Euthanasia: A painless killing of a person who is suffering from an incurable disease, senility, or permanent damage to the brain, which cannot be repaired or cured.

5.1: Types of Euthanasia

• Active euthanasia (Positive euthanasia) — an Act of Commission. Death is induced by direct/indirect action.

• Passive euthanasia (Negative euthanasia) — an Act of Omission. Here there is no active intervention to end the life.

  • No specific medicine is given or life-supporting measures are provided.

  • It is refraining from action that would probably delay the death and permit natural death to occur

• Voluntary euthanasia — is induced at the will of an individual by his or her request.

• Involuntary/ non-voluntary euthanasia — is induced in persons who are unable to express their wishes.

5.2: Euthanasia and its Ethical Aspects

• Medical ethics always emphasized the need for the preservation of life. It has rejected the act of taking away life.

• Hippocratic oath says: “...neither I will administer a poison to anybody when asked for to do so, nor will I suggest such a course...”. All ethical codes reject euthanasia.

• The prime responsibility of the medical professional is to relieve human suffering.

  • The physician must treat, heal and offer an acceptable quality of life to an ailing patient.

• It is the relief of suffering by all means available to him. When the endpoint is reached, death by nature or via the medium of voluntary euthanasia is immaterial.

  • A physician need not hesitate or feel guilty to practice this, as the final remedy is for the patient or the relatives.

  • Accepting the patient’s choice— euthanasia can certainly be considered the most intelligent and diligent time-honored ethics in irremediable conditions or diseases.

• A physician respecting the existing practice of medical ethics, such as the patient’s right to refuse any treatment offered; or at times using doses of painkiller drugs, which may shorten the life— a physician is not transgressing any ethical bounds.

• A doctor, acting in good conscience, is ethically justified in assisting death which, relieves intense and unnecessary pain or distress caused by an incurable illness, greatly outweighs the benefit to the patient than further prolonging life.

5.3: Requirements of Euthanasia

• The patient must be suffering from unbearable pain.

• The patient’s condition must be terminal, with no hope of recovery.

• Euthanasia must be undertaken to relieve suffering.

• It can only be undertaken at the expressed request of the patient.

• A qualified physician must carry out the procedure.

• The method adopted must be ethically acceptable.

Role of the Physician

• The role of the physician in voluntary euthanasia is not only desirable but also almost imperative, as he can only make several vital decisions.

• The involvement of a qualified physician is a must to assess several aspects of euthanasia such as The request by a competent patient, ensuring that the request is voluntary, the incurability of the condition from which the patient is suffering, presence of caring at the time of death and swift painless death.

5.4: Voluntary Euthanasia — Indian Doctors’ Viewpoint

• Extracts from a sample survey of 200 doctors, carried out by the Society for the Right to Die with Dignity in Mumbai, do offer some signs. Accordingly:

  • 90% stated they had the topic in their mind and were concerned.

  • 78% argued that patients should have the right to choose in case of a terminal illness.

  • 74% believed that artificial life supports should not be extended when death is imminent, but only 65% stated that they would withdraw life support.

  • 41% argued that living will be respected.

  • 31% had reservations.

  • Considerations involved ethics, morality, law, and religion in that order of importance.

  • More than 70% were apprehensive of the abuse of the law if one was enacted to legalize voluntary euthanasia.

5.5: Voluntary Euthanasia and Indian Society

• All sections of society must be vitally involved as the issues transcend any philosophical, moral, legal, or theological considerations. It is an issue of humanism and compassion.

• Society will need to change its value systems in the context of the changing medical scenario, socioeconomic environment, the increasing cost of medical services, and their cost-effectiveness.

• Using knowledge and new power intelligently is better than just adhering to the dogmas and beliefs of the past, which have no relevance for this age of biological revolution and spectacular medical skills.

• To call ourselves a civilized society, one must understand death, and respect it as much as we respect life.