Critical Thinking Assignment

Topic- Euthanasia

Submitted byShyam Jhalani 1011631 2BBA-B

Introduction
Euthanasia is one of society's most widely and fiercely debated moral issues. No one is able to determine the significance of ones life and the quality a person should live. Euthanasia is categorized into two separate definitions; active and passive euthanasia. Euthanasia gives the terminally ill the ability to orchestrate their death. Euthanasia lifts a burden from the sufferer as well as their caretakers. Euthanasia gives the terminally ill the final dignifying say which allows them to practice the ultimate freedom; the right to die. Euthanasia is split into two different categories; active and passive euthanasia. Active euthanasia, which by definition, is; "Doing something, such as administering a lethal drug, or using other means that cause a person's death (MacKinnon, 126) is more detestable than passive euthanasia, which is defined as; "Stopping (or not starting) some treatment, which allows a person to die, the person's condition causes his or her death," (MacKinnon, 126). Active euthanasia is typically the more highly debated of the two acts of euthanasia and is better known because of the actions of Dr. Jack Kevorkian, who has aided in many successful suicides. Passive euthanasia, on the other hand, is rarely debated and usually never enters controversial dialogue because it is typically looked at as letting someone die naturally. In passive euthanasia one simply refuses treatment with the knowledge that death is imminent. This offers little debate for several reasons, primarily because it is seen as a natural way of dying. There are exceptions, for example, some religions refuse to accept life preserving treatments with the knowledge that without the treatment they will die. For example in the faith of the Jehovah's Witness, a child, who has been in a serious car accident and is in need of blood, will die rather that accept treatment (Humphry, 104). Although this kind of passive euthanasia would endure much scrutiny, it would be accepted because it is tied to religious convictions. In either case, active or passive, the victim will die due to the aid of a physician or another able bodied individual. There is essentially no difference between the two types of euthanasia; both aid the terminally ill in taking their own life. From herein, both active and passive euthanasia will be referred to as euthanasia. Essentially euthanasia aids people in ending their lives, and gives those who are terminally ill, the last and

perhaps only decisive measure during their illness. Supporters of the practice of euthanasia argue that helping the terminally ill to bring about their own deaths and allowing them to determine the how and when they die, defends their basic human right to decide whether they should live in suffering, or die in peace. Euthanasia is not only humane, but also allows the person the ability to maintain their dignity by planning their own end, thus letting them die with dignity and at peace. Freedom to choose how one lives their life is not taken away due to a terminal illness, thus this freedom should be carried out regardless of whether the issue is death or our freedom of speech. Supporters of euthanasia state that, "[They] believe that everyone has the right to choose how they live and die" (The Voluntary Euthanasia Society [TVES]). Euthanasia allows the person, who is principally awaiting their death, to maintain a fraction of their dignity by coordinating their own death. Thus letting the person die in peace, rather than suffering through their illness until their eventual demise. The Voluntary Euthanasia Society states that, "Each person has value and is worthy of respect, has basic rights and freedoms and the power to control his or her destiny. [The proponents] campaign to legalize assisted dying within certain strictly defined circumstances is fundamentally about choice" (TVES). The choice being discussed is their right to a persons freedom to choose whether or not to live in pain and suffering or die in peace. The worth of a humans life does not change because they are terminally ill, but the manner in which one lives there life changes significantly. In some cases, victims of terminal diseases suffer great humiliation due to loss of control over their muscles and other parts of their body, making them completely dependant upon someone else. These hardships are often times degrading to the sufferer and costly to both the victim and their loved ones, which puts strain not only on the person affected by the disease but also those who are taking care of them. In many cases, euthanasia is the victims way to pay back their debt to their family, and their last effort at dignity. Suffering from a terminal illness is costly and time consuming for those who take care of the victim. Victims in the advanced stages of some terminal illness will have limited muscle control and

