Project on Mercy Killing

7/28/2019 Project on Mercy Killing

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AKNOLEDEGEMENT

I express my sincere thanks to my teacher Mrs.Vijeta Dua

to helping and encouraging me to do this study. Hervaluable support, guidance and suggestion really helpedme in the collection of material from various sourcesregarding this project.Ive tried my best to keep this project correct andreadable. But if any mistake is found that should beconsidered as human error.

Thank you.

(Pranjal Srivastava)


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Objective of the study:

1. To find out that what people think about Euthanasia. Are they aware of this

term?

2. To find out what important factor people consider about the Mercy Killing

whether it should be given or not.

3. To find out the perception of the people about legalizing Mercy killing in

India.

Methodology:

The study is based on the perception of the people from different Background like

Lecturers of different Management Institute, Law & Medical Practitioners, and

Engineers of NTPC Noida, Bank Officer & Home makers.

The study was accomplished in February & March 2011 within a time span of 3

weeks. This survey was done in Varanasi & Noida.

People of different background were given a Questionnaire comprising of 13

questions and they were asked to give their opinion on that.

Limitations:

No study is free from limitations, which are caused by constraints of time, money,

knowledge base and similar factors. An attempt was made to broad base the study as

far as possible, however it is but natural that this study also suffers from some

limitations which are broadly mentioned below:

1. Though People are aware of the term Mercy Killing but they knowledge in

this context is limited only to this extent only

2. It was practically impossible to cover large area in a short span of three weeks.

Hence time constraint was one of the limitations.

3. The attitude of people regarding filling the questionnaire was a limiting factor.

4. The conservative and unwilling attitude of some of the people was

a limiting factor in gaining information.


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CONTENT1-Introduction:

2-Classification of Euthanasia:

3-Foreign Prospective:

4-The Indian Perspective(Before Aruna Shanbuag case):

i)-Right to Live vs Right to Die :

ii)-An impracticable solution:iii)-Technology has come of age:

iv)-Poles Apart:

v)-Patients Rights:

vi)- Physicians Opinion:

vii)-Dutch Experience With Euthanasia:

viii)-Potential For Abuse:

ix)-The Alternative to Euthanasia:

5-Current Position in India (After Aruna Shanbaug case)

6-World map

7-Data Interpretation and Analysis:

8-Interpretation of Data:

9-Findings:

10-Recommendations:

11-Conclusion:


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1-Introduction:

A very sensitive subject indeed. Mercy killing, or allowing a person to take his own

life (or a team of doctors to do so) is a dilemma that raises ethical questions all over the world. For a world that has derived many of its laws and regulations from

religious backgrounds (Ten Commandments / The Gita / The Koran / etc..), mercy

killing is something that raises the hackles of a large section of the worlds

population. It is only permissible in some countries, and that too under strict control.

In many other countries (even one such as the United States), mercy killing has run

against a moral hard rock and many physicians have been sentenced for helping in

carrying it out. In a recent case of Terry Schiavo (Wikipedia) , the case went throughmajor conflict, with people at all levels (politicians, religious figures, family rights

groups, etc) getting involved.

The basic premise for mercy killing is simple: There are many medical conditions that

are terminal, and there is no established medical treatments that can cure the disease

or prevent death. And unlike movies, people dont dance or sing till almost just before

death, they go through horrible phases of steadily declining abilities losing control

of vital motor abilities, losing control of their mental faculties, unable to fend for themselves and being dependent on others, and a steadily increasing pain. In such

cases, there has been the logic that given that their condition is terminal (that is, they

have reached a condition where death is confirmed and they no longer have a life that

seems meaningful in any way), they should be allowed an option to end their life

when they still can command control of their life.

Euthanasia refers to the practice of ending a life in a manner which relieves pain and

suffering. According to the House of Lords Select Committee on Medical Ethics, the precise definition of euthanasia is "a deliberate intervention undertaken with the

express intention of ending a life, to relieve intractable suffering."

Euthanasia is categorized in different ways, which include voluntary, non-voluntary,

or involuntary and active or passive. Euthanasia is usually used to refer to active

euthanasia, and in this sense, euthanasia is usually considered to be criminal

homicide, but voluntary, passive euthanasia is widely non-criminal.

The controversy surrounding euthanasia centers around a two-pronged argument byopponents which characterizes euthanasia as either voluntary " suicides" , or as
http://en.wikipedia.org/wiki/Terri_Schiavohttp://en.wikipedia.org/wiki/House_of_Lordshttp://en.wikipedia.org/wiki/Select_Committee_(Westminster_System)http://en.wikipedia.org/wiki/Medical_Ethicshttp://en.wikipedia.org/wiki/Suicideshttp://en.wikipedia.org/wiki/Suicideshttp://en.wikipedia.org/wiki/Medical_Ethicshttp://en.wikipedia.org/wiki/Select_Committee_(Westminster_System)http://en.wikipedia.org/wiki/House_of_Lordshttp://en.wikipedia.org/wiki/Terri_Schiavo


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involuntary murders. (Hence, opponents argue that a broad policy of "euthanasia" is

tantamount to eugenics) . Much hinges on whether a particular death was considered

an "easy", "painless", or "happy" one, or whether it was a "wrongful death ".

Proponents typically consider a death that increased suffering to be "wrongful", while

opponents typically consider any deliberate death as "wrongful". "Euthanasia's"

original meaning introduced the idea of a "rightful death" beyond that only found

in natural deaths.

