Dying Wish

The Telegraph, July 24, 2014, by Dr. Arunabha Sengupta

The acquittal of the former doctor, Nicolas Bonnemaison, by a court in the French town of Pau recently garnered great media attention. He was accused of having murdered seven terminally ill patients by giving them lethal injections. The jury, presumably made up of local people, dodged every uncomfortable question and concluded that Bonnemaison’s homicidal intent had not been established. Perhaps this revealed the veiled support in Catholic communities such as that in Pau for hastening death to end suffering.

Such popular support has enabled the Netherlands, Belgium, Luxembourg and a handful of states in the United States of America to grant their citizens the ‘right to die’ through euthanasia. But the matter remains disputed elsewhere in the world. Recently, a higher European court of law refused to let France take a quadriplegic man off life support. But there is a discernible mood globally to end this dispute: Five out of nine justices in the UK’s highest court concluded that the court had the “constitutional authority” to declare that a general prohibition on assisted suicide was “incompatible” with human rights. Moreover, a five-judge bench of the Supreme Court in India was constituted to re-examine every aspect of euthanasia.

The argument that the right to live with dignity also includes the right to die with dignity clashes with the contention that only God can take what he has given. An ordinary Indian citizen wanting to make an informed decision wonders who will benefit from the right to euthanasia. Advanced medicine now allows even the critically ill to live longer. Hastening death can be merciful when the illness is very painful and there is no hope of survival. It can even be helpful for people such as Aruna Shanbaug, who have to languish in a permanent vegetative state even though death is not imminent. In March 2011, the apex court rejected an appeal to passively euthanize Shanbaug, but ruled that passive euthanasia in such cases would be legally permissible till the government passed appropriate laws. (It has since said its 2011 verdict of allowing passive euthanasia was delivered on a “wrong premise”.)

Such legal sanction permits passive euthanasia, which involves a gradual withdrawal of treatment, instead of actively administering a lethal drug. The latter is also called physician-assisted suicide, and would be treated as murder by the courts, even though it is argued that a quick, painless death by a lethal injection is more humane than a slow death from starvation and dehydration. The death must also be initiated or consented to by the patient or his close relatives (or by the court acting as parens patriae), approved by a high court and a medical committee, and should never be conducted without the express wish of the patient.

The idea of mercy killing is not new. But can a State, the public policy of which involves the preservation of life, grant its citizens the right to commit suicide? England decriminalized suicide in 1961; it is debating on ‘assisted suicide’. In India, suicide and passive euthanasia remain illegal. With the law commission recommending the annulment of Section 309 of the Indian Penal Code and setting procedural guidelines for passive euthanasia, there might be a change in the offing if the government cooperates.

There are valid concerns about the power that such a ‘right’ would give to greedy relatives, shady doctors and large hospitals that want to hush up cases of negligence. Doctors may be obligated to give patients and families the option of a quick death in place of palliative care in terminal cases. With ‘suicide clinics’ and doctors of death springing up, aged or sick people may wonder why they should wait for death. The ‘beneficiaries’ of the ‘right’ to die might gradually begin to include Alzheimer’s patients, sick children, the deformed and the deranged, and even the depressed, as is happening in Holland and Belgium. One hopes that Indian society is resilient enough to avoid falling down a slippery slope.