experience excruciating and unrelenting pain. Rather than suffer through an illness, one should have the right to end the pain and plan their death. As the Euthanasia Society states, "Not everyone dies well. At least 5% of terminal pain cannot be fully controlled, even with the best care. Other distressing symptoms such as sickness, incontinence or breathlessness cannot always be relieved" (Dr. Jack Kevorkian). Not only does the sufferer endure the hardships of their disease, but often times their loved ones also bear the brunt of the monetary costs related to their illness. The costs of at-home treatments as well as hospital, medicine and treatment costs are an extreme burden upon the victims family. In the victims eyes, their death signifies eliminating their own, as well as their next of Kins, perception of them dying to be a burden, physically and financially, and then can focus on the positive aspect of their death; the end to their suffering. Derek Humphry states that patients with a high wish to hasten death have greater concerns with physical symptoms and psychological suffering, perceive themselves to be more of a burden to others (Humphry, 127.) Patients suffering from illness simply want to lessen the weight and dependence upon their loved ones, and exercise their freedom to decide when and how they want to die. No one is capable of determining the worth of someones life; however those who suffer terminal illnesses should have the freedom of determining whether the pain they are forced to endure is worth continuing their lives. Euthanasia is categorized into separate definitions, both of which are scrutinized and both allowing the freedom of choice. Through euthanasia, the choice of how and when the victim of a terminal illness should die lies in the hands of the person themselves. The victim views their final demise as a way for them to repay those who took care of them or the final lift of burden from their loved ones. Euthanasia allows the practice of basic human rights and gives the terminally ill the right to die.

RELATED CONCEPTS
Euthanasia and Murder
Normally, murder means intentionally killing someone in unlawful manner and such killing can be of two kinds. Firstly, those where the murderer has informed consent of the person killed and secondly, where the murderer does not have the informed consent of the person killed. For pro-life Proponents, Euthanasia is equivalent to murder because it is the act of deliberately ending the life of a patient both at the patients own request and at the request of his kith and kin. The term Mercy killing, closely akin to euthanasia becomes murder only when there is no consent of the patient ,says Roedy Green. Where as proponents of euthanasia feels that Phaspacts , that is ( Physician assisted patient activated suicide) is not murder but phactpared which is ( physician activated patient request ) death is equivalent to murder under law, because in the later physician actively participates in the process of killing the patient. 11

Euthanasia and Suicide

Felo De Se or suicide is, where a man of age of discretion and compose mentis voluntarily kills himself by stabbing, poison or any other way and was a felony at common law .12 In India, both attempt as well as abetment to commit suicide are punishable offences under Indian Penal Code. Suicide and Euthanasia are two different acts and cannot be considered on the same footing. The Bombay High Court in Maruti Shripati Dubal vs. State of Maharastra13 has attempted to make a distinction between suicide and mercy killing. According to the court , the suicide by its very nature is an act of self killing or termination of ones own life by ones act without assistance from others. But Euthanasia means the intervention of others human agency to end the life. Mercy killing is nothing but a homicide, whatever be the circumstances in which it is committed. This is the Indian opinion on the topic of Euthanasia. 4.3 Euthanasia and Physician Assisted Suicide In this type of suicide , the doctor provides information to the patient, with the guidance and means to take his or her own life with the intention that they will be used for such purpose . The patient himself ends his life by using the information and means provided by the doctor, it is called Physician assisted suicide. 14 It is important that Euthanasia is not confused with physician assisted suicide. The later involves a patients voluntarily bringing about his or her own death with the assistance of a physician.In this case the act is a suicide (international self-inflicted death), because the patient actually causes his or her own death

thus while in assisted suicide the doctor makes available to the patient the means by which he can kill himself, in Euthanasia the doctor himself (by act or omission ) kills the patient. 15 Furthermore some countries16 have preferred to legalize assisted suicide though they remain averse to permitting Euthanasia.