2-Classification of Euthanasia:

Euthanasia may be classified according to whether a person gives informed

consent into three types: voluntary, non-voluntary and involuntary .[5][6]

There is a debate within the medical and bioethics literature about whether or not thenon-voluntary (and by extension, involuntary) killing of patients can be regarded as

euthanasia, irrespective of intent or the patient's circumstances. In the definitions

offered by Beauchamp & Davidson and, later, by Wreen, consent on the part of the

patient was not considered to be one of their criteria .[7][8] However, others see consent

as essential. For example, in a discussion of euthanasia presented in 2003 by the

European Association of Palliative Care (EPAC) Ethics Task Force, the authors

offered the unambiguous statement:Medicalized killing of a person without the person's consent, whether nonvoluntary

(where the person in unable to consent) or involuntary (against the person's will) is

not euthanasia: it is murder. Hence, euthanasia can be voluntary only .[9]

Voluntary euthanasia

Euthanasia conducted with the consent of the patient is termed voluntary euthanasia.

Active voluntary euthanasia is legal in Belgium, Luxembourg and the Netherlands.

Passive voluntary euthanasia is legal throughout the U.S. per Cruzan v. Director,

Missouri Department of Health . When the patient brings about his or her own death

with the assistance of a physician, the term assisted suicide is often used instead.

Assisted suicide is legal in Switzerland and the U.S. states of Oregon, Washington

and Montana.

Non-voluntary euthanasia

Euthanasia conducted where the consent of the patient is unavailable is termed non-

voluntary euthanasia. Examples include child euthanasia, which is illegal worldwide
http://en.wikipedia.org/wiki/Murderhttp://en.wikipedia.org/wiki/Eugenicshttp://en.wikipedia.org/wiki/Wrongful_death_claimhttp://en.wikipedia.org/wiki/Natural_deathhttp://en.wikipedia.org/wiki/Informed_consenthttp://en.wikipedia.org/wiki/Informed_consenthttp://en.wikipedia.org/wiki/Euthanasia#cite_note-4http://en.wikipedia.org/wiki/Euthanasia#cite_note-4http://en.wikipedia.org/wiki/Euthanasia#cite_note-4http://en.wikipedia.org/wiki/Euthanasia#cite_note-BeauchampDavidson1979-6http://en.wikipedia.org/wiki/Euthanasia#cite_note-BeauchampDavidson1979-6http://en.wikipedia.org/wiki/Euthanasia#cite_note-BeauchampDavidson1979-6http://en.wikipedia.org/wiki/Euthanasia#cite_note-Materstvedt2003-8http://en.wikipedia.org/wiki/Euthanasia#cite_note-Materstvedt2003-8http://en.wikipedia.org/wiki/Euthanasia#cite_note-Materstvedt2003-8http://en.wikipedia.org/wiki/Voluntary_euthanasiahttp://en.wikipedia.org/wiki/Cruzan_v._Director,_Missouri_Department_of_Healthhttp://en.wikipedia.org/wiki/Cruzan_v._Director,_Missouri_Department_of_Healthhttp://en.wikipedia.org/wiki/Cruzan_v._Director,_Missouri_Department_of_Healthhttp://en.wikipedia.org/wiki/Cruzan_v._Director,_Missouri_Department_of_Healthhttp://en.wikipedia.org/wiki/Assisted_suicidehttp://en.wikipedia.org/wiki/Non-voluntary_euthanasiahttp://en.wikipedia.org/wiki/Non-voluntary_euthanasiahttp://en.wikipedia.org/wiki/Child_euthanasiahttp://en.wikipedia.org/wiki/Child_euthanasiahttp://en.wikipedia.org/wiki/Non-voluntary_euthanasiahttp://en.wikipedia.org/wiki/Non-voluntary_euthanasiahttp://en.wikipedia.org/wiki/Assisted_suicidehttp://en.wikipedia.org/wiki/Cruzan_v._Director,_Missouri_Department_of_Healthhttp://en.wikipedia.org/wiki/Cruzan_v._Director,_Missouri_Department_of_Healthhttp://en.wikipedia.org/wiki/Voluntary_euthanasiahttp://en.wikipedia.org/wiki/Euthanasia#cite_note-Materstvedt2003-8http://en.wikipedia.org/wiki/Euthanasia#cite_note-BeauchampDavidson1979-6http://en.wikipedia.org/wiki/Euthanasia#cite_note-BeauchampDavidson1979-6http://en.wikipedia.org/wiki/Euthanasia#cite_note-4http://en.wikipedia.org/wiki/Euthanasia#cite_note-4http://en.wikipedia.org/wiki/Informed_consenthttp://en.wikipedia.org/wiki/Informed_consenthttp://en.wikipedia.org/wiki/Natural_deathhttp://en.wikipedia.org/wiki/Wrongful_death_claimhttp://en.wikipedia.org/wiki/Eugenicshttp://en.wikipedia.org/wiki/Murder


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but decriminalised under certain specific circumstances in the Netherlands under

the Groningen Protocol.

Involuntary euthanasia

Euthanasia conducted against the will of the patient is termed involuntary euthanasia.

Procedural Decisions

Voluntary, non-voluntary and involuntary euthanasia can all be further divided into

passive or active variants.A number of authors consider these terms to be misleading

and unhelpful.

Passive euthanasia

Passive euthanasia entails the withholding of common treatments, such as antibiotics,

necessary for the continuance of life.

