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10 Jul 2020, Edition - 1823, Friday

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Health Matters

Can we decide our death? Looking at the judgement of passive euthanasia from a doctor’s lens

Indrani Thakurata

The debate on Euthanasia in India really began with Aruna Ramchandra Shanbaug. Shanbaug, a nurse at the King Edward Memorial Hospital in Mumbai was lying in a vegetative state for 42 years before dying naturally in 2015. In 2011 a petition to stop nutrition to Aruna was dismissed by the SC but that gave them enough food for thought. What’s treated as a landmark judgement because right to life also entails the right to a dignified life. By Recognising living wills made by terminally-ill patients, the Supreme Court has upheld the right to die with dignity as a fundamental right by allowing passive euthanasia. “A five judge bench of the supreme court sanctioned legality to passive euthanasia by withholding artificial life support in form of ventilator or medication support for terminally ill patients of various natures with specific guidelines of implementation. However active euthanasia meaning thereby actively inducing death by medication administration in similar or other circumstances is prohibited. A patient in terminal phase requiring such care can himself/herself decide the stoppage of treatment by writing a “living will” or if the patient is not in a position to legally consent due to any reason ( like come etc) then the closest relatives can decide and request the physicians accordingly,” says Dr R K Deshpande, Onco Surgeon, Asian Cancer Institute. Echoing similar thoughts, Dr Pradeep Gadge, Leading Diabetologist, Gadge’s Diabetes’s Care Centre says, “I feel this was needed. I have seen many patients who become brain dead & live a vegetative life just because they are not dying. I think this verdict will help such patients.

*Prolonging life should be our motto as doctors, not just prolonging death & making the patient suffer *

The distinction between active and passive euthanasia was made by the SC in the Aruna Ramchandra Shanbaug vs Union Of India & Ors (March 7, 2011) judgment where it stated, “Active euthanasia entails the use of lethal substances or forces to kill a person, e.g. a lethal injection… Passive euthanasia entails withholding of medical treatment for continuance of life, e.g. withholding of antibiotics where without giving it, a patient is likely to die…” Eventhough the legal sanction has only recently come in, many doctors have revealed that passive euthanasia is already a common practice in most hospitals in India where poor terminally ill patients or their family withdraw support or treatment due to lack of funds. Although, people who can afford it maintain life with life supports and palliative care. “It is true that with many modern diseases, care is what doctors look at, since cure is a distant entity,” says Dr Mukut.

The main contention with euthanasia has been probable misuse which many are worried about. The debate has always been around issues that are legal, ethical, human rights-related, health-related, religious, economic, spiritual, social and cultural. “Biggest challenge we doctor’s face is to treat patient who is on ventilator support in vegetative state. It is moral and ethical issues of which every doctor has to face. The Supreme Court has approved “passive euthanasia”. This allows a patient to create a living will which permits medical professionals to end his life when he reaches a point of no return,” explains Dr. Roy Patankar Director, Zen Multi specialty Hospital.

“If monitored and administered properly this would help..what Can be termed as unnecessary and eventually futile prolongation of human suffering , reduce expenses and financial burden on the family and may be relieve partly, pressure over crucial critical care facilities releasing them for better care. The possibility of misuse as in case of any good measure has to be eliminated by tightly controlling such events,” concludes Dr R K Deshpande.

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