Ethics: Passive Euthanasia | Current Affairs & Hindu Analysis: Daily, Weekly & Monthly - UPSC PDF Download

Why in News? 

Recently, the Supreme Court of India rejected a petition from an elderly couple requesting "passive euthanasia" for their comatose son, who has been bedridden for 11 years following a fall. This ruling has sparked renewed discussions on the legal and ethical aspects of euthanasia in India.

 What is the Background of the Case? 

The Supreme Court denied the parents' plea for passive euthanasia, explaining that the case did not meet the criteria for passive euthanasia. The court clarified that the patient was not on life support and was receiving nutrition through a feeding tube. Allowing him to die, according to the court, would constitute active euthanasia, which is illegal in India.

What is Passive Euthanasia? 

Euthanasia refers to the practice of ending a patient's life to alleviate their suffering. There are two main types of euthanasia: passive and active.

Active Euthanasia involves medical professionals or others intentionally causing a patient's death, such as through a lethal injection.

Passive Euthanasia entails withholding or withdrawing medical treatment, like life support, with the intention of allowing a person to die.

Euthanasia in India 

In a significant ruling in 2018, the Supreme Court of India acknowledged an individual's right to die with dignity, permitting terminally ill patients to choose passive euthanasia and create a living will to refuse medical treatment. The court also established guidelines for living wills made by terminally ill patients who are aware of their potential to enter a permanent vegetative state.

In 2011, the Supreme Court first recognized passive euthanasia in the Aruna Shanbaug case. The court emphasized that dying with dignity is an integral part of the right to life under Article 21 of the Indian Constitution. Depriving an individual of dignity at the end of life, according to the court, undermines their meaningful existence.

Different Countries with Euthanasia

• Netherlands, Luxembourg, Belgium: These countries permit both types of euthanasia and assisted suicide for individuals experiencing "unbearable suffering" with no prospect of improvement.
• Switzerland: While euthanasia is banned, assisted dying is allowed in the presence of a doctor. Since 1942, Switzerland has permitted assisted suicide, emphasizing personal choice and control over the dying process. Individuals must be of sound mind, and their decision should not be motivated by selfish reasons.
• Australia: Euthanasia, both active and passive, has been legalized, applicable to adults with full decision-making capacity facing terminal illnesses with a prognosis of death within six or twelve months.
• Netherlands: The legal framework for euthanasia is well-established, governed by the "Termination of Life on Request and Assisted Suicide (Review Procedures) Act" of 2001.

What were the Recent Changes in Guidelines made by the Supreme Court on Passive Euthanasia? 

In 2023, the Supreme Court of India revised the 2018 Euthanasia Guidelines to streamline the process for granting passive euthanasia to terminally ill patients. The 2018 guidelines had recognized the right to die with dignity as a fundamental right and outlined procedures for enforcing this right.

Modifications in SC Guidelines

• Attestation of Living Will: The requirement for a judicial magistrate's attestation on a living will was removed. Now, attestation by a notary or a gazetted officer is sufficient, making it easier for individuals to express their end-of-life preferences.
• Integration with National Health Digital Record: Living wills are now required to be part of the National Health Digital Record, ensuring easier access for hospitals and doctors across the country. This change facilitates timely decision-making regarding passive euthanasia.
• Appeal Process for Denial of Euthanasia: If a hospital's medical board refuses permission to withdraw life support, the patient's family can appeal to the relevant High Court. The court will then assemble a new medical board to reassess the case, ensuring a thorough and fair review of the decision.

 What are the Ethical Considerations of Euthanasia? 

• Autonomy and Informed Consent: Euthanasia respects individual autonomy, allowing people to decide about their own lives, especially in ending suffering if they are mentally competent. It also requires informed consent, ensuring the person understands their condition, the euthanasia process, and its consequences, preventing coercion or manipulation.
• Quality of Life vs. Sanctity of Life: Euthanasia debates often focus on quality of life, emphasizing the ethicality of ending suffering and preserving dignity in severe illness, versus sanctity of life, which values life intrinsically and opposes premature ending, reflecting religious or philosophical beliefs.
• Legal and Social Implications: Euthanasia's legal framework varies by jurisdiction, reflecting different cultural attitudes and ethical debates on end-of-life issues. The social impact involves questions about medical professionals' roles, societal responsibilities, and the need for equitable access to palliative care and psychological support to address underlying reasons for seeking euthanasia.