Active euthanasia

Active euthanasia entails the use of lethal substances or forces to kill and is the most

controversial means.

3-Foreign Prospective:

Belgium and the Netherlands are the first countries in the world that have legalized

euthanasia and assisted suicide. Since September 23, 2002, Belgian physicians can perform an act of euthanasia without at the same time performing a criminal act. In

the Netherlands, the act on euthanasia went into force already on April 1, 2002. This

special issue of Ethical Perspectives on Euthanasia in the Low Countries offers a

forum for critical dialogue on the different aspects of this new legal situation in

Belgium and the Netherlands.

First, the legal situation will be introduced. In his contribution, Herman Nys makes a

careful comparison of both laws. In spite of the fact that Belgium and the Netherlandsare the first countries in the world that legalized euthanasia, the differences between

the Belgian and Dutch law are fundamental. As Nys indicates, the scope of the Dutch

law is more specified since it explicitly includes physician-assisted suicide while it

remains unclear whether the Belgian act is also applicable in cases of assisted suicide.

There are also fundamental differences regarding the persons regulated by the law, the

health condition of the patient, the obligations of the physician with respect to the

request and the health status of the patient, and the notification procedure.
http://en.wikipedia.org/wiki/Groningen_Protocolhttp://en.wikipedia.org/wiki/Involuntary_euthanasiahttp://en.wikipedia.org/wiki/Involuntary_euthanasiahttp://en.wikipedia.org/wiki/Groningen_Protocol


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However, not only are there fundamental differences between Belgium and the

Netherlands on the level of the law. Also the public debate and the values underlying

the the debate show dissimilarities. In the Netherlands this debate took more than

twenty years and the subsequent law on euthanasia reflected an existing medical

practice. In Belgium, on the contrary, the parliament came to vote on the euthanasia

law after only half a decade of debate. In our contribution (Meulenbergs &

Schotsmans), we identify the right to autonomy understood as self - possession as the

central value in the Belgian debate. Guy Widdershoven asserts that the moral basis of

euthanasia in the Netherlands is different. He argues that the Dutch debate and by

now Dutch practice cannot be reduced to the "principlist canon of autonomy and

beneficence". Instead, the values of responsibility, deliberation and care are claimed

to be central to Dutch euthanasia practice.

In his contribution, Daniel Sulmasy offers an exhaustive analysis of the notion of

dignity that constantly arises in the debate on euthanasia. For Christian churches and

Catholic healthcare institutions, the recent legalization of euthanasia and assisted

suicide is at least challenging. Jan Jans describes the way in which the main Christian

churches in Belgium and the Netherlands engaged in the debate and reacted to the

eventual legalization. Chris Gastmans presents the view of the Flemish Association of

Catholic Healthcare Institutions.

Law-making with respect to euthanasia is one thing. Bringing the law into practice is

somewhat different. The question arises to what extent the new legal situation will

bear upon the medical practice. Particularly, the responses of physicians are difficult

to assess in advance. Physicians face the dilemma to report or not to report. They can

take up their responsibility and report their practices of euthanasia, thereby exposing

themselves to critical examination and possibly criminal prosecution. On the other

hand, the physician can opt for safety and decide not to report his involvement in one

of his patients euthanasia. In the latter case, the introduction of new legislation would

have missed the mark. To this day, the only available data with regard to physicians

reactions to an established legal framework wherein euthanasia is legalized come

from the Netherlands. In his contribution, Albert Klijn presents the reactions of Dutch

physicians to the new legal situation in their country and, particularly, the

performance of their duty to report cases of euthanasia. Since the vote on the law in

2000 and the establishment of regional review committees for termination of life onrequest and assisted suicide in 2001, the reports of euthanasia have declined. Klijn


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considers two possible explanations. On the one hand, there is insecurity about how

the newly established regional review committees will evaluate physician' reports. On

the other hand, the increased investment in research on palliative care and the

availability of palliative sedation are held responsible for the drop in reported cases.

This very interesting suggestion by Klijn needs further clarification. Therefore, the

meaning of palliative care and the possibility of palliative sedation are elaborated in

the contribution of Bert Broeckaert and Rien Janssens.

With this special issue on Euthanasia in the Low Countries we hope to have

answered the numerous requests for further information on the Belgian and Dutch

situation. Data, clarification and critical review may shed more light on the

development of a practice, which some still consider as non-medical behaviour. This

issue may therefore also function as a catalyst for further medical, ethical and legal

debate.

EUTHANASIA OR mercy killing or Physician Assisted Suicide (PAS ) is the bringing

about of the gentle death of a patient in the case of a painful, chronic and incurable

disease. Now, all these adjectives are of equal importance. A painful disease is one in

which the patient suffers unbearable and excruciating pain. A chronic disease is a long

lasting one and an incurable disease is one whose cure has not been found till date.

Netherlands was one of the first countries to legalize euthanasia followed by Canada,

state of Oregon in USA and Columbia. The state of Oregon has a Death with

Dignity law, which has been in place for almost 10 years. It has allowed terminally

ill patients to take legal, proscribed medication to end their suffering. The legalizing

of euthanasia has been a bone of contention throughout the world and will continue to

do so but no one asks a terminally ill patient the kind of pain he goes through. The

individual should have at least the right to choose a graceful death for himself. Why

should he be allowed to keep suffering day and night?

