Ritika Pandey, a 3rd-Year Student, at Galgotias University has written the article” Right to Die: Evolution, Contradictions, and Current Scenario”
Introduction
The Right to die generally and in its literal sense can be understood as the right possessed by a person to end his own life or decide the way to die. The Right to die when interpreted in a broader sense also means that every individual has a right to die with dignity. Article 21 of the Indian Constitution[1] states that “No person shall be deprived of his life or personal liberty except according to procedure established by law.” This article assures the citizens that they can live their life with dignity and in the meanwhile puts an obligation on the State to ensure that the citizens live respectable and dignified life.
Since every person has the right to end his or her own life, an attempt to suicide shouldn’t be an offense, although it is punishable under Section 309 of the Indian Penal Code,1860[2] which states that “Whoever attempts to commit suicide and does any act towards the commission of such offense, shall be punished with simple imprisonment for a term which may extend to one year [or with fine, or with both].”
Another way of ending up one’s own life is through Euthanasia, which means ‘good death’. It derives its meaning from the Greek words ‘eu’ which means ‘good’ and ‘thanatos’ which means ‘death’. Euthanasia is generally known as mercy killing and is given to people who are suffering from an incurable disease. It is generally done by a doctor at the patient’s request. The Netherlands was the first country to legalize Euthanasia.
Types of Euthanasia
Active Euthanasia
It is also known as ‘Positive Euthanasia’ or ‘Aggressive Euthanasia’. Active Euthanasia refers to causing the intentional death of a human being by direct intervention. It alludes to directly interfering with another person’s life with the purpose to kill them. It is a direct action taken to put an end to a pointless life and existence. For example, by administering a deadly dosage of a medicine or a lethal injection. Active euthanasia is typically a quicker way to bring about death, and all forms are prohibited.
Passive Euthanasia
it is also known as ‘Negative Euthanasia’ or ‘Non-Aggressive Euthanasia’. By failing to provide basic, routine care, food, and drink, it is purposefully causing death. It suggests stopping, eliminating, or withdrawing artificial life support. In general, passive euthanasia is slower and more uncomfortable than aggressive euthanasia. Euthanasia that is done voluntarily, passively, infrequently, involuntarily, or passively, is lawful in most cases.
Voluntary Euthanasia
When the person who is killed has requested to be killed.
Non-voluntary Euthanasia
When the person who is killed made no request and gave no consent. In other words, it is done when the person is unable to communicate his wishes and is in a coma.
Involuntary Euthanasia
when the person who is killed made an expressed wish to the contrary. In other words, it is involuntary when the person killed gives his consent not to die.
The evolution of Right to die and euthanasia with landmark cases.
Maruti Shripati Dubal v. State of Maharashtra, (1986) 88 BOMLR 589[3]
The question of the right to die was raised for the first time in 1986. Respondent Maruti Dubal tried to kill himself by pouring kerosene on his body and by lighting a matchstick because of physical injury caused by an accident and mental illness. After he failed in attempting suicide, he challenged section 309 of IPC. High Court found that section 309 of IPC ultra vires articles 14 and 21. The right to die forms an inherent part of the right to life under Article 21 of the Constitution.
P. Rathinam v. Union of India, 1994 AIR 1844[4]
In this case, Section 309 of the Indian Penal Code, 1860[5], i.e., attempting to commit suicide, was challenged on the ground of being against fundamental rights. Invoking the ruling in Maruti Shripati Dubal v. the State of Maharashtra (1987), the Court determined that Section 309 of the Indian Penal Code was unconstitutional because fundamental rights can have both constructive as well as detrimental aspects. It stated that the right to life would also include the right to die.
Gian Kaur vs. the State of Punjab [6]
Gian Gaur and her husband Harbans Singh had committed the offense of abetment to suicide of their daughter-in-law.
Trail Court convicted them both under section 306 of the Indian Penal Code, 1860[7] and punished them with the rigorous imprisonment of six years with a fine amounting to Rs. 2,000 and if the appellant cannot pay the amount, then nine months’ imprisonment will be extended.
