A draft bill by the Union health ministry on passive euthanasia, withholding medical treatment or life support system required to keep a patient alive, has once again stoked a debate over ‘right to life’ and ‘right to die with dignity’.
The ministry uploaded the draft bill - Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill -on its website (www.mohfw.nic.in) on May 9 and invited public comments on the issue that can be emailed to email@example.com by June 19.
“Government of India has decided to solicit public opinion/comments before formulation of Law on Passive Euthanasia… the opinion/comments may be sought by June 19, 2016,” the government circular said.
The call has evoked mixed reaction among doctors, who say the government needs to take a careful approach before legalising passive euthanasia when the measures to prolong the life of the patient are withdrawn.
According to doctors at the All India Institute of Medical Sciences’ (AIIMS) busy Trauma Centre, at any given time about six patients occupying beds are in a completely vegetative state, with no hope of recovery.
A 15-year-old boy from Jharkhand, who is paralysed neck down in an accident and is on a ventilator, has been in the hospital for close to three years. If the ventilator support is withdrawn, the boy may die gradually.
“These people have nowhere to go. Their families have spent the last penny to keep them alive and are left with no money to move them anywhere else,” a senior doctor at the Trauma Centre, where a shortage of beds is a common problem, said.
The patients are observed in the trauma centre for a maximum of one year before being declared vegetative.
“I personally am for euthanasia. It is a huge drain on the country’s resources. We should gracefully let these patients go rather than torturing them and their families,” said the doctor.
Dr Naresh Trehan, renowned cardiac surgeon and founder of Medanta—The Medicity, however, has been concerned about the morality of the action.
“The biggest concern around the world about euthanasia is if we can play god, and also, if the law can be abused,” he said when Aruna Shanbaug’s mercy killing petition was rejected in 2011.
A nurse at KEM Hospital in Mumbai, Shanbaug was in a vegetative state since 1973 after a brutal sodomisation and strangling with a dog-chain during a sexual assault. She died in 2015 while on a ventilator for several days after suffering from pneumonia.
“Ordinarily if a life is not functional, it is not worth continuing. How long you can actively keep intervening to prolong a life is the question. There should be a point where we should be able to stop intervening,” he added.
Most doctors, however, agree that euthanasia should be made legal in cases where there is no scope of a patient recovering. But many feel that India is not yet ready for a decision like this which requires a mix of sensitivity and maturity.
“We Indians are extremely emotional by nature and also know how to find loopholes in the law. There are chances of the law getting misused for financial or other gains. It needs a careful thought,” Dr Bipin Walia, senior consultant neurosurgery and head of neuro-spine surgery at south Delhi’s Max Hospital, said.
“Though there is no point in prolonging the physical agony of a terminally ill person,” he added.
The issue of euthanasia was first examined by the health ministry in consultation with the experts in 2006, based on the 196th Law Commission of India report. After due deliberation, it was decided to not make any laws on euthanasia.
However, in 2011 the Supreme Court, while hearing the case of Shanbaug, had legalised passive euthanasia. In a landmark judgement, the SC had given thousands of patients living in a vegetative state all over the country the right to have artificial life-support systems withdrawn to enable them to end a life of misery.
It laid down comprehensive guidelines to process passive euthanasia in the case of incompetent patients, also saying the procedure should be followed all over India until the Parliament makes a legislation on the subject.
The guidelines include seeking a declaration from the high court, after getting clearance from a medical board and state government.
Active euthanasia, which involves killing a person by a positive act in order to end the suffering of a person, was not recommended and termed ‘unconstitutional’ by the apex court.
Passive versus active euthanasia
Passive: When medical treatment is withdrawn with the intention of causing the patient’s death. For instance, if the patient is on life-support system, the deliberate removal of it will be termed passive euthanasia. In passive euthanasia, the measures to prolong the life of the patient are withdrawn.
Active: Active euthanasia entails deliberately causing the patient’s death by injecting with poison or giving an overdose of sleeping pills and other medicines.