By Vanshika Rajan, Editorial Intern at Law Daily.
The word euthanasia is derived from Greek etymology, and was earliest used in the 17th century in the sense of an “easy death”. Passive Euthanasia, in simpler terms, involves withdrawal or withholding of the medical treatment of an individual in a vegetative state, to avoid prolonged agony and save the dignity of an individual.
According to BBC, “Passive euthanasia occurs when the patient dies because the medical professionals either don't do something necessary to keep the patient alive or when they stop doing something that is keeping the patient alive.” The essentials of Passive Euthanasia vary across different countries; however, its most consistent characteristic is its voluntary execution, without any coercion. Many cases that call for passive euthanasia originate from the medical insistence on prolonging the life of an irreversible coma where chances of improvement are largely non-existent.
However, beyond these technical aspects involving Passive Euthanasia, what makes this concept important for discussion is its psychological aspects of pain, suffering, and dignity. The complexities not only revolve around the psychological dignity of an individual but that of his/her loved ones who ache to see the suffering and loss of someone close to them. Thus, Passive Euthanasia beyond a legal concept is a psychological choice of an individual, a choice for life and dignity.
INTERNATIONAL CONTEXT
The Netherlands was the first country to have legalized Passive Euthanasia in 2002. Since then, various other countries such as Belgium, Canada, and Columbia. Italy, Spain, Australia, and Luxembourg have also gone ahead to legalize this form of euthanasia with varying guidelines. The world is currently on a journey of destigmatizing the biases around Passive Euthanasia and thus more and more countries from around the world are holding discussions on legalising the same, as an attempt to give rightful dignity to an individual. At the same time, various countries are yet to give their nod to Passive Euthanasia, these include various developed states of The United States, China, and Denmark, to name a few.
STATUS OF PASSIVE EUTHANASIA IN INDIA
India is a land of complex origins, traditions, and communities that had its fair share of twists and turns when it came to the decision to legalise Passive Euthanasia. With different sections of the societies holding diverse views about the same, it became extremely important for the judges of the Hon'ble Supreme Court of India to seek redressal from our constitution with a lens of pragmatism or practicality, moral reasoning, and purposive interpretation.
The landmark judgments pertaining to the legality of Passive Euthanasia date back to the 1969 case of Gian Kaur v. The State of Punjab. The case involved various discussions on the legality of, euthanasia in India with its supporters arguing that Article 21 of the constitution, which talks about the Right to Life, should have an extended purview of the Right to Death. However, the honourable Supreme Court rejected these claims leading to no significant development in this area other than a base for further discussions.
In furtherance of this in 2005, an NGO named Common Cause filed a Public Interest Litigation in the Supreme Court to allow the composition of a “living will” for individuals in a vegetative state wanting to opt for Passive Euthanasia. However, what brought this PIL to affect and systematically changed the entire dynamics of euthanasia in India was the case of Aruna Ramchandra Shanbaug vs Union Of India & Ors which took place in 2011. In this particular case, the court laid down the distinction between active and passive Euthanasia, completely dismissing the former, which involves active participation in the “killing” of an individual through injections or other outside assistance, with the former being limited to the withdrawal of life-supporting systems.
However, what may some claim to be a ray of hope was the decision of the Supreme Court to allow the use of Passive Euthanasia for patients in a Permanently Vegetative State (PVS), laying down stringent guidelines for the same. A PVS is a state in which an individual irreversibly loses his/her capacity to remain conscious, with only a few physiological functions still in force.
While the Aruna Shanbaug case formed the base of a revolution, it was the March 2018 judgement of the Common Cause v. Union of India case which brought the revolution. This highly proclaimed judgment headed by a 5 judge-bench made Passive Euthanasia legal in India. However, what really made this judgement revolutionary was the decision of judges to extend the purview of Article 21 of the Indian Constitution to the Right to Death.
In simpler terms, this judgement suggested that one can only have complete autonomy over one’s Right to Life if one has his/her say in his or her Right to Death. Although the judgement included various nitty-gritty and technical details, to the common man it now meant to have a “living will” but more importantly a death of dignity.
IS THE CONCEPT SOCIALLY ACCEPTABLE?
While a legal judgement is the first step for any change, without societal acceptance it remains hollow. Thus, it is important to also look at how the Indian society took this decision. While a large number of nationals supported the stance, there were a few concerns and arguments by its opposers. Many believed that this judgement was morally unacceptable since it lay in conflict with the importance of life, which may lead to people taking it for granted. Various religious leaders also came into the picture with claims that the decision was against their ideologies and traditions. On the professional front, doctors who are all subjected to the famous Hippocrates oath were also caught up with the ethical dilemma of whether their judgement could be discrete enough to determine the individual's life or death.
CONCLUSION
However, each and every concern boils down to one answer, which is Article 21. As propagated by the Indian Constitution, nothing should prevail over the Fundamental Rights of an individual, and thus, the moment at which the Right to Death was included to be a part of these Fundamental Rights, it became non-negotiable. Even beyond this legality, it is ethically and morally incorrect to allow suffering to prevail over relief, choice over compulsion. Since, at the end of the day, it is an individual whose body is at stake, and it should ultimately be their choice especially if there is no way possible to live a quality life, a life propagated again by Article 21 of our constitution. Thus, Passive Euthanasia may be seen as a dynamic concept involving of various facets. It thereby becomes important to analyse the same with a neutral mindset equally driven by ethics, society, law, and knowledge.
Life and death are inseparable...Every moment our bodies undergo change… life is not disconnected from death, dying is a part of the process of living.”
-Justice Chandrachud
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