Euthanasia is the legal term for a medically assisted mercy killing; however in

most countries, euthanasia is illegal. This begs two fundamental questions.

First, is euthanasia ethical or unethical? Second, depending on the first
question, should euthanasia be legal or illegal?
To help answer these questions, we must first understand both types of
euthanasia.

The first form of euthanasia is the voluntary decision of a patient. This is when
a patient asks a doctor to terminate the patients life if and when the patient
suffers too much, the patient has no hope of recovery, the patient has no hope
for a decent quality of life, or the patient wishes to relieve the financial or
psychological burden on the patients family. This is sometimes referred to
as euthanasia by consent.
This form of euthanasia has the least number of issues. The first issue is that
the mental competency of the patient is always is question. However, I think
that the mental competency of an individual should be easy to prove or
disprove. Second, the social pressure can affect this decision. Again, if the
person is proven mentally competent, this should not be an issue. Therefore, if
a person is mentally competent, the government should not question or
disagree with a persons euthanasia decision. And finally, some religions do
not allow suicide, and most people consider euthanasia as a form of suicide.
Since not everyone shares the same religion, some peoples beliefs allow
euthanasia. Furthermore, it does not make sense for a government to outlaw
euthanasia by consent for reasons of religious beliefs. This is equivalent with
forcing a religion on a patient.
The other form of euthanasia is an involuntary decision by friends or family of
the patient to end the patient's life. This is sometimes referred to
aseuthanasia without consent from the patient.
This form of euthanasia is definitely the most complicated. Sometimes the
friends or family members do not agree, either among themselves or even
with the patient, for or against euthanasia. If the patient is no longer able to
communicate, this adds even further confusion. Since euthanasia is illegal in
most countries, there are almost no policies or laws dictating who has the final
decision of euthanasia, if the patient can not make it. I think such laws should
exist, and this decision should be determined by the spouse, parents, and

children of the patient in that order. Again, religion and beliefs should not be a
reason for the governments intervention. Also, the person(s) making the
decision should be proven mentally competent too.

I find it very hypocritical that most countries that do not allow euthanasia, do
allow animal euthanasia. For instance, if a horse or cow breaks its leg, then
the animals owners or veterinarians can easily put down an animal with little
or no moral or legal issues. Another example is if a very old dog is no longer
mobile and in great pain, the owner can ask a veterinarian to put the dog to
sleep. However, the same person can not ask a doctor to do the same for
themselves or another person.
Moreover, the Hippocratic Oath that all doctors take can be interpreted
differently by different doctors. Some doctors believe that euthanasia is not
moral, and I believe this act should not be imposed on those doctors.
However other doctors, who believe euthanasia is moral, should step in
instead.
Whether euthanasia is murder, assisted suicide, or mercy killing, I believe
euthanasia should be the decision and belief of individuals rather than the
government. And an individual has the first and final decision for their own
life.

The debate of Euthanasia and India

Jun 29, 2015

Medical science and technology have made great strides in recent years.
The medical profession has today more power over life and death than it
would have chosen to have. It has the power to prolong life where life
seems to have lost its meaning and power to terminate life without
suffering. There are many points of view on euthanasia -- legal, social and
compassionate.
The debate on euthanasia has again become a live issue in India as the
supreme court of India recently passed a verdict that attempted suicide is
not a crime. This signifies social approval of suicide and euthanasia which
is
assisted
suicide.

What

is

euthanasia?

Euthanasia is deliberately bringing about a gentle and easy death making

the last days of the patient as comfortable as possible. This is to ensure a
calm and peaceful death, within the context of relieving incurable suffering
in terminal illness or disability. Euthanasia is voluntary, when requested by
the sufferer, involuntary or compulsory if it is against the will of the
patient, passive when death is hastened by deliberate withdrawal of
effective
therapy
or
nourishment.
The

