Assisted Suicide and Passive Euthanasia | Important Acts and Laws for Judiciary Exams PDF Download

Introduction

• Passive euthanasia involves ending the life of individuals with terminal illnesses or distressing conditions painlessly. Derived from Greek roots, euthanasia, or mercy killing, occurs when terminally ill individuals request assistance in dying from a doctor, friend, or relative. The act commonly involves physician-assisted suicide.
• However, the practice has nuances. It specifically refers to a doctor's decision to end a patient's life upon the patient's request, which must be voluntary, explicit, and well-considered. Ethical dilemmas arise, such as the rights of terminally ill patients to request death by withholding medical treatment.
• Further debates revolve around whether family members can decide to terminate life support for individuals in a persistent vegetative state with no chance of recovery. Legal complexities also arise, especially regarding whether aiding in active euthanasia should be exempt from legal consequences under Section 306 of the Indian Penal Code, which penalizes abetment to suicide with up to ten years of imprisonment.
• Euthanasia remains a highly controversial ethical issue, sparking diverse viewpoints and heated debates. While opinions abound, translating these into effective legislation proves challenging, given the intersection of legal, moral, and ethical concerns unique to this topic.

Historical Background

• Throughout history, different societies have held varying views on euthanasia.
• Ancient Greece and Rome permitted euthanasia under certain circumstances, such as assisting in death.
• In Sparta, infants with severe birth defects were often euthanized.
• In many ancient cultures, voluntary euthanasia for the elderly was a common practice.
• Christianity's rise led to the moral condemnation of euthanasia as a violation of the sanctity of life.
• Modern laws on euthanasia have evolved from religious to more secular perspectives.
• In the 1930s, organizations advocating for euthanasia legalization emerged in the US and UK.
• A pivotal event in the late 1970s involving Karen Ann Quinlan amplified the pro-euthanasia movement.
• Quinlan's case involved a legal battle to remove life support, sparking debates on patients' rights.
• The Nancy B. v. Hotel-Dieu de Quebec case in Canada further highlighted euthanasia concerns in the early 1990s.
• In this case, a woman paralyzed by Guillain-Barré syndrome requested the removal of her life-sustaining equipment.
• A Quebec court ruled in favor of the woman, underscoring the legality of refusing treatment.

Legal Status of Euthanasia across the World

• Most countries prohibit euthanasia due to ethical and religious reasons.
• There is a distinction between passive euthanasia (allowing someone to die) and active euthanasia (killing someone), with passive euthanasia generally more accepted.
• Dealing with individuals in a persistent vegetative state raises ethical dilemmas regarding the right to die.
• Criteria for justified euthanasia include voluntary, informed, and stable patient request, unbearable pain with no relief, consultation with another physician, and thorough analysis of the patient's situation by the physician.
• Euthanasia accounts for approximately 2% of all deaths in the Netherlands annually.

America

• Active euthanasia is prohibited in the US, but patients have the right to refuse medical treatment.
• States like Oregon, Washington, Montana, and Texas have euthanasia provisions.
• Physician-assisted suicide is allowed in certain states under specific regulations.
• Legal cases like Baxter v. Montana have influenced the legality of physician-assisted dying.

United Kingdom

• Euthanasia is illegal in the UK, but leniency is shown towards doctors aiding in suicide.
• Assisting suicide is considered a crime unless the person is physically able to commit suicide themselves.
• Attempts to pass euthanasia legislation in the UK have been unsuccessful.
• Legal cases like R. v. Director of Public Prosecutions have challenged the UK's stance on assisted suicide.

Switzerland

• Euthanasia is banned, but assisted suicide is not illegal if done for unselfish reasons.
• No safeguards are in place for assisted suicide, and it's not widely practiced.
• Inducing suicide for selfish reasons is punishable under Swiss law.

Belgium

• Belgium legalized euthanasia and assisted suicide in 2002 for capable adults and emancipated youngsters.
• Strict regulations are in place, including a one-month waiting period and obtaining a second opinion.
• A permanent committee monitors euthanasia cases in Belgium.

Australia

• Australia was the first country to legalize euthanasia in 1996, but later reversed the decision, making it illegal nationwide.
• Legal cases like Wake v. Northern Territory of Australia have influenced the country's stance on euthanasia.

Canada

• Patients in Canada can refuse life-sustaining treatments but cannot request active euthanasia or assisted suicide.
• Physician-assisted suicide is prohibited in Canada under the Criminal Code.
• Legal cases like Rodriguez v. British Columbia have shaped Canada's laws on euthanasia.