The appellant appealed to the High Court. It reiterated the judgment in the court and reduced the imprisonment from six years to three years.
The court held that Article 21 of the Indian Constitution states “Right to life and Personal Liberty” which does not include “Right to die” or “Right to kill” as it is against the nature or rule of God. No person has a right to accelerate the process of death. Hence, Section 309 of the IPC does not violate Articles 21 and 14. Therefore, it is constitutionally valid.
If we talk about the validity of Section 306, then every citizen in India may not be punished for a suicide attempt. In addition but if any person is abetting another to do suicide, then that person will be punished keeping in mind the interest of society. Thus, the decision made in P. Rathinam vs UOI was set aside and it was held that section 306 and 309 of the IPC is constitutionally valid and made both appellants held liable for abetment for suicide.
Aruna Ramachandra Shanbaug v. Union of India, (2011) 4 SCC 454[8]
A ‘friend’ of Aruna Shanbaug who had been in a Persistent Vegetative State (PVS) ever since she had been sexually assaulted in 1973 had filed a request for passive euthanasia. A medical team was appointed to review her physical and mental condition. While the court did not allow the request, it did pass orders to allow passive euthanasia.
The doctrine of Parents Patriae (The State is the parent) was invoked and it was held that upon the informed opinion of a medical board of doctors, the Supreme Court (and the High Courts) may allow passive euthanasia on a case-to-case basis.
Passive euthanasia was discussed at length in this case and was defined as the deliberate act of withdrawing medical support of the patient, to cause their death.
Common Cause v. Union of India, (2017) 10 SCC 1[9]
In this case, the petitioners, an NGO prayed for the right to die with dignity to be declared a fundamental right. It further asked the court to issue directions on the concept of “living wills”. This would allow individuals, who are of sound mind, to issue an advanced medical directive which could include the right to refuse a life support system in situations wherein they cannot be kept alive without the aid of such systems.
The judgment allows terminally ill patients to seek death with dignity by exercising their living will.
Contradictions: Religious Views
Hinduism
Hindus in India have varying opinions on euthanasia, which is evident while discussing India. According to one viewpoint, physicians who perform euthanasia should initially refuse such patient requests because doing so would cause the patient to die unnaturally by severing his soul from his body. Both the doctors and the patient’s karma will suffer as a result of this deed. Another group of people holds the opinion that euthanasia should not be practiced because it goes against the idea of ahimsa, which is based on the idea that no one should be killed. Some Hindus support euthanasia and believe that it is acceptable to end the lives of those who are suffering.
Islam
Muslims, in particular, do not support the idea of euthanasia. They hold that Allah has granted human beings with lives. Moreover, they are extremely devout, and only Allah has the authority to take someone’s life. Human intervention is not permitted in this. Christians primarily hold this belief. They typically argue that God created the cycle of birth and death and gave humans the gift of life. Hence, interfering with it would cause an imbalance in the entire world. Hence, no matter who is involved or the circumstances, it is forbidden for a human to take another person’s life.
Sikhism
The Rehat Maryada, which discusses the Sikh code of behavior, and the Guru Granth Sahib, their sacred scripture, are the main sources of the Sikhs’ thoughts. The idea of suicide and euthanasia was rejected by Sikhs also. Since they shared the same viewpoint that it interferes with God’s purposes. They think that since God has given them life, including both pleasure and suffering, they should make the most of it rather than an object.
Difference Between Euthanasia and Suicide
Suicide and euthanasia are conceptually distinct from one another. In a suicide, a man intentionally kills himself by poisoning, stabbing, or another method. Without a doubt, suicide refers to a deliberate attempt at suicide. It is an intentional act or event where someone kills themselves. This act of suicide is typically a result of depression or other personal struggles. It may include relationship difficulties, academic or career setbacks, and more. Euthanasia, on the other hand, involves someone else taking action to end the life of a third party. A third party participates in euthanasia either actively or passively, aiding or abetting the death of another.
