Euthanasia also referred to as mercy killing, is a situation whereby an individual who is critically ill and is suffering is put to death. The word euthanasia comes from the Greek language meaning good death. A euthanasia patient may be suffering from an incurable disease or may be going through an amount of pain that makes a living harder than being already sick. It may be a request from the patient, the patient’s relatives, or even a suggestion by the doctor. This practice is usually done by withholding treatments or any artificial life-support machine. Since there is no particular provision that has been laid out in most countries, mercy killing is often considered suicide if performed by the patient himself or murder if carried out by another person.
Mercy killing may be performed in various ways, from active whereby something is introduced to cause the death-like, for example, the attending physician administers a fatal dose of medicine to passive euthanasia whereby a patient is left out to die. However, active mercy killing is not considered legal and can be regarded as murder once caught doing it. Requests for mercy killing has brought about debates about the practice. The debates have cut across a wide range of issues such as spiritual, ethical, legal, social, religious, and many others.
We will argue about this issue from both the supporters and the opponents’ perspectives. The main objective, however, will be to discuss the issue from human rights and medical perspectives. In India, both active and passive euthanasia are considered offenses. The constitutional validity of the Indian Penal Code Section (IPC Sec) 309 was challenged in the Supreme Court in the year 1994. The constitution declared it inhuman, therefore invalid under Article 21 (Right to life) of the constitution in a judgment that was landmark. Later on, in the year 1996, an similar case was presented to the supreme court whereby the accused were convicted in the trial court and later it was upheld by the High Court. The convicted then appealed to the supreme court and they contended that ‘right to die’ should be included in Article 21vof the constitution and any person acting on the request of suicide from another person (a suffering patient to be precise) is merely giving out a hand to the enforcement of the law. This made the Supreme Court to reconsider the decision of right to die and immediately the case was handled out to a Constitution Bench of the Indian Supreme Court.
The Supreme Court reconsidered its decision on suicide. One’s involvement to suicide (IPC Sec 306) and the attempt to suicide (IPC Sec 309) are two distinct crimes and both sections were independent thus each could survive on its own. It also continued and stated that a person chooses to commit suicide out of depression and hence he needs help rather than punishment. Therefore, the Supreme Court laid it out to parliament to consider the feasibility of deleting Section 309 from the penal code.
Supporters of ‘right to die’ have argued that it is better for the terminally ill to die in dignity. They further defend their petition saying that most of the heavy part falls on the shoulders of family members and care givers. These burdens cut across domains such as time, financial, emotional, mental and even physical. Hence it is not shocking to hear family members of the terminally ill asking for poison.
If a patient may be having an illness that requires a medical specialist around the clock, this could become a very tight situation since the patient will have to stay in the hospital for as long as he is alive. This puts hospital beds and resources in very tight situations because that patient is not the only one requiring medical attention. There are others who might be having illnesses that may for instance require just a couple of days in the hospital. If the terminally ill do not want to live, then they should not be allowed to use up the resources of those that do. Long term care for those with incurable diseases is also a wasteful drain on resources. Why throw away opportunities for people who can get well and get back to living their lives? To top that up, these resources could be used to further research of the incurable diseases in order to give the future generation to either not have the illness or to improve the care for future patients.
A person who is terminally ill, take for example a disease caused by a virus may be a threat to the society if not handled with proper care. There is risk of the disease spreading to others which may be catastrophic especially if the disease does not have a vaccine or cure. The longer the duration the individual may be kept alive, it may increase the risk of others getting infected. It is therefore wise to choose to end the life of that person to save those of many others especially if the disease kills within a short period of time.
Right to refuse medical treatment is also recognized by the law. Some patients may feel that being alive and around their loved ones in a situation where they would only be a burden would make them feel ashamed. Therefore some think that it is best if they just died and let their relatives live in peace than watch them every day suffer. A patient may also find it easy to not suffer every day. If such laws exist, then a way is paved out for euthanasia. Some family members also report that it is a wise decision by the diseased and that it should be respected. On the bright side, euthanasia has promoted ‘right to life’ since transplants to patients suffering from organ failure is now possible. This has proved helpful since many people have benefited from the practice. The constitution therefore upholds this since promoting the right ‘right to life’
The opponents, however, brought forth their argument that if society was to embrace mercy killing with dignity, victims of incurable and debilitating illness will be eliminated or disposed of from the society. The practice of palliative care would give relief from distressing symptoms and pain and support to the patient as well as the care giver. Palliative care is full devotion to caring for the dying. They then furthered their argument saying that ‘right to life’ is a natural right embodied in Article 21 but suicide is an unnatural termination or extinction of life and thus it is incompatible with the concept of ‘right to life’. It is therefore the duty of the country to protect the life of its citizens and also the obligation of a physician to make sure that the life of his/her patient is out of risk at all cost. If mercy killing was to be legalized then there would be grave danger since the state would now reduce the provision of funds which are to be allocated to health care facilities.
