severe decline in quality of care of terminally-ill patients.
    2. Commercialization of Health Care:
      1. The court wisely noted that we cannot put the life of a person in hands of commercial health sector (doctors) who could put to death many older and disabled patients in the hospitals.
    3. Malafide Intent:
      1. Additionally, unscrupulous elements in the family or relative circle may not understand the best for the patient.
    4. Constitutional Right to Life — Article 21
    5. Hence, active euthanasia has been completely banned in India.
  5. Arguments in Favour of Euthanasia:
    1. Right to Die with Dignity
    2. Organ transplantation encouraged
      1. Terminally ill patients may be encouraged to donate their organs, thereby allowing “Right to live” for another patient
    3. The burden of the caregiver
      1. The caregiver must provide all the possible treatments regardless of the financial, legal and personal reasons as it is only ethical thing to do.
    4. Right to Refuse Care
      1. Right to refuse care is recognized by the law and effectively gives way for passive euthanasia.
    5. Judicial Pronouncements
      1. In Gian Kaur Case 1996, the Supreme Court has interpreted the constitution’s Article 21 —Right to Life as an article that does not include the Right to Die.
      2. 2011: In this light, the Supreme Court has ruled in 2011 that only passive euthanasia can be administered in India.
        1. Passive euthanasia means that only withdrawal of life support or nutrition is allowed, and doctors cannot administer any medicine or drug to actually put the patient to snuff out life.
          1. Additionally, the family members need to get a permission from the relevant High Court.
          2. The HC chief justice would form a bench of 2 judges as well as appoint 3 reputed doctors to administer such as decision.
          3. The doctors must provide a report to the next of kin and the state government in regard to this.
        2. Legislative Action
          1. Government has framed a new “Passive Euthansia” or “Medical treatment for terminally ill patients” Bill
          2. Allows for a “Living Will” or “Advance Medical Directive” by patients beforehand in terms of medical treatment when they become ill
          3. A patient (above 16 years of age) will have full authority for withholding medical care to himself or herself and allow the nature to take its course.
          4. Information regarding this has to passed on to parents, relatives, friend etc. by the medical practitoner.