Legal Status of Euthanasia and Assisted Suicide in India

• Section 306 of the Indian Penal Code addresses abetment to suicide.
• Suicide itself is not considered a crime under the Indian Penal Code. This is because if a person successfully commits suicide, they cannot be prosecuted posthumously.
• Suicide attempts, however, are punishable under Sections 305 and 306 of the IPC. These sections aim to prevent individuals from influencing, instigating, or aiding in the death of another person.
• To establish a case of abetment, there must be active encouragement or suggestion by the accused for the person to commit suicide.
• The key element of the crime of abetment is the accused's intentional involvement in assisting and encouraging the act of suicide.
• Section 306 makes continuous incitement to suicide illegal.
• In the case of Wazir Chand v. State of Haryana, the accused were convicted under IPC Section 498A due to failure to prove beyond a reasonable doubt that the deceased committed suicide.
• In Gurbachan Singh v. Satpal Singh, the defendants were found guilty of aiding and abetting suicide due to evidence of harassment and torture related to insufficient dowry.

Passive Euthanasia and Section 306 of IPC

• Passive euthanasia and physician-assisted suicide are not legal in India. Doctors who assist in ending a patient's life can be charged with aiding suicide.
• Both suicide abetment (section 306, IPC) and suicide attempt (section 309, IPC) are considered criminal offenses in India, unlike in some other countries.
• If a doctor attempts to kill a patient at their request, they can be charged with negligent homicide under section 304 of IPC.
• Non-voluntary and involuntary euthanasia are considered illegal under section 92 of the IPC.

Legal Landscape in India

• In the case of Gian Kaur v. State of Punjab, the Supreme Court of India ruled that euthanasia and assisted suicide are illegal in the country.
• Physician-aided suicide, legal in some nations, is prohibited in India, and doctors can face legal consequences for assisting in suicides.

Passive Euthanasia in India

• While active euthanasia is not allowed, passive euthanasia is permitted in India. This includes withdrawing life support from patients in a permanent vegetative state.
• In the case of Aruna Ramchandra Shanbaug v. Union of India, passive euthanasia was legalized by the Supreme Court of India in 2011.

Guidelines for Passive Euthanasia in India

• The decision to stop life support must be made by close relatives, doctors, or a next friend acting in the best interests of the patient.
• Approval from the High Court is required for any decision to withdraw life support.
• A committee of doctors appointed by the High Court will assess the patient's condition before a decision is made.

Parliament's Consideration on Suicide Laws

• The Supreme Court urged Parliament to reconsider decriminalizing attempted suicide, emphasizing support over punishment for individuals in distress.
• The distinction between active and passive euthanasia allows for the removal of life support as a morally acceptable practice in certain circumstances.

Legalizing Euthanasia

• The debate surrounding the legalization of euthanasia remains contentious, with opposition stemming from various quarters including religious bodies, medical societies, and politicians. Despite efforts to advocate for its legalization, strong opposition persists, largely grounded in the principle of "the sanctity of life" upheld by religious and moral beliefs.
• In India, being a secular nation, the discourse on euthanasia necessitates rational and humane considerations, rather than solely religious or moral viewpoints. While religion and morality do exert influence, the pressing issues of medical commercialization and accessibility to healthcare must be addressed. The escalating costs of medical treatment, coupled with the uncertainty of improvement in incurable conditions, underscore the complexities of the euthanasia debate.
• The country's healthcare landscape, marked by the privatization of medical facilities, has led to exorbitant expenses for patients, often at the expense of ethical medical practices. The recent ruling in the Aruna Shanbaug case, while significant, overlooks the harsh reality of India's costly and inaccessible medical care.
• As discussions on euthanasia continue, it's imperative to consider the broader context of healthcare commercialization and its ethical implications, alongside religious and moral perspectives, in crafting legislation or policies on end-of-life choices.

Conclusion

• The discourse surrounding euthanasia in medical practice often revolves around the distinction between active and passive euthanasia, where the former involves intentionally ending a life, while the latter entails withdrawing or withholding treatment to allow nature to take its course. While euthanasia remains a contentious issue, especially in jurisdictions like India where attempted suicide is considered a crime, there are compelling arguments in favor of its consideration.
• In India, a significant portion of the population comprises disabled individuals and the elderly, with a growing percentage facing severe physical and mental challenges. Advances in medicine have extended life expectancy, but often without ensuring a commensurate quality of life, particularly in the later years. Many individuals find themselves suffering from various ailments without adequate support or caregivers.
• For those facing terminal illness, disability, or simply a diminished quality of life due to aging or chronic diseases, the option of a dignified death may be preferable to prolonged suffering. Additionally, legalizing euthanasia could address the shortage of vital organs available for transplantation. Doctor-assisted suicide could allow patients to donate organs while they are still viable, potentially saving other lives.
• Considering these factors, euthanasia and assisted suicide deserve careful consideration within the realm of medical ethics and legal frameworks. It's essential to weigh the autonomy and dignity of individuals against societal and moral concerns, ensuring that any legislation or policy reflects a balance of these interests.