PRESENT GLOBAL SCENARIO

Associations promoting legal Euthanasia exist in many countries now-a-days. But it is worth while to note that first in vain attempt to legalize mercy killing was made in the years 1936 in England.17 Organizations supporting the legalization of voluntary Euthanasia were established in Britain in 1935 and in the United States in 1938. They had gained some public support, but have so for been unable to achieve their goal in either nation. In the past few decades western laws against passive and voluntary Euthanasia have slowly been eased Although serious moral and legal questions still exist. 18 The Netherlands charted out a new chapter in the history of legalizing euthanasia and has become the first country which allows the physicians to end the lives of the patients suffering unbearably and without hope. In April, 2001 Netherlands parliament passed the bill on same. The new law sets fourth rules that will make a long-tolerated Dutch practice legal. The law requests a long standing doctor-patients relationship,patients awareness of other available medical options and that the patient must have obtained a second professional opinion. The law also allows people to leave written requests for Euthanasia in the nature of advance directives. 19 After this the Belgium followed the suit and under the Belgium Act on Euthanasia May 2002 permission has been granted for Euthanasia and assisted suicide in patients who are terminally ill. A patient must be above 18 years of age, terminally ill, suffering constantly and sane. The request has to be made at least one month before suicide in writing . In Australia in 1996 after long debate the Northern Territory passed pioneering legislation that permitted medically assisted suicide using a computer program which enabled the patient to tap his or her command in to a laptop computer and administer a lethal dose of drugs if appropriate- the first place in the world to make this from of Euthanasia legal, however in early 1997 the Australia government repealed the legislation as said act was shown to be inconsistent with national views. 20 In the US, the Oregon state approved a physician assisted suicide law in 1994 which was implemented in 1997 similarly under Florida state constitution right to die is clearly supported. Under the law an individual has a right to refuse life- sustaining medical treatment. Various other U.S states where till date

multiple legislative attempts have been made to legalise assisted suicide are Arizona, Alaska, Michigan , Vermont etc. Switzerland allows suicide by doctors and those having medical training, though Euthanasia is not legal. In Germany also Euthanasia is illegal but physician- assisted suicide is legal. It is clear from the abovementioned discussion that Euthanasia is still under consideration in majority of the countries in the world. Although physician assisted suicide has been accepted and approved by a number of countries but there is still a hesitation on their part for accepting Euthanasia as such .

STATUS OF EUTHANASIA IN INDIA

In our country, legislative attempts to legalize Euthanasia started way back in 1985 when a private bill (Varde bill) was introduced in the Maharashtra legislative council to give immunity from civil and criminal liability to medical practitioners who at the request of terminally ill or terminally injured patient withdrew medical treatment. 21 The bill was strongly criticized as giving scope for misuse. One B.V.Patil also made a similar attempt in the Lok Sabha in the same year. But both the attempts resulted in naught. Under Indian Constitution every citizen has been given a constitutional guarantee to live. 22 In addition the medical profession is charged with the responsibility to protect the life of all citizens by providing medical attention. Further, Euthanasia is not explicitly stated as a criminal offence in the Indian Penal Code. It is generally accepted that it is covered under the offence of attempted suicide (section 309 IPC) or abetment of suicide (section 306 IPC) or under exception 5 to section 300 i.e. death by consent. However, judicial opinion acknowledges that Euthanasia is a grey area in Indian criminal law. This unsettled status has been brought into stark focus in several cases e.g. P.Rathinam Vs. Union of India23 , Smt. Gian Kaur Vs. State of Punjab 24 etc. As per the Supreme Courts view, passive voluntary Euthanasia can be visualized as a fundamental right protected by Article 21 of the Indian Constitution, which assures the right to privacy, since right to privacy can be said to encompass the right of a patient to refuse life saving medical treatment. In other words, the right to personal liberty as guaranteed by Article 21 of the Constitution includes the freedom to die with dignity. Active Euthanasia (voluntary or otherwise) is of course unambiguously viewed as a crime though convictions have not been brought so for against any individual in India for the commission of such an offence 25

RECENT DEVELOPMENTS
The debate on ending of ones life again came to fore with the recent developments like on January 31, 2007, ignoring Centers opposition, the Supreme Court admitted a Public Interest Litigation by an NGO seeking to declare right to die with dignity a fundamental right and legalize mercy killing of terminally ill patients. The NGO has sought a direction to the centre to adopt suitable procedures to ensure that a terminally ill patient should be able to execute a document titled My Living Will and Attorney Authorization. The Will could be presented to hospital for appropriate action if the persons condition becomes serious. 26 The above-stated PIL is still pending before the Supreme Court. After K. Venkateshs case Euthanasia is again under the glare of public attention. on November 30, 2007, C.K Chandrappan, a representative from Trichur Kerela, who belongs to Communist Party of India introduced a bill to legalize Euthanasia to the Lok Sabha. The bill, which would overturn the current Indian Laws prohibiting Euthanasia, has received criticism from medical groups afraid of abuse and religious groups defending the right to life. 27 In a very recent case (July, 2008) of Seema Sood from Palampur, a brilliant Indian engineering graduate bedridden by crippling rheumatoid arthritis for the past 15 years now has new hope for life and says she regrets ever having petitioned for Euthanasia, as surgery has brought up new hopes for her.