The essence of human life is to be able to live a dignified life but when some law

forces you to live in intense pain and humiliation, there is something wrong with our

society. Who are we to prolong the life of one who is suffering and has decided

without any undue pressure that he would like to be put to rest? Obviously

legalization of euthanasia should not include anyone wanting to end their life at the

flimsiest of excuses but a patient should be allowed to decide when he has suffered

enough.


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Apart from the miserable pain, that the patient goes through, the trauma and the

emotional turmoil his relatives go through is also immense. To see your close ones

suffering and going through pain is not an easy sight. You wish the laws should be

changed. After all as an individual, you decide where to marry, you decide where to

work, and at the last hurdle of your life, you should be allowed to choose how do you

want to end your life.

But this question cannot be answered so easily. The science of medicine has over the

years seen miracles taking place. As long as the patient lives, there is hope. And as

long as there is hope, anything can happen. With the new technological advancements

taking place all around the globe, we could have cures for diseases like AIDS, cancer

etc.

On the other hand, the chances of the legalization being misused are also very high.

What if the patient is in coma and is unable to make a decision, should the relatives be

allowed to make it? This is the era of family disputes over property and money.

People could also get away with cold-blooded murder. Legalising voluntary

Euthanasia would lead to involuntary euthanasia. In this society, full of greed and

corruption anything is possible.

In a country like ours, the religious aspects also have to be considered before taking

such decisions. The Bible says, Thou shalt not kill And even Islam does not allow

anyone to take away life. Is our society mature enough to understand the implications

of this? We have cases, where doctors are often beaten up if the patient was not

treated properly, what would happen to a doctor if he merely suggested Euthanasia to

the relatives? Will the relatives be able to understand the suffering of the patient?

Life is a gift, and even a life of pain is a life at least. Some people feel we don t

choose when to be born and we should not be given the right to choose when to die.

On the contrary, others feel that a life of pain is not a life but an imposition and we

should be at least allowed to end it in a dignified peaceful manner. Euthanasia could

be legalized, but the laws would have to be very stringent. Every case will have to be

carefully monitored taking into consideration the point of views of the patient, the

relatives and the doctors. But whether Indian society is mature enough to face this,

after all its a matter of life and death, is yet to be seen.


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4-The Indian Perspective(Before Aruna Shanbuag case):

In the advent of delving into what has unfurled into one of the most controversial

issues that could have tremendous ramifications on basic ethical concepts and most

importantly, the sanctity of life. The precious words of Thomas Jefferson strike achord.

"The care of human life and happiness and not their destruction is the first and only

legitimate object of good governance."

In juxtaposition, the words "Right to Die" evoke an exactly opposite sentiment. How

can it be a right if you are using it to give up your rights? The above right has been

used as a guise or a camouflage to include various concepts that are opposed to

preservation of life. Euthanasia, Physician Assisted Suicide (PAS), Suicide, thoughconceptually different, are species of the same genre.

i)-Right to Live vs Right to Die :

In India, the sanctity of life has been placed on the highest pedestal. " The right to

life" under Article 21 of the Constitution has received the widest possible

interpretation under the able hands of the judiciary and rightly so. This right is

inalienable and is inherent in us. It cannot and is not conferred upon us. This vital

point seems to elude all those who keep on clamoring for the "Right to Die".The stance taken by the judiciary in this regard is unquestionable.

In Gian Kaur vs. State of Punjab, a five judge Constitutional Bench held that the

"right to life" is inherently inconsistent with the "right to die" as is "death" with "life".

In furtherance, the right to life, which includes right to live with human dignity,

would mean the existence of such a right up to the natural end of life. It may further

include "death with dignity" but such existence should not be confused with unnatural

extinction of life curtailing natural span of life. In progression of the above, theconstitutionality of Section 309 of the I.P.C, which makes "attempt to suicide" an

offence, was upheld, overruling the judgment in P. Rathinam's case.

The factor of immense significance to be noted here is that suicide, euthanasia, mercy

killing and the like amount to unnatural ebbing of life. This decision thereby

overruling P.Rathinam's case establishes that the "Right to life" not only precludes the

"right to die" but also the right to kill."


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Interestingly in P.Rathinam's case, even when a Division bench affirmed the view

in M.S Dubal v. State of Maharashtra that the "right to life" provided by the

Constitution may be said to bring into its purview, the right not to live a forced life,

the plea that euthanasia be legalized was discarded. It was held that as euthanasia

involves the intervention of a third person, it would indirectly amount to a person

aiding or abetting the killing of another, which would be inviting Section 306 of the

I.P.C.

In Naresh Marotrao Sakhre v. Union of India, Lodha J. affirmed that "Euthanasia or

mercy killing is nothing but homicide whatever the circumstances in which it is

effected."(Emphasis added).

The above inferences lead to one irresistible conclusion i.e. any form that involvesunnatural termination of life, whether an attempt to suicide, abetment to

suicide/assisted suicide or euthanasia, is illegal. The fact that even an attempt to

suicide is punishable goes to show the extent of credibility accorded to the sanctity of

life and the right to life as a whole. This apart, the decriminalization of euthanasia is

unworkable in the Indian perspective, even on humanitarian grounds, as it involves a

third person.

Though, there has been no legislation pertaining to euthanasia in India, the term keepson coming back for public approval like a recurring decimal.

ii)-An impracticable solution:

The implication of the term "euthanasia" is itself shrouded in ambiguity. Derived

from the Greek word "euthanatos" meaning "good death". To reiterate the judicial

pronouncements in the Indian context, good or happy death would imply the ebbing

of life the natural way.