Life is not always stable, there are times when one hits rock bottom and it must continue. It not wise to choose death just because a doctor has said one will suffer since the illness does not have a cure. Suffering is part of life and everyone goes through it one way or another. Medication can also be engineered in a way that one does not suffer the way the medical experts lay it out for patients. If a person was in sedation on drugs like morphine and the person had the ability to talk then a dumb person would say ‘I wish I could be like that person’. Similarly, if another was still in sedation but could use his sight then a blind person would wish to be that person. We all suffer in different ways and it is always important to consider what we have and its value before making a life changing decision.
If euthanasia is allowed in some cases, people whose treatment may be costing relatives a fortune may feel that they are crossing the line and get compelled to opt for mercy killing. Many people would feel not worth all the cost incurred in keeping them alive. This feeling is very painful and it is not what any of us would want to feel as in essence if someone feels it, it takes away his freedom to deciding what that is good for him on a certain matter.
There would also be an increase in the number of deaths of those who are terminally ill since relatives and health care specialists would have it in mind that when a critical situation arises there is a solution that involves using less money and effort and since everyone must die at some point, they will take advantage of the practice. Also, the society would neglect the responsibility to take care of the old and sick as expected since there is no way a person will pay for bill to the foster care and hospitals just to keep a dying patient alive when the euthanasia option is legal. Countries like Holland for example have experienced severe decline in the quality of care for terminally-ill patients due to legalization of the practice. The question is, why should mercy killing be an option in a welfare state?
Analysts have reported that not all deaths caused by carrying out euthanasia are always right. If a patient suffers from depression, schizophrenia and also side effects from substance abuse, he will be convinced in his mind that death is the only solution. All of us have seen drunkards sleeping along the roads, walking at the middle of the road and all kinds of mindless actions a normal person would never think of so how is wanting to die out of a few doses of drugs from a health care specialist any different? Some of the problems patients may be suffering from can be fixed by a number of visits to the psychologist and also out of the patients own will. Confrontations by relatives and closest individuals of the patients may also contribute to the patient changing his decision. Therefore, it is essential to determine the mental status of the person asking for euthanasia.
In the reign of euthanasia, there would be a high possibility of relatives taking advantage of the situation in order to inherit the property of the patient especially the ones who find sweating out their muscles hard. ‘Mercy killing’ should not lead to ‘Killing mercy’. This is an issue that has to be carefully considered. The Supreme Court has also raised this issue in the recent judgement since when left unsupervised, people ma mess very badly especially doctors since most of the patients who undergo this practice go through their hands. Therefore, to keep order and control over medical specialists, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, goes through euthanasia clearly in Chapter 6, Section 6.7 and it is in accordance with the provisions of the Transplantation of Human Organ Act, 1994. There is a need to protect the lives which can be pulled back to the right track and also the medical practitioners fighting for a patient’s right, the right to life.
Getting rid of a patient because of fear of contracting the disease should not be a legitimate reason. What would hospitals be for? Are they not the institutions that should research about dangerous diseases and explore on their symptoms and every series of ways they can occur? What if a victim die today and another contacts the same disease but in a different way? We would be trying to find a cure for a disease we once got close to treat. What if the patient we killed eventually got cured? We would be saving resources for another battle not forgetting that the healed patients would be busy starting a new life. Patients who are in comas have an equal right just like any other normal person to continue breathing if they have not indicated that they want to die. Who are we to decide when convenient it is to kill someone? Every individual has the right to make their decision.
As mentioned earlier, passive euthanasia occurs in majority of the health care centers across the country. This happens when poor patients and their families withdraw or refuse treatment because of the huge bills awaiting for them every now and then if they have to be alive. If mercy killing is made legal, then health centers would declare death sentences to very many disabled people. This has been well highlighted in the Supreme Court. All that most patients want is palliative and rehabilitative care. They want attention and it is not wrong for one to want to be noticed and taken care of since at the end of the day, we are all human and everybody wants to be loved. Every effort should be made so that right to life becomes a reality.
If the states would take reasonable degrees in terms of monitoring and catering for patients then euthanasia supporters would reconsider their argument. All government movements and strict laws that have been enacted to ensure mercy killing doesn’t become legal are being praised since our system and the society at large is not yet ready for it. The issue however, need to be re-examined again after some years depending upon the evolution of the society with regard to caring for the elderly, poor and sick.