dilemma

Should one prolong the act of dying in a case of inevitable death or when
a life is effectively over? This is one of prominent dilemma. One of the
achievements of modern medical technology is the use of artificial life
support systems like artificial feeding, dialysis, controlled respiration,
pump circulation etc. In some cases it can be so dehumanising, painful,
hazardous or costly that other considerations outweigh the aim to
conserve
life.
Euthanasists raise the question, how long should one sustain life? A
patient might say,I do not want a vegetative existence by drips, drugs
and dialysis. I want to die with dignity. I have a right to lay down my life
just
as
I
have
a
right
to
live.
In a well known trial, a Dr. Arthur in U. K. had prescribed an overdose of
codeine to a baby with Down syndrome with the object of hastening his
death Dr. Arthur was charged with murder. Many eminent witnesses were
tried. Most of them justified the procedure. Finally the court acquitted Dr.
Arthur as his motive was compassion. There is an argument that if a
foetus is found to be abnormal and severely handicapped it should be
eliminated before birth as such children are socially valueless. Do not the
physically handicapped and mentally retarded have as much right to life
as
others
and
get
the
needed
care?
Death

and

dying

The concept of death is changing in the light of new knowledge. It may be

obtained by redefining life. Descriptions of life are organised at many
different levels of complexity - molecular, cellular, organ, system, corporal,
mental, spiritual etc. Human life may be described as the ability, actual or
potential to respond to others, or to be self-aware. This is based on
cerebral function. Silverman and others in 1969 have established this by

extensive studies and confirmed it by encephalogram findings. Once

cerebral death is confirmed, there is no chance for survival though heart
and lung functions continue. So it would be quite unnecessary to continue
supportive
measures
after
cerebral
death.
The

Christian

concept

Almighty God has created man in his image. He is the giver and sustainer
of life. He alone has the right to withdraw life. Life is not a right but a gift
of God, belonging to God and at all times in His hand. We have no right to
take
away
deliberately
a
human
life,
even
ones
own.
Euthanasia requests may be born of depression and confusion or out or a
feeling of worthlessness or due to persuasion of interested parties with
ulterior motives. Respect for the person of the patient and concern for the
family should lead us to use our resources as best as we can to promote
life. The essence of our approach to a dying patient is to give ourselves in
loving care to meet his need. A patient is not merely a biological unit but
a
person
before
God
with
social
family
connections.
Suffering
Suffering can be redemptive and purposeful. It is as much a God- sent
opportunity as is health and provides an opportunity for a creative
outcome
or
an
amendment
of
life.
Let me share with you the experience of two of my friends who faced the
issue of caring for children with disability. One was a hospital chaplain.
When a child with disability was born to him, he asked God why this
happened to him, but he could not get an immediate answer. He loved
that child but the child could not respond to his love in the normal way.
They helped the pastor to realise how God loves us inspite of our not
being responsive to His love. The other was a colleague of mine and a
highly qualified paediatrician when a child with disability was born to him
and his doctor wife. They did their very best to sustain her life. The child
became critically ill immediately after birth,needing exchange blood
transfusions. Though their colleagues questioned the wisdom of taking
such an extreme step for such a child, they choose to have the exchange
transfusions. The child recovered and subsequently brought a new
purpose to their life before she finally died at 4 months of age. Through
this the parents realised that God had a purpose in bringing her to their
home. This experience was an act of God to make them aware of the need
of caring for many neglected children with disability in our society.So they
resigned from their clinical work and offered their lives to start a centre

for children with mental handicaps and special needs. An apparent

traumatic experience became the rallying point for a new mission and for
compassion.
Our

guiding

principle

Ever since the time of Hippocrates in the fifth century BC, the medical
profession has been guided by the concept of the worth of each individual
human life. This was recently reaffirmed by the Geneva code in 1948,
which states,I will show the utmost respect for human life from the time
of
conception.
Hitler had a utilitarian philosophy of life. He preserved any person who
had utilitarian value. The others he eliminated. We respect the unique
value of human life. Life should be cherished, supported and cared.
Some
1.Doctors

practical
should

serve

and

care

steps
for

their

patients

in

love.

