OVERVIEW

The legality of Euthanasia or mercy killing in India according to the Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill

Index:

What is Euthanasia?
Types of Euthanasia
Why is Active Euthanasia not permissible in India?
History of Euthanasia in India
The legality of Euthanasia in India
Guidelines on passive Euthanasia by the Supreme Court of India
Medical Treatment of Terminally Ill Patients (MTTIP) (Protection of Patients and Medical Practitioners) Bill Keywords
The Main Provisions of this Bill
Potential Concerns of this Bill

Conclusion

We are mortal beings as human beings. Our life span is limited. Still, we try to hang on to our lives for as long as possible. Sadly, there are people in terrible medical conditions who want to die. They are in pain and suffering, and they no longer find their quality of life to be at an acceptable level anymore.

The fear of death and the desire to live forever are part of human nature. However, the field of medicine takes advantage of this aspect of humanity. While it is undoubtedly true that one goal of therapy has always been to prolong life, another goal has been to reduce pain and suffering. One point at which these two views clash is the hotly debated issue of Euthanasia. This article is about what Euthanasia is, the types of Euthanasia that are legal in India, etc.

What is Euthanasia?

The word euthanasia comes from the Greek "EU," meaning 'well' and "Thanatos," meaning 'death' in English. The word euthanasia means a "good death."

If a person is on the deathbed in a long and slow way, they should have the right to end their life comfortably. This can be known as mercy killing and sometimes known as Euthanasia.

Mercy killing is when a doctor directly ends their patient's life; this is done to put the patient out of its suffrage and relieve them from an incurable and terminal condition. It creates an enormous controversy if mercy killing should be allowed to any human being. It is thought to be unlawful and is concerned to be murder. Many patients who suffer from excessive pain have asked their doctors and loved ones to put them out of this pain, but the laws are considered murder.

Euthanasia, or "mercy killing," is not an issue with only two sides. Both of these include several shades of grey.

Types of Euthanasia:

Active EuthanasiaActive Euthanasia is comparatively more controversial because it impairs moral, ethical, religious, and compassionate values. The victim's death is caused when the medical professionals or someone else intentionally performs some positive act. Such as injecting a lethal drug dose or giving a victim an overdose of a drug that would not result in death if not for the overdose in which the person dies.

Passive Euthanasia:

Euthanasia involves letting a person die naturally without life support or "pulling the plug." Passive Euthanasia is ever morally permissible suggests that we must do everything we can to keep someone alive, even if they are miserable and want to die.

Voluntary Euthanasia:

Voluntary Euthanasia means Euthanasia is performed with the patient's consent. In this, a patient requests to be killed for their own life (wants to die of his own will).

Non-voluntary Euthanasia:

Non-voluntary Euthanasia means an individual who neither wants to die nor intends to live. When a person is unable to give consent (for example- the patient is in a coma or severely brain-damaged), another person makes decisions on their behalf, often because the sick person has previously ended their life and expressed a desire to in such circumstances. It simply means when someone unconscious for a long time says in a coma and has reason to believe that consciousness will never return.

Involuntary Euthanasia:

Euthanasia conducted against the patient's will is involuntary Euthanasia. It is also regarded as murder (without asking consent or against the patient's will).

Why is Active Euthanasia not permissible in India?

In India, most people believe in God and miracles. They have faith that there is always a chance of recovery in a patient, so Euthanasia is wrong. But making essential decisions on doubtful cases is often unwise. There are many objections to Active Euthanasia. Some are concerned about Euthanasia in general, and others claim that pain can always be controlled, so there is no need to permit Euthanasia. But pain can always be made bearable is not bad, but it is unnecessary.

Further objections claim there are essential differences between active and passive Euthanasia, making inactive permissible but active wrong. Generally, Active Euthanasia is wrong because it kills someone intentionally. It is always bad to kill a patient because they usually want to live and don't have lives full of pain.

Euthanasia can save the expenditure involved in sustaining the lives of many terminally ill patients, depending on or relying on sophisticated medical equipment such as ventilators to remain alive. Spending vast amounts of money on medicines, medical personnel, and equipment is unreasonable when there is no hope for recovery. Moreover, Muslim countries are being orthodox, such as the UAE, where such a practice is strongly restricted and subsidizes many patients in a vegetative state. Not wasting money on those patients who have no hope for life; use that money to treat other patients who can be brought back to a healthy life.
Criminal elements could be misusing this law that can be abused. Before permitting Active Euthanasia, doctors must perform a proper investigation. Sometimes it is influenced by criminal factors. Good surveillance can prevent the occurrence of crimes related to this issue.

Allowing active Euthanasia in India might put on a charge of murdering people who want to live.

History of Euthanasia in India:

Case: Gian Kaur VS. the State of Punjab, 1996

The Hon'ble Supreme Court held that Euthanasia and assisted suicide are illegal in India. The Court stated that Article 21 of the Constitution of India's "right to life" does not include the "right to die," and Article 21 protects life and personal liberty. In this case, the Court didn't make any practical rules or laws relating to Euthanasia.

Law Commission Report:

The 196th Law Commission report, 2006, brought no law on Euthanasia; however, brought a bill `The Medical Treatment of Terminally ill Patients (TTIP)(Protection of Patients and Medical Practitioners) Bill 2006.

Case: Aruna Ramchandra Shanbaug v. Union of India, 2011

The Hon'ble Supreme Court laid down guidelines to process pleas for passive Euthanasia. Until Parliament works out legislation, the guidelines' procedures should be followed. It also spelled out the differences between active and passive Euthanasia. In this case, Aruna was not brain dead, and she was able to breathe independently without any machine's support.

