‘Passive Euthanasia’ is now legal in India; but does it help the Covid-19 patients?

By- Muskaan Singh

What is Passive Euthanasia? And is Passive euthanasia legal in India? Well, just as our country is trying to update its laws, the Legality of Euthanasia was one of the concerned topics. But on 9th March 2018 in a landmark Supreme Court Judgement[1], Indian Supreme Court gave the order that Passive Euthanasia is legal as well as lawful in our country.

But the question arises how will the general public perceive this law and does that make any significant change in the life care laws of India?

The judgement gave key points which are:

(i) for the first time in India, the Apex Court has declared Passive Euthanasia as legal. The judgment defines “Passive Euthanasia” as “removing the life support system given to a medically ill patient who is only alive depending on the lifesaver system”

(ii) the judgement passed recognizes that a living will or advance directive shall be given by the patient seeking passive euthanasia with valid legal documents and

(iii) this judgment affirms the right to take informed decisions to refuse medical help which includes pulling out from life-sustaining devices.

Before this judgement, Passive Euthanasia was considered as an “Unethical act” which was prohibited in medical practises. Now after the judgement, essence of the unethical act still remains the same i.e. nobody is allowed to cause death of another in order to mitigate pain as well as suffering.

The significant change because of this ruling is simply that now the Supreme Court has explicitly declared that Passive euthanasia is now legalised.

Now, the medical practitioners have the permission to formulate these decisions without worrying about the legal prospective as long as they follow the guidelines and order of the court.

The medical practitioners now don’t have to seek a legal directive before a decision of such kind is to be made.

But implementing this judgement in India will be a tedious task as

(a) there is lack of awareness amongst people. People still don’t know such judgements have been passed and that now they can free their loved ones from any sufferings

(b) because of the lack of awareness, the ICU beds in town hospitals as well as the biggest hospitals in the state have been occupied by such people.

The real distinction can be made by spreading as much community awareness as possible regarding the decision making of end of life care.

This is because in India such critical decisions are left for the family members to take and are highly influenced by their financial abilities and societal pressure which they can cater to in the society. Also a member’s life experience also counts in them making the decision.

The reason why using the phrase ‘passive euthanasia’ instantly poses threats and challenges is because Indian Council of Medical Research, 2018 released this report days after the Supreme Court verdict rejected the use of term “passive euthanasia”[2]:

“The phrase passive euthanasia is an outdated terminology and ought to be avoided as it cannot be passive and withdrawing a potentially inappropriate treatment in a patient dying with a life-threatening illness that only prolongs the dying process, cannot be construed as an objective to kill.”

The confusion was increasing more and more as when the legal terminology reached to people in their own regional language the meaning was twisted. The word used in Tamil for ‘passive euthanasia’ is “karunaikkolai” literally meaning ‘mercy killing’. In India, the journalists take fragile knowledge to the actuality that removing/replacing words like ‘active’ and ‘passive’ can change the whole legal meaning of the terminology used. And these small mistakes lead to a huge amount of confusion amongst people.

Another possible problem arises when we take into consideration “living will”. The purpose to use living will is to promote dignity and autonomous decision-making ability but it ends with several practical challenges. The living will which the judgement has decided has to be a written document signed by at least two witnesses along with the Judicial Magistrate while this decision was taken so that there is an informed and voluntary way of going ahead with the decision. But in India such decisions of ending someone’s life is considered inauspicious.

In India, taking signatures of the family and friends of the loved one is in itself a tough task as family and friends of the person will not be readily happy to sign the living will. Even, in case that the witnesses have signed, the sign of the Judicial Magistrate in itself is a tough task yet again.

These procedures were introduced so that the legal provision of ‘living will’ appears to be patient autonomy and person-centric of the person who has decided to end his/her life. However, in practical aspects these benefits are nowhere in use, also, such grounds of benefits may be limited.

Just as we were about to move forward with the verdict and its enactments in March 2020, the World Health Organization declared Covid-19 a Pandemic.

The whole world stopped! People were instructed to stay home and not move out. Because once you’re affected with Covid-19 it directly affects your lungs i.e. your respiratory tract.

And when the patient’s condition turns into a serious one the patient then needs a ventilator. Well, as we are all well aware of India’s health priorities, we very well know how diversely equipped is each state as Bihar in India has a ratio of 1:43,000 for the doctor-patient ratio.

India, in comparison to the developed first world countries, is yet a budding nation. And Hospital varies in India from a lavish hospital to a municipal hospital in the inferior parts.

And if in such case the beds are occupied with people who are alive only because of their life support system then isn’t it unfair for the person whose life can be saved if the bed could be given to him along with the ventilator.

Here is where we need to spread public awareness as to how now even the Legal system of India has allowed people to free their loved ones from pain and agony as they are only living because their loved ones want them to.

Well, there has been a lot of debate on hospital beds and the shortage which is there in recent times. People are not given admission in hospitals because the biggest of the biggest hospitals have their beds full and people are dying because of medical negligence.

In such times families of people whose dear ones are on life support should consider the option of Passive Euthanasia as it will not help one but relieve the other one from the pain. In such ways, our country can battle pandemics as well as take care of its population.

No wonder this judgment has received such a mixed response in India. The legal aspect of ending one’s life is such a fruitful and optimistic judgment, wherein a person suffering has the right to end his/her life legally.

Or in case the person is not capable of taking such decisions then his/her family and friends have been specified power to take the decision on behalf of their loved one. This will not only help them but also other people who need ICU beds in the utmost emergency.

With such merits, the verdict is still having mixed emotions as, in India, more clarity is to be established amongst people before such decisions are taken by them.

Therefore, public awareness is one such aspect that needs to be covered before giving out such important decisions. And more informative and clear discussions should be held as to how our diverse country with such diverse communities perceive such judgments in their societies.

[1]Common Cause (A Regd. Society) v. Union of India & Anr. (2018) 5 SCC 1.

[2]Indian Council of Medical Research, 2018. (Definition of terms used in limitation of treatment and providing palliative care at end of life)


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