2.Deliberate attempt to end or shorten life, whether by omission or

commission,
is
wrong
and
should
not
be
done.
3.Our society should proclaim the way of righteousness and truth and
provide compassionate care. It must take a stand against taking innocent
lives.
4.Medical personnel and the people at large must be educated in moral
and spiritual values. These should lead to sound legislation.
5.Bring
Points

in

the
in

principle

of

Favor

love

as
of

the

mainspring.
Euthanasia

Those in favour of euthanasia think that there is no reason why

euthanasia can't be controlled by proper regulation, but they acknowledge
that
some
problems
will
remain.
For example, it will be difficult to deal with people who want to implement
euthanasia for selfish reasons or pressurise vulnerable patients into dying.
This is little different from the position with any crime. The law prohibits
theft,
but
that
doesn't
stop
bad
people
stealing
things

 Arguments based on ri ghts

People

have

an

explicit

right

to

die

A separate right to die is not necessary, because our other human

rights
imply
the
right
to
die

Death is a private matter and if there is no harm to others, the state

and other people have no right to interfere (a libertarian argument)
Practical arguments

It

is

possible

to

regulate

euthanasia

Death is a private matter and if there is no harm to others, the state

and other people have no right to interfere (a libertarian argument)

Allowing people to die may free up scarce health resources (this is a

possible argument, but no authority has seriously proposed it)

Euthanasia
argument)

happens

anyway

(a

utilitarian

or

consequentialist

Philosophical arguments

Euthanasia satisfies
universalisable

the

Euthanasia
argument)

anyway

happens

criterion

(a

that

moral

utilitarian

or

rules

must

be

consequentialist

Points

against

Euthnasia

Ethical arguments

Euthanasia weakens society's respect for the sanctity of life

Accepting euthanasia accepts that some lives (those of the disabled

or
sick)
are
worth
less
than
others

Voluntary euthanasia is the start of a slippery slope that leads to

involuntary euthanasia and the killing of people who are thought
undesirable

Euthanasia

might

not

be

in

person's

best

interests

Euthanasia affects other people's rights, not just those of the patient
Practical arguments

Proper

There's

palliative

no

way

care

of

makes

properly

euthanasia

regulating

unnecessary

euthanasia

Allowing euthanasia will lead to less good care for the terminally ill

Allowing euthanasia undermines the committment of doctors and

nurses
to
saving
lives

 Euthanasia may become a cost-effective way to treat the terminally

ill

Allowing euthanasia will discourage the search for new cures and
treatments
for
the
terminally
ill

Euthanasia undermines the motivation to provide good care for the

dying,
and
good
pain
relief

Euthanasia

gives

too

much

power

to

doctors

Euthanasia exposes vulnerable people to pressure to end their lives

Moral

Moral

pressure

pressure

on

elderly

to

free

relatives

up

by

selfish

medical

families

resources

Patients who are abandoned by their families may feel euthanasia is

the only solution
Historical arguments

Voluntary euthanasia is the start of a slippery slope that leads to

involuntary euthanasia and the killing of people who are thought
undesirable

 Religious arguments

Euthanasia

is

against

the

word

and

will

of

God.

Euthanasia weakens society's respect for the sanctity of life.

Suffering

may

have

value.

Voluntary euthanasia is the start of a slippery slope that leads to

involuntary euthanasia and the killing of people who are thought
undesirable.
Supreme Court
vegetative

disallows

friend's

plea

for

mercy

killing of
Aruna.

Unaware of her unwanted fame, the 67-year-old became India's

metaphor for the right to life. The Supreme Court in Aruna shanbaug
case allowed passive mercy killing of a patient in a permanent
vegetative state (PVS) by withdrawing the life support system with
the approval of a medical board and on the directions of the High
Court
concerned.
A Bench of Justices Markandey Katju and Gyan Sudha Misra,
however, did not accept the plea of Pinky Viranai seeking permission
to withdraw life support to her friend, Aruna Ramachandra
Shanbaug, who has been lying in a PVS in the KEM hospital Mumbai
for 37 years. Though it dismissed the petition filed by Ms. Pinky
Virani of Bombay on the ground that she did not have the locus
standi and that only the hospital could make such a request, the
Bench allowed passive euthanasia and laid down guidelines.
The Bench, however, held illegal active mercy killing of a patient
suffering acute ailment with a poisonous injection or by other
means.