In its earlier form, it was used as an omnibus term to signify a painless death. In itsmodern context, the term is used a deliberate euphemism to reduce the culpability of

an act". an act which is a subset of murder, by injecting the term "mercy". The fact

remains" Euthanasia/ Mercy killing is about giving license for the right to kill.

Euthanasia is defined as an "intentional killing by an act/ omission of person whose

life is felt is not to be worth living." The above attribution consequentially includes

just about any one who has a suicidal impulse. Moreover the term "person" is


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inclusive of any and everybody and is not solely restricted to "patients." The

legalization of the above would result in nothing but pandemonium.

There have been views propagating the practice of passive euthanasia (letting some

one die) to be morally permissible and active euthanasia (killing someone), morallyimpermissible. It is submitted that these distinctions are irrelevant and unnecessary as

t of both acts inevitably center around a single element- an intention to kill.

The above premise has been aptly summed up by Professor James Rachels5 who

believes. The active and passive dichotomy is a distinction without a difference.

Proponents and "Right to die" groups argue that, a patient in unbearable agony and

excruciating pain or "terminally ill", the saving- grace is euthanasia on compassionate

grounds.

It is submitted that the problem here is" the term "terminally ill" has no precise

definition. For instance, Jack Kervorkian, a famous proponent of euthanasia, defined

"terminal illness" as "any disease that curtails life even for a day". Some laws define

"terminal" as one from which death will occur in a "relatively short time" or "within a

span of six months".

The nub of the point is that all these definitions scream ambiguity and medical experts

have acknowledged that it is virtually impossible to predict the life expectancy of a

particular individual.

Interestingly, euthanasia activists have dropped references to terminal illness,

replacing them with such phrases as "gentle landing", "hopelessly ill"' desperately ill"

and "meaningless life."

It is reinforced that this issue hovers around an invaluable asset called "life". Just as a

mistaken diagnosis is possible, so is a mistaken prognosis. It must be remembered that

death is final and a chance of error too great to approve the practice of euthanasia.

iii)-Technology has come of age:

On the flip side of the coin, an undeniable transition is evidenced in the augmentation

of medicine and technology. What was excessive in medicine fifty years ago may be

ordinary and routine today. The idea here is that what is excessively burdensome and

offers little hope for one may be less burdensome and more hopeful for a second

patient in a different state of health.


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A startling revelation...... Research has shown that ninety-percent of the pain can be

alleviated by proper pain control methods. Appropriate care can make a huge

difference. This goes to show that medicine and technological breakthroughs have a

fitting reply to almost every problem and the extent of medical commitment is

unassailable.

In contradistinction, if every terminal patient were prodded to a "gentle landing",

impetus to research, which is the answer to curative medicine, would be foiled. If

legalized, doctors would be forced to perform such acts against their consent that

would amount to a violation of the Hippocratic Oath. Incidentally, it was as early as

400 B.C., when the renowned Greek physician stipulated in his Oath ........" I will give

no deadly medicine to anyone if asked, nor suggest any such course."

The fact remains that the practice of euthanasia has been ostracized since time

immemorial and Oregon, Belgium and The Netherlands are the only jurisdictions in

the world where laws specifically permit euthanasia or assisted suicide.

It may be pertinent to mention that the most vital point is the repercussions that could

take place once something as controversial is legalized. The matter is not an issue of

force but an issue of the way laws can be expanded once something is declared

legal. In India, where abuse of the law is the rule rather than the exception and where

conniving relatives clamor to lap up an heirloom, the abovementioned argument holds

great weight age.

To elucidate, in England, the House of Lords in Airedale NHS Trust v.

Bland permitted non-voluntary euthanasia in case of patients in a persistent vegetative

state. Subsequently, the Supreme Court of Ireland in Re A Ward of Court expanded

the persistent vegetative state to include cases where the patient possessed limited

cognitive faculties.

In Netherlands, the Supreme Court in a 1984 ruling held that euthanasia could be

lawful only in cases of physical illness. However, a decade down the line, the

Supreme Court in Chabot's case held that it could even extend to cases of mental

illness.

Thus, there is evidenced a conceptual degradation of the right to live with dignity.

The sole qualitative argument in favor of euthanasia, is the fact that if procedures are

stringent and foolproof and with proper mechanisms in place, then the legalization of the same could be effected in India. For instance, in The Netherlands the request for


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euthanasia should come only from the patient and be free, voluntary, and persistent; it

should be the last resort and should be performed by a physician in consultation with

an independent physician colleague who has experience in the field.

iv)-Poles Apart: It is humbly submitted that the implementation of the above mechanism in India is

utopian and thus the two situations incomparable. It is ironical to note that ninety

percent of the patients succumb to death without receiving any primary health

care. Thus the logical derivation of this aspect would be that India does not have an

appropriate health-care mechanism in place, let alone foolproof procedures for

euthanasia.

In the presence of the above bottlenecks and policing rampant in our country, theappropriate course of action would be to develop proper "care ethics", ensuring a

"dignified existence and termination" of life. Let us augment the above and

resultantly, the concept of euthanasia will be nothing but a distant reality.

v)-Patients Rights:

It is often overlooked that patients have the common law right to refuse any medical

treatment. A doctor who treats a patient against his or her express wishes can be

charged with assault. It would be wise to educate people as to their right to refusetreatment. There is no need to convert this well established legal principle into

legislation.

