Live And Let Die – The Euthanasia Debate

By Ipshita Agarwal

Edited by Nidhi Singh, Junior Editor, The Indian Economist

They say man is born alone and he dies alone. But they never say man has a choice in life, or in death. For they claim man’s life is not only his own. He owes his existence to society, to his relatives and friends. Thus, he lives in the middle, where there is no black and white, only grey. Neither is there hope, nor, however, is there absence of complete hope. A sign, a signal, a movement.. a miracle. That’s what they pray for.

The Euthanasia debate is not a new one. The moralistic, practical and ethical aspects of Euthanasia have been discussed for decades. However, with the exception of three countries in the world, no others have found a common ground. What is it, about this issue that makes it so widely contested? Is it correct to say that any death, apart from a natural one, is a type of suicide? Or is it correct to say that man must have the right to die when his body gives up the strength to be able to endure more pain?

Before I discuss the arguments for and against Euthanasia, let me first discuss how the world defines it. According to Wikipedia, Euthanasia is “The painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.” This definition however, does not take into account the terms ‘passive euthanasia’, ‘physician assisted suicide’ and ‘active euthanasia’.

Passive euthanasia refers to a situation where in life supporting or life saving treatment is withheld. This means that if a person is on a ventilator, the ventilator might be withdrawn. In such a situation, the patient is then left at the mercy of Mother Nature to take its course.. over some hours or several days, weeks or even months.

Active euthanasia, on the other hand, is a situation where in the physician, on the request of the patient, injects a lethal injection into the patient, to put an end to his/her suffering.

Somewhere in between these two, lies Physician Assisted Suicide (PAS). In this, lethal means are made available to the patient to be used at a time of the patient’s own choosing. It is considered to be morally and emotionally easier for physicians, as compared to Active euthanasia.

The debate over active vs passive euthanasia is based on the ground that letting the disease take a person’s life by withholding treatment is different from actually ending a person’s life. I, however, beg to differ. What people do not take into account is the rationale behind euthanasia itself – the concept of ‘suffering’. What is the aim of euthanasia? To end suffering. When life becomes more painful than the loss of a life itself, only in those circumstances, does one think of euthanasia. Passive euthanasia absolves the physician of any moral or ethical conflict as he/she is not seen as being ‘directly’ responsible for the patient’s death. However, the pain that follows once the treatment is withheld, is more painful than what the patient was bearing till now, or what he would have to bear, were he to be administered the lethal injection. If, we as a society, agree that the aim is to put an end to suffering, does it not make sense to adopt a method which ‘directly’ puts an end to suffering, rather than making the patient go through more?

However, even developed and ideologically ‘progressed’ countries like the US and Britain have not legalized euthanasia. The patient has a right to refuse treatment, but no right to ask for death. The American Medical Association holds true the ‘autonomy’ principle of euthanasia and that life sustaining treatment can be foregone at the patient’s request (passive euthanasia). However, it says that doctors must not engage in active euthanasia or PAS.

The ‘autonomy’ principle says that a patient should have the right to refuse treatment and thus a right to ask life sustaining treatment to be withheld. Supporters of euthanasia quote the ‘autonomy’ principle as one of the strongest reasons to legalize it. Further, compassion and the right to die with dignity are other reasons why they say that euthanasia should be allowed. They also say that every individual has a right to life and individualism.

The opponents, on the other hand, say that alternative treatments such as palliative care are available. Most of their arguments are based on moral grounds, which in most countries, would be tenable. They say that, if legalized, the ‘right’ to die may become a ‘duty’ to die. The patient might feel he/she is a burden to the family, both emotionally and financially, and may thus be guiltily provoked into asking for euthanasia. Sometimes, the family or the physicians may themselves impose this decision upon the patient against his will, as happened in Netherlands in 1990 when an estimated 1000 people were ‘killed’ due to the physician’s decision to end the person’s life.

In some countries, passive euthanasia is legalized on the grounds that it is not a form a suicide. And this leads them to say that, to ensure that immoral practices are avoided, active euthanasia should not be legalized. My question, however is, when you have a common end in mind i.e. when the purpose for both the methods is the same, why do we settle for a method that in fact only worsens the suffering, before (maybe, in a few days or weeks) putting an end to it? The question is not about morals or suicide vs death, the question is about suffering. The ethical implementation of active suicide, if ever legally allowed, is the biggest hindrance and argument against this legislation. How will we ensure that it happens in good faith? How will we make sure that the autonomy of the patient does not become the autonomy of his family or his doctor?

This debate is open in Britain in the House of Lords as the bill presented by Lord Falconer – Assisted Dying Bill 2013, is being debated upon. Following heed, the Supreme Court of India has also asked the states and union territories to discuss this matter and provide their opinions in the next 8 weeks.

While we might not be anywhere close to legalizing the right to die, however open debate is the beginning of change. The legislation will be made stronger keeping in view the opinions of people all across the country, and an inclusive view is what the SC seeks.

It might be some time before Hrithik Roshan’s Euthanasia appeal in Guzaarish can be accepted in Indian courts, but we’ve begun the journey at least.

Ipshita is a second year student pursuing B.Com Honors at SRCC, Delhi University. She loves to read, interact and network. Books are her first love and she dreams to set up a chain of bookstores around the globe. Writing is her passion and she is particularly interested in the fields of public policy, politics and international relations. She aspires to build a career in public life and take up writing as a medium to bring change.