Writing the judgment, Justice Katju said: There is no statutory

provision in our country as to the legal procedure for withdrawing
life support to a person in PVS or who is otherwise incompetent to
take a decision. We agree with Mr. T.R. Andhyarujina that passive
euthanasia should be permitted in our country in certain situations,
and we disagree with the learned Attorney General [G.E. Vahanvati]
that
it
should
never
be
permitted.
The Bench pointed out that in the absence of a law against sexual
harassment at work places, the Supreme Court in the Visakha case
had laid down guidelines. Similarly, we are laying down the law in
this connection which will continue to be the law until Parliament
makes a law on the subject. A decision has to be taken to
discontinue life support [to a patient in PVS] either by the parents or
the spouse or other close relatives, or in the absence of any of
them, such a decision can be taken even by a person or a body of
persons acting as a next friend. It can also be taken by the doctors
attending the patient. However, the decision should be taken bona
fide
in
the
best
interest
of
the
patient.
The Bench said: If we leave it solely to the patient's relatives or to
the doctors or the next friend to decide whether to withdraw life
support to an incompetent person, there is always a risk in our
country that this may be misused by some unscrupulous persons
who wish to inherit or otherwise grab the property of the patient.
Considering the low ethical levels prevailing in our society today and
the rampant commercialisation and corruption, we cannot rule out
the possibility that unscrupulous persons with the help of some
unscrupulous doctors may fabricate material to show that it is a
terminal
case
with
no
chance
of
recovery.
In the present case, Aruna Shanbaug's parents are dead and other
close relatives have not been interested in her ever since she had
the unfortunate assault on her. It is the KEM Hospital staff, who have
been amazingly caring for her day and night for so many long years,
who really are her next friends, and not Ms. Pinky Virani, who has
only visited her on a few occasions and written a book on her. Hence
it is for the KEM Hospital staff to take that decision. The KEM
hospital staff have clearly expressed their wish that Aruna Shanbaug

should

be

allowed

to

live.

Background:

Aruna Shanbaug is a nurse from Haldipur, Uttar Kannada, Karnataka

in India. In 1973, while working at King Edward Memorial Hospital,
Parel, Mumbai, she was sexually assaulted by Sohanlal Bhartha
Walmiki, a ward boy at the hospital. Walmiki was motivated partly
by resentment for being ordered about and castigated by Shanbaug.

On the night of 27 November 1973 he attacked her while she was

changing clothes in the hospital basement. He choked her with a dog
chain and sodomized her. The asphyxiation cut off oxygen supply to
her brain resulting in brain stem contusion injury and cervical cord
injury
apart
from
leaving
her
cortically
blind.

The initial medical examination to verify rape as the crime found

that Aruna had no vaginal bruises and her hymen was intact. She
was menstruating on the day and therefore the rapist did not
penetrate her. Subsequent medical reports proved that she bled for
days
together
from
the
anus.

The police case was registered as a case of robbery and attempted

murder on account of the concealment of anal rape by the doctors
under the instructions of the Dean of KEM, the late Dr. Deshpande
perhaps to avoid the social rejection which might break her
impending
marriage
to
Dr.
Sundeep
Sardesai.

Since the assault, she has been in a vegetative state. On 24th

January 2011, the Supreme Court of India responded to the plea for
Euthanasia filed by Aruna's friend journalist Pinki Virani, by setting
up
a
medical
panel
to
examine
her.

 Pinki Virani, the journalist first brought her story to light. Ms Virani
campaigned for a legal end to her being force fed; and she took the
case
all
the
way
to
India's
Supreme
Court.

The nurses of hospital, who successively tended to one of their own,

had a diametrically opposite opinion. They argued that Aruna
Shanbaug responded to stimulus and actually "relished" her fish
curry, albeit through tubes. Their stand was upheld in this landmark
Judgement.
Vegetative state

A vegetative state is a condition in which someone is awake, but not

aware. People usually emerge from a coma into a vegetative state as
their brains slowly recover from injury and they start to become
more alert and aware. From a vegetative state, a patient can move
into a minimally conscious state and then into a state of full
consciousness. However, sometimes patients do not recover from a
vegetative state because their brains are too badly damaged.