Regardless of the intention of "right to die" or "aid in dying" laws, they could very

easily open the door to active euthanasia.

In the present climate of opinion, it is easy to imagine a doctor giving a lethal dose of

pain-killing drug and then claiming that death was the best way to eliminate physical

suffering. If the doctor could also show that the patient had requested the lethal

dosage, the court might well interpret the law in the doctor's favor.

Many do not find the prospect of legal voluntary active euthanasia in any way

alarming. But two things should give us pause.

First, as a soon-to-be-published Canadian study will show, most health care

professionals who work with the dying endorse the patient's right to refuse medical

treatment, but oppose legalizing active euthanasia. The professionals recognize that if

pain is controlled, as it can be in virtually all cases, very few terminally ill people ask


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to be put to death. Second, experience in Holland tells us that voluntary Euthanasia

can quickly become involuntary euthanasia.

vi)- Physicians Opinion :

The world medical community considers both euthanasia and assisted suicide to be inconflict with basic ethical principles of medical practice. The World Medical

Association, with members representing medical associations (including the

American Medical Association) from eighty-two countries, has adopted strong

resolutions condemning both practices and urging all national medical associations

and physicians to refrain from participating in them even if national law allows or

decriminalizes the practices.

Euthanasia, that is the act of deliberately ending the life of a patient, even at the patients own request or at the request of close relatives, is unethical. This does not

prevent the physician from respecting the desire of a patient to allow the natural

process of death to follow its course in the terminal phase of sickness.

Physician-assisted suicide, like euthanasia is unethical and must be condemned by

the medical profession. Where the assistance of the physician is intentionally and

deliberately directed at enabling an individual to end his or her own life, the physician

acts unethically. However, the right to decline medical treatment is a basic right of the patient and the physician does not act unethically even if respecting such a wish

results in the death of the patient.

Furthermore, in deciding an assisted-suicide case, the European Court of Human

Rights found that its prohib ition on the use of lethal force or other conduct that might

lead to the death of a human being did not confer any claim on an individual to

require a State to permit or facilitate his or her death. (4) The European Court judges

described the prohibition as a measure intended to protect the weak and thevulnerable.

In spite of the nearly universal rejection of assisted suicide and euthanasia because

they are outside of the bounds of legitimate medical practice, several jurisdictions, in

addition to the state of Oregon, have or did permit either or both euthanasia and

assisted suicide in recent years.

A survey in the United States of more than 10,000 physicians came to the result that

approximately 16% of physicians would ever consider halting life-sustaining therapy
http://www.patientsrightscouncil.org/site/rpt2005-part3/#4http://www.patientsrightscouncil.org/site/rpt2005-part3/#4


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because the family demands it, even if believed that it was premature. Approximately

55% would not, and for the remaining 29%, it would depend on circumstances.

This study also stated that approx. 46% of physicians agree that physician-assisted

suicide should be allowed in some cases; 41% do not, and the remaining 14% think itdepends.

vii)-Dutch Experience With Euthanasia:

Holland is widely regarded as one of the world's most civilized countries. Active

euthanasia is legal there, but for the past decade the government has not prosecuted

doctors who report having assisted their patients to commit suicide.

A recent Dutch government investigation of euthanasia has come up with some

disturbing findings. In 1990, 1,030 Dutch patients were killed WITHOUT THEIR

CONSENT. And of 22,500 deaths due to withdrawal of life support, 63% (14,175

patients) were denied medical treatment WITHOUT THEIR CONSENT. Twelve per-

cent (1,701 patients) were mentally competent but were NOT CONSULTED.

These findings were widely publicized before the November 1991 referendum in

Washington State, and contributed to the defeat of the proposition to legalize lethal

injections and assisted suicide.

The Dutch experience seems to demonstrate that the "right to die" can soon turn into

an obligation. This concept is dangerous, and you could find yourself the victim if

Euthanasia becomes legal in North America.

We have all heard and some of us have experienced, moving stories of elderly people

in great pain, unable to perform even the most basic human functions, who have asked

to die, or have perhaps brought about their own deaths.

What these stories overlook is that today, in almost all cases, it is possible to kill pain

without killing the patient. When someone's pain is relieved that person usually wants

to go on living. We need to reflect carefully on the consequences of legalizing active

euthanasia. If we enshrine the absolute right to die, will it then become illegal to

intervene to obstruct would-be suicide? Will pharmacists be obligated to sell a lethal

dose of hemlock to anyone who is temporarily depressed?

viii)-Potential For Abuse:

We need to think of the potential for abuse if mercy killing becomes legal. What if

someone stands to inherit one million dollars when Aunt Gladys dies? Might the heir


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not find it tempting to nudge her in the direction of accepting a lethal injection? Or, if

she didn't get the hint, to make her miserable enough to want it?

If voluntary euthanasia is made legal for "persons of sound mind" there will

inevitably be tremendous pressure to provide it for those who "would request it if they were able to" - the mentally ill or handicapped, the senile, etc.

Finally, despite genuine compassion for the suffering of dying people, does there not

also lurk in many hearts a less admirable motive? Few people are so tasteless as to

link euthanasia and health care costs in the same breath, but there is a widespread few

that medical care for the elderly costs more than we can afford. These financial

pressures will multiply in the coming years as our population ages.

