passive euthanasia - POLITY

Recently, the Supreme Court of India denied a petition from an elderly couple seeking News: “passive euthanasia” for their comatose (deeply unconscious) son, who has been bedridden for 11 years following a fall. 

What’s in the news?

What is euthanasia, and what is a living will?

  • Euthanasia refers to the practice of an individual deliberately ending their life, oftentimes to get relief from an incurable condition, or intolerable pain and suffering.
  • Euthanasia, which can be administered only by a physician, can be either ‘active’ or ‘passive’.
    • Active euthanasia involves an active intervention to end a person’s life with substances or external force, such as administering a lethal injection.
    • Passive euthanasia refers to withdrawing life support or treatment that is essential to keep a terminally ill person alive.
  • Passive euthanasia was legalised in India by the Supreme Court in 2018, contingent upon the person having a ‘living will’ or a written document that specifies what actions should be taken if the person is unable to make their own medical decisions in the future.

In case a person does not have a living will, members of their family can make a plea before the High Court to seek permission for passive euthanasia.

 

SC rule in 2018

  • The Supreme Court allowed passive euthanasia while recognising the living wills of terminally-ill patients who could go into a permanent vegetative state, and issued guidelines regulating this procedure.
  • A five-judge Constitution Bench headed by then Chief Justice of India (CJI) Dipak Misra said that the guidelines would be in force until Parliament passed legislation on this.
  • However, this has not happened, and the absence of a law on this subject has rendered the 2018 judgment the last conclusive set of directions on euthanasia.
  • The guidelines pertained to questions such as who would execute the living will, and the process by which approval could be granted by the medical board.
  • “We declare that an adult human being having mental capacity to take an informed decision has right to refuse medical treatment including withdrawal from life-saving devices,” the court said in the 2018 ruling.

 

Changes to Living Will Guidelines in India

The 2018 Guidelines

  • A living will was required to be signed by an executor in the presence of two attesting witnesses, countersigned by a Judicial Magistrate of First Class
  • The treating physician was required to constitute a board comprising three expert medical practitioners with at least 20 years of experience to decide whether to carry out the living will or not
  • If the medical board granted permission, the will had to be forwarded to the District Collector for his approval
  • The Collector was to then form another medical board of three expert doctors, including the Chief District Medical Officer
  • Only if this second board agreed with the hospital board’s findings would the decision be forwarded to the JMFC, who would then visit the patient and examine whether to accord approval

 

Changes Made by the Supreme Court

  • Instead of the hospital and Collector forming the two medical boards, both boards will now be formed by the hospital
  • The requirement of 20 years of experience for the doctors has been relaxed to five years
  • The requirement for the Magistrate’s approval has been replaced by an intimation to the Magistrate
  • The medical board must communicate its decision within 48 hours
  • The 2018 guidelines required two witnesses and a signature by the Magistrate; now a notary or gazetted officer can sign the living will in the presence of two witnesses instead of the Magistrate’s countersign
  • In case the medical boards set up by the hospital refuses permission, it will now be open to the kin to approach the High Court which will form a fresh medical team.

 

Different countries, different laws

  • Netherlands, luxembourg, belgium allow both euthanasia and assisted suicide for anyone who faces “unbearable suffering” that has no chance of improvement.
  • Switzerland bans euthanasia but allows assisted dying in the presence of a doctor or physician.
  • Canada had announced that euthanasia and assisted dying would be allowed for mentally ill patients by March 2023; however, the decision has been widely criticised, and the move may be delayed.
  • United states has different laws in different states. Euthanasia is allowed in some states like Washington, Oregon, and Montana.
  • United kingdom considers it illegal and equivalent to manslaughter.

 

Source: https://indianexpress.com/article/opinion/columns/passive-euthanasia-terminally-ill-9528196/