Euthanasia law by country

Australia Euthanasia is now illegal in Australia. It was once legal in the Northern Territory, by the Rights of the Terminally Ill Act 1995. In 1997, the Australian Federal Government overrode the Northern Territory legislation through the introduction of the Euthanasia Laws Act 1997.[1] Unlike the states, legislation in the Northern Territory is not guaranteed by the Australian constitution. Before this law was passed by the Australian Government, Dr. Philip Nitschke has helped three people by them using his Deliverance machine. Organisations such as Exit International (founded by Nitschke himself), want the government to bring back euthanasia rights to Australia. Exit made TV commercials which were banned before they made it to air in September 2010.[2]

Belgium The Belgian parliament legalized euthanasia in late September 2002.[3] A survey published in 2010 that those who died from euthanasia (compared with other deaths) were more often younger, male, cancer patients and more often died in their homes. In almost all cases, unbearable physical suffering were reported. Euthanasia for nonterminal patients was rare. Japan The Japanese government has no official laws on the status of euthanasia and the Supreme Court of Japan has never ruled on the matter. Rather, to date, Japan's euthanasia policy has been decided by two local court cases, one in Nagoya in 1962, and another after an incident at Tokai University in 1995. The first case involved "passive euthanasia" ( shkyokuteki anrakushi?) (i.e., allowing a patient to die by turning off life support) and the latter case involved "active euthanasia" ( sekkyokuteki anrakushi?) (e.g., through injection). The judgments in these cases set forth a legal framework and a set of conditions within which both passive and active euthanasia could be legal. Nevertheless, in both of these particular cases the doctors were found guilty of violating these conditions when taking the lives of their patients. Further, because the findings of these courts have yet to be upheld at the national level, these precedents are not necessarily binding. Nevertheless, at present, there is a tentative legal framework for implementing euthanasia in Japan.[7] In the case of passive euthanasia, three conditions must be met: 1. the patient must be suffering from an incurable disease, and in the final stages of the disease from which he/she/ is unlikely to make a recovery; 2. the patient must give express consent to stopping treatment, and this consent must be obtained and preserved prior to death. If the patient is not able to give clear consent, their consent may be determined from a prewritten document such as a living will or the testimony of the family; 3. the patient may be passively euthanized by stopping medical treatment, chemotherapy, dialysis, artificial respiration, blood transfusion, IV drip, etc. For active euthanasia, four conditions must be met: 1. the patient must be suffering from unbearable physical pain; 2. death must be inevitable and drawing near;

3. the patient must give consent. (Unlike passive euthanasia, living wills and family consent will not suffice.) 4. the physician must have (ineffectively) exhausted all other measures of pain relief. The problems that arose from this, in addition to the problem faced by many other families in the country, has led to the creation of "bioethics SWAT teams".[8]These teams will be made available to the families of terminally ill patients in order to help them, along with the doctors, come to a decision based on the personal facts of the case. Though in its early stages and relying on subsidies from the Ministry of Health, Labor and Welfare there are plans to create a nonprofit organization to allow this effort to continue. [9] The Netherlands In the 1973 "Postma case" a physician was convicted for having facilitated the death of her mother following repeated explicit requests for euthanasia.[16] While upholding the conviction, the court's judgment set out critera when a doctor would not be required to keep a patient alive contrary to their will. This set of critera was formalized in the course of a number of court cases during the 1980s. In 2002, the Netherlands passed a law legalizing euthanasia including physician assisted suicide.[17] This law codifies the twenty year old convention of not prosecuting doctors who have committed euthanasia in very specific cases, under very specific circumstances. The Ministry of Public Health, Wellbeing and Sports claims that this practice "allows a person to end their life in dignity after having received every available type of palliative care."[18] The United Nations has reviewed and commented on the Netherlands euthanasia law.[19] In September 2004 the Groningen Protocol was developed, which sets out criteria to be met for carrying out child euthanasia without the physician being prosecuted.[20] United Kingdom Euthanasia is illegal in the United Kingdom. Any person found to be assisting suicide is breaking the law and can be convicted of assisting suicide or attempting to do so (e.g. if a doctor gives a patient in great pain a bottle of morphine to take (to commit suicide) when the pain gets too great).[23][24] Between 2003 and 2006 Lord Joffe made four attempts to introduce bills that would have legalized voluntary euthanasia - all were rejected by the UK Parliament.[25] Currently, Dr Nigel Cox is the only British doctor to have been convicted of attempted euthanasia. He was given a 12 month suspended