Many elderly people are already responding to this not-so-subtle message bydeclaring their willingness to die when their lives are no longer productive. Their

reluctance to be a financial burden on the young is admirable, but the long term

consequences could be brutal.

What will happen to the trust that people still feel toward their doctors if our country

follows Holland? What emotion will elderly or seriously ill patients feel when the

nurse approaches them with a full syringe? How soundly will they sleep in the

hospital?

ix)-The Alternative to Euthanasia:

The alternative to legalized euthanasia is not extraordinary, futile treatment to

hopelessly dying patients. The alternatives are appropriate medical care - including

1) The withdrawal of treatment upon patient request, or if that treatment serves no

therapeutic purpose; and

2) Dispensing drugs as necessary to control pain. No doctors, laws, or organizations

oppose ceasing care when the time to die has arrived.


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5-Current Position in India (After Aruna Shanbaug case)

SC allows passive euthanasia, rejects Aruna's plea In a path-breaking

judgement, the Supreme Court allowed "passive euthanasia" of withdrawing life

support to patients in permanently vegetative state (PVS) but rejected outrightactive euthanasia of ending life through administration of lethal substances.

Refusing mercy killing of Aruna Shanbaug, lying in a vegetative state for 37 years in

a Mumbai hospital, a two- judge bench of justices Markandeya Katju and Gyan Sudha

Mishra, laid a set of tough guidelines under which passive euthanasia can be legalised

through high court monitored mechanism.

The apex court while framing the guidelines for passive euthanasia asserted that it

would now become the law of the land until Parliament enacts a suitable legislation todeal with the issue.

The bench also asked Parliament to delete Section 309 IPC (attempt to suicide) as it

has become "anachronistic though it has become Constitutionally valid."

"A person attempts suicide in a depression, and hence he needs help, rather than

punishment," Justice Katju writing the judgement said.

The apex court said though there is no statutory provision for withdrawing life

support system from a person in permanently vegetative state, it was of the view that"passive euthanasia" could be permissible in certain cases for which it laid down

guidelines and cast the responsibility on high courts to take decisions on pleas for

mercy killings.

"We agree with senior counsel T R Andhyarujina (who assisted the court in the

matter) that passive euthanasia should be permitted in our country in certain

situations, and we disagree with Attorney General (G E Vahanvati) that it should

never be permitted," said the bench of justices Markandey Katju and Gyan SudhaMishra dismissed the plea filed on behalf of KEM hospital nurse Aruna Ramachandra

Shanbaug, saying that while active euthanasia (mercy killing) was illegal, yet "passive

euthanasia" can be permissible in exceptional circumstances.

While dismissing writer Pinky Virani's plea for subjecting to mercy killing of the

KEM Hospital nurse who was sexually assaulted by a ward boy, the apex court cast

the responsibility of taking a call on passive euthanasia on high courts, if the plea is

made by close relatives or friends who have strongly opposed such a step.


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The bench, in its 141-page ruling, said in the case of Aruna, the plea for her mercy

killing could be permitted if the Mumbai King Edward Hospital makes it to the

Bombay High Court on her behalf and the high court accepts it.

"A decision has to be taken to discontinue life support either by the parents or thespouse 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 added.

"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," and should be approved

by the high court, it said.

In the case of nurse Aruna "it is for the KEM hospital staff to take that decision," and

not writer Pinky Virani, the bench said , adding that "the hospital staff 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."

"Hence it is for the KEM hospital staff to take that decision. And the KEM hospital

staff have clearly expressed their wish that Aruna Shanbaug should be allowed to

live," the bench said, rejecting the plea for Aruna's mercy killing at present.

"Assuming that the KEM hospital staff at some future time changes its mind, in our

opinion in such a situation the KEM hospital would have to apply to the Bombay

High Court for approval of the decision to withdraw life support," the bench said.

Laying down the law on the issue, the bench added that "even if a decision is taken by

the near relatives or doctors or next friend to withdraw life support, such a decision

requires approval from the high court concerned."

"In our opinion, this is even more necessary in our country as we cannot rule out the

possibility of mischief being done by relatives or others for inheriting the property of

the patient," it said.

"In our opinion, if we leave it solely to the patient's relatives or to the doctors or next

friend to decide whether to withdraw the life support of 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," it said.

The bench held that it's only the high court which has the power under the Article 226

of the Constitution to decide the plea for mercy killings.

"In our opinion, Article 226 gives abundant power to the high court to pass suitable

orders on the application filed by the near relatives or next friend or the doctors or


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hospital staff praying for permission to withdraw the life support to an incompetent

person like Aruna," the bench said.

While holding high courts to be constitutionally empowered to take calls on pleas for

euthanasia, the bench also laid down a detailed procedure for them on how to dealwith such pleas.

It said the chief justices of the high courts, on receipt of an euthanasia plea, would

forthwith constitute a bench to decide it.

The bench in turn would appoint a committee of at least three renowned doctors to

advise them on the matter.

The bench said the high court should also seek the stands of various stakeholders to

the plea including the relatives, next friends state etc to examine it and decide thematter as expeditiously as possible.

"The high court should give its decision speedily at the earliest, since delay in the

matter may result in causing great mental agony to the relatives and persons close to

the patient," the bench said, adding that the decision should be given with "specific

reasons in accordance with the principle of 'best interest of the patient' laid down by

the House of Lords in Airedale's case."


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6-World map where either form of Euthansia is Legal (after 7/03/2011)


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7-Data Interpretation and Analysis:

QUES.1 ARE YOU AWARE OF THE TERM ETHUANASIA/MERCYKILLING?