Difference Between Euthanasia and Assisted Suicide
Assisting someone to commit suicide by providing the means is called assisted suicide. It is referred to as “physician-assisted suicide” when a doctor gives a patient a prescription for a lethal drug to help them kill themselves. As the patient commits the act of suicide, they have entire control over the steps leading to death in an aided suicide. Simply said, the other person aids (for example, by providing the means for acting). On the other hand, euthanasia can be active, like when a doctor gives a patient a lethal injection, or passive, like when a doctor turns off the patient’s life support system.
Current Scenario
The Hon’ble Supreme Court of India eases the norms for passive euthanasia. The Constitutional bench which brought the major changes was headed by Justice KM Joseph. It made the procedure to die with dignity a little less complex.
The major changes brought by the Bench are as follows:
Notary or Gazetted Officer’s Attestation Sufficient for Valid Living Will, Not Judicial Magistrate’s
As per the 2018 landmark judgment of the Supreme Court of India, it is not necessary for a living will to be attested or countersigned by a judicial magistrate. Instead, an attestation by a notary or a gazetted officer would be sufficient for a person to make a valid living will. A living will is a legal document that allows an individual to express their wishes regarding medical treatment in case they become unable to communicate their decisions due to illness or injury. This judgment made it easier for people to create and register a living will without going through the hassle of approaching a judicial magistrate.
Living Will to be included in National Health Digital Record
The Supreme Court has ruled that the living will, also known as an advance directive, will now be a part of the National Health Digital Record, which will be accessible by hospitals and doctors across the country. Living will not need district court custody; to be part of the national health digital record. This move is expected to make the process of accessing the living will easier. It is more efficient for healthcare professionals, as they will be able to access it from any part of the country. It will also ensure that the person’s end-of-life wishes are more easily accessible. Hence, can be adhered to by the medical professionals treating them.
The composition of Boards of Doctors Changed for Decision Making on Living Will Directives
The Supreme Court of India has changed the composition of the primary and secondary boards of doctors who are responsible for examining the patient’s condition and deciding whether the instructions given in the living will be carried out. Earlier, the primary board was required to have at least four experts from the fields of general medicine, cardiology, neurology, nephrology, psychiatry, or oncology, with overall standing in the profession for at least 20 years. However, now the primary board will comprise a team of three doctors. Board shall include the treating physician and two other doctors with at least five years of experience in the concerned specialty. This change is aimed at making the process more accessible and efficient for patients and their families.
Composition of Secondary Medical Board for Living Will Cases Changed
As per the recent Supreme Court ruling, if the primary medical board certifies that the treatment should be withdrawn as per the instructions contained in the living will, the hospital will immediately form a secondary medical board. The secondary board will now comprise a doctor nominated by the chief medical officer of the district concerned and two subject experts of the relevant specialty with a minimum of five years standing who were not part of the primary board. This is a change from the previous requirement where the district collector concerned had to constitute the second board of medical experts. The change aims to streamline the process of forming the secondary board and make it more efficient.[10]
The bench also questioned the Centre on the status of a new law because the 2018 judgment said that the guidelines laid down by the court shall remain in force till legislation is brought on the issue. To this the Centre replied that “it would not enact legislation on passive euthanasia, adding that the anxiety to take someone’s life must not outweigh the requirement of essential safeguards. The government said that the top court’s 2018 judgment on allowing passive euthanasia after complying with certain safeguards sufficiently occupies the field. So there is no need for a specific law on the subject matter.”
[1] India Const. art. 21
[2] Indian Penal Code,1860§ 309
[3] Maruti Shripati Dubal v. State of Maharashtra, (1986) 88 BOMLR 589
[4] P. Rathinam v. Union of India, 1994 AIR 1844
[5] Indian Penal Code,1860§ 309
[6] Gian Kaur vs. the State of Punjab 1996 AIR 946, 1996 SCC (2) 648
[7] Indian Penal Code,1860§ 306
[8] Aruna Ramachandra Shanbaug v. Union of India, (2011) 4 SCC 454
[9] Common Cause v. Union of India (2017) 10 SCC 1
[10] https://www.hindustantimes.com/india-news/sc-eases-norms-for-passive-euthanasia-101674585035342.html
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