sentence in 1992.[26] In 1957 Judge Devlin in the trial of Dr John Bodkin Adams ruled that causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome.[27] United States Active euthanasia is illegal in most of the United States. Patients retain the rights to refuse medical treatment and to receive appropriate management of pain at their request (passive euthanasia), even if the patients' choices hasten their deaths. Additionally, futile or disproportionately burdensome treatments, such as life-support machines, may be withdrawn under specified circumstances and, under federal law and most state laws only with the informed consent of the patient or in the event of the incompetence of the patient, with the informed consent of the legal surrogate. The Supreme Court of the United States has not dealt with "quality of life issues" or "futility issues" and apppears to only condone active or passive "euthanasia" (not legally defined) when there is clear and convincing evidence that informed consent to the euthanasia, passive or active, has been obtained from the competent patient or the legal surrogate of the incompetent patient. While active euthanasia is illegal throughout the US, assisted suicide is legal in three states: Oregon, Washington and Montana.[28]

CONCLUSION
Proponents of Euthanasia argues unbearable pain, right to commit suicide- a private affair and people should not be forced to stay alive and above all proper legal safeguards can minimize misuse of the Right are sufficient reasons for permitting Euthanasia. On the other hand opponents of Euthanasia treat it as a euphemism for murder and maintain that Euthanasia is not about the right to die but about the right to kill. While in India, the case for Euthanasia is complicated by societal realities which could leave it open to gross abuse. The judiciary is justified in its lack of confidence in cherished Indian institutions like the family. There is always the fear that greedy relatives might mislead a widow in order to grab her property. There is a fear from nature of medical facilities available in India, that the team terminally ill may not be properly valued. The levels of education and enlightenment in India do not suggest that the arguments for and implications of Euthanasia will be properly understood and appreciated. There will always be the danger that Euthanasia will not be the affirmation of individual choice that it is supposed to represent. It is further submitted that in the present scheme of criminal law, it is not

possible to construe the provisions so as to include voluntary Euthanasia without including non-voluntary and in-voluntary Euthanasia and many other provisions of Indian penal code will need drastic changes in the from of provisos and exceptions which seems to be a complicated job. Above all in a country like India in which fake encountering and corruption have became day to day business a sensitive and risky issue like Euthanasia is almost impossible. Because in Euthanasia there is a question of life or death of the patient concerned and it cannot be taken so lightly as any other question of law. In the developed countries like England, Canada, USA (except Oregon and Florida states) laws are still hesitant to provide for Euthanasia. It is a fact that India is used to follow the examples of above stated countries. In Netherlands, where this concept has been legalized, provides for foolproof mechanism in place but it is humbly submitted that the implementation of such mechanism in India is utopian and two situations are incomparable. It is ironical to note that ninety percent of the patients succumb to death without receiving any primary health care. India has so many blind people, handicapped Persons, mentally- retarded people, leprosy patients, child labourers, persons living below the poverty line, illiterates, should not we work hard to eradicate them instead of devoting our time and energy on delicacies like right to die. Hence in a developing country like India it is really a hard concept to digest and it may further take a long time to be suited in Indian scenario. All in all.. no life that breathes with human breath has ever truly longed for death..