YES NO

100% -

QUES2. ARE YOU AWARE OF BOTH KINDS OF ETHUANASIA/MERCYKILLING?

YES NO

45% 55%

QUES.3 DO YOU KNOW THAT EUTHANASIA IS LEGAL IN VERY FEWCOUNTRIES?

YES NO

70% 30%

QUES.4 ARE YOU AWARE OF THE LEGAL STATUS OF ETHUNASIA ININDIA?

YES NO CANT SAY

55% 42.5% 2.5%

QUES.5 ARE YOU AWARE OF THE FUNDAMENTAL RIGHT Right to L ive

YES NO

92.5% 7.5%


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QUES.6 DO YOU THINK Right to L ive also confers Right to D ie

YES NO

25% 75%

QUES.7 ARE YOU AWARE OF THE CASE OF ARUNASHANBAUGRECENTLY DECIDED BY SUPREME COURT OF INDIA?

YES NO

75% 25%

QUES.8 ARE YOU AWARE THAT AFTER THIS VERDICT, INDIA IS ALSOIN THE LIST OF COUNTRIES, WHERE EITHER FORM (ACTIVE OR PASSIVE) OF ETHANASIA IS LEGAL?

YES NO CANT SAY

47.5% 50% 2.5%

QUES.9 IS LEGALIZING ETHANASIA, IN INDIA RIGHT DECISION INYOUR OPINION?

YES NO CANT SAY

57.5% 37.5% 5%

QUES.10 DO YOU THINK ETHANASIA IS GOOD FOR SUFFERERS ASWELL AS FOR THEIR FAMILY?

YES NO GOOD FOR SUFFERERS

60% 32.5% 7.5%

QUES.11 DO YOU THINK ETHANASIA COULD BE MISUSED?

YES NO CANT SAY

75% 10% 15%


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QUES.12 DO YOU THINK, IS THERE ANY OTHER ALTERNATIVE OFETHANASIA?

YES NO CANT SAY 17.5% 60% 22.5%

8-Interpretation of Data:

From the analysis of the above mentioned data and the question asked to comment on

the Ethanasia of the present study says that all the people who have filled the

questonnaire are aware of the term mercy killing but they dont know about its

kind.People know that Ethanasia is legal in few countries but not in India.People are

aware about their right to live at the same time they know that their right to live

doesnt give them option right to die as well .Majority of the them have heard about

the Aruna Shaunbaug and the decision made by the court in her case.Most of the

people believe that legalizing Ethanasia in India was a right decision because it is

good for sufferer to get rid of their pain but at the same time they are also of the

opinion that Ethanasia could be misused because there is no other alternative available

for this .

9-Findings:

Finding of the above study says that:

Euthanasia is not a new term for Indians.

It was not a legal practice in India before the verdict given by Supreme Court

of India in Aruna Shanbaug case. After this case people who are dead by their brain can be given Mercy killing.

Mercy Killing is considered good for sufferer because it will help them to get

rid of their pain.

Euthanasia can be misused badly.

People are of the opinion that it should be practiced very vigilantly so that it

cannot be misused by the people.


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10-Recommendations:

From the inferences drawn from the above Data Interpretation & Analysis it is quite

clear that people are aware of the term Euthanasia as well as its legal status in India

.People think that as there is lack of any other alternative of Euthanasia it should beused to help the sufferer to get rid of their pain & suffering adversely .But as

everything has two aspect good and bad it has also the same good one will help the

people to get rid of their suffering but bad will lead to it misusage so people are of the

opinion that it should be used but proper enquiry and due care should be taken by the

Doctors before practicing it actually.


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11-Conclusion:

However, aside from the moral and ethical problems that this issue comes up with,

there are many other problems that arise when such a discussion comes up:

- There are a host of new treatments that are arising as we experiment more withgenes and new areas such as stem cell technology, so is it right to assume that a

condition that is treated as terminal now could not become one where a treatment is

possible in a few years

- Who decides whether the condition is terminal ? If it is a team of doctors, who do

you trust? How do you prevent misuse, especially when we have seen so many new

cases whereby elderly people are dumped because of the effort of taking care of them

- Will this become a poor vs. rich thing ? Suppose that a very expensive treatment is

available abroad, and a poor person cannot afford to get this done for the terminal

condition?

- How will the actual logistics of carrying out the termination of a medically

terminally affected patient be carried out?

- In a country where there are many more needy people than hospital beds, would this

become a misused thing ?

What do you people think ? Is India ready for something like mercy killing ?

I agree that we need to do this, subject to some stringent checks and balances.

Many people support the right of a terminally ill patient to die - but what if the right

becomes an obligation??? And what of the potential for abuse by impatient heirs???

Should dying patients have the right to order their doctors not to start or continue

medical treatment? Should doctors be protected from prosecution if they shorten a

patient's life expectancy with pain-killing drugs?

Most of us would answer yes to both questions. But does this mean we need a "rightto die" law? Or is there more to the issue than first meets the eye?

Public discussion of the treatment of dying patients often confuses two separate

issues. First, is the right of the terminally ill person to be allowed to die without being

subjected to invasive medical procedures? Second, is the question of whether a dying

person should also have the right to hasten his or her own death, and require the help

of doctors and nurses to do so.

.

Project on Mercy Killing

Documents

Transcript of Project on Mercy Killing