241st report of Law Commission, 2012

Again prepared a draft on passive Euthanasia and passed a bill, Medical treatment of terminally ill patients (MTTIP) (protection of patients and medical practitioners). It deals with passive Euthanasia and the living will of the patient. This Bill does not recommend active Euthanasia in any condition.

Supreme Court's three-judge bench in 2014

The bench called its judgment and stated that the Aruna Shanbaug case was 'inconsistent.' It referred to the subject of Euthanasia to its five-judge Constitution bench.

The Health ministry uploaded the draft bill for public opinion in 2016 so that people could give their views on passing a law on passive Euthanasia or not.

The legality of Euthanasia in India:

Since March 2018, the Hon'ble Supreme Court of India has ruled that passive euthanasia is legal in India under strict guidelines. Although the Supreme Court has already decided on this issue, some doubts were persisted about its execution. Now it is clear after passing this Bill.

Guidelines on passive Euthanasia by the Supreme Court of India:

The decision should be taken either by parents, a close relative, the spouse, or a person acting as a next friend to discontinue the patient life. The doctors can also decide for the patient bonafide in the patient's best interest.
The High Court can give this decision. After receiving an application to the concerned High Court, the Chief Justice of the High Court should constitute at least two Judges Bench, who decides to grant the permission or not.
The High Court bench will form a committee of three reputed doctors and need a report from the committee.
After receiving a report from doctors, Court gives notice to the Close relatives and the State. The High Court can give its verdict after hearing the parties (close relatives and the State).

Medical Treatment of Terminally Ill Patients (MTTIP) (Protection of Patients and Medical Practitioners) Bill Keywords-

Advance Medical Directive:

They are also known as Living Will. It means the instruction given by a person as to whether they will be given medical treatment, as the case may be, in the future when they become seriously ill.

Palliative care:

The provision of appropriate medical and nursing procedures to relieve physical pain, discomfort, suffering, or psychosocial or emotional suffering.
Proper provision for food and water.

Capable patient (Competent patient):

A patient who is not disabled.

Disabled patient (Incompetent patient):

Means a minor under the age of 16 years or unsound mind, or who is unable to:

Understand the relevant information for an informed decision about their medical treatment.
Retaining and using that information to make decisions.
Communicate your informed decision by speech, sign, language, or other means.
Due to disturbances in brain/mind functioning, not being able to make decisions.

Informed decision:

It means a decision to continue or stop or withdraw medical treatment taken by a competent patient who has been informed.

The nature of their disease.
Any alternative form of treatment is available in that situation.
The consequences of those forms of treatment.
Consequences of remaining untreated.

Terminal illness:

It means such illness, injury, or degeneration of mental or physical condition causes extreme pain. According to medical opinion, the patient suffers a lot due to the disease, and inevitably, the patient concerned dies untimely, or the meaningful existence of life is not possible due to irreversible vegetative conditions.

The Main Provisions of this Bill:

Every competent patient, including minors over the age of 16, has the right to decide and express his/her wish to the medical practitioner caring for them whether to continue with further treatment of a patient or allow nature to take its course.
The Bill protects patients and doctors from any obligations to withhold or withdraw medical treatment and states that palliative care (pain management) may continue.
The medical practitioner is bound when a patient communicates their decision to the medical practitioner. The medical practitioner must "satisfy" that the patient is "competent" and that the decision is made of free will.
There will be a panel of medical experts to decide on a case-by-case basis
The medical practitioner has to retain all patient details and make an informed decision. The medical practitioner must inform the patient whether it would be best to withdraw or continue the treatment. If the patient is not conscious, inform their family members, or inform a person who is a regular visitor in the absence of their family members.
The draft also spells out the procedure for seeking Euthanasia, from the composition of the medical team to approach the High Court for permission.
Permission has to be taken from the High Court. Any close relative, friend, legal guardian, doctor/staff attending to the patient, or any other person seeking leave of Court can apply to the jurisdictional High Court. Such an application is treated as a substantive petition, and the Chief Justice of the High Court will, without wasting time, refer it to the Divisional Bench. As far as practicable, it should be disposed of within one month. This bench will nominate and require a report from a committee of three eminent doctors.
The Bill only points to legalizing "passive euthanasia," as discussed in the decision on Aruna Shaunbaug. Active Euthanasia is not being considered "because it is likely to be used by unscrupulous persons to achieve their covert purposes."
Advanced medical instruction or subsistence shall be void and not a medical practitioner.
The Medical Council of India may issue guidelines by the provisions of the Bill. It may review and revise from time to time.

Potential Concerns of this Bill:

There has been a mixed reaction to the draft bill. Some considered this a "good start," but others disagreed. Some possible concerns are:

The draft has disappointed experts who wanted complete clarity on the concept of the living will. At the same time, advance medical directives (also known as a living will) are sought to be recognized, whereby a person declares in advance whether treatment should be given or not if he decides in the future. Unable to take and incompetent, the government has rightly shot down the proposal.
Child rights activists are of the opinion that it is not allowed to sign a contract or get married before the age of 18 in India, then how can a child decide to live or die.
The concern for its misuse is an important issue that must be addressed before it becomes a law in our country:

The doctor can come under the influence of corruption and create material to prove that it is an incurable case with no chances of recovery.
It can be misused by some unscrupulous persons who wish to inherit or otherwise usurp, except the relatives or doctors or next friend of the patient, to take the decision support of a disabled person to the patient's property.

Conclusion:

For a patient suffering for a long time with an incurable illness in that situation, such a decision can be proved much better than giving a peaceful death. The Government of India can prevent the misuse of Euthanasia by taking strict actions. While death is, arguably, usually sad for the person who dies, the goal of Euthanasia is to make this less harmful. The word euthanasia means a "good death." These issues are essential, not just for people currently facing hard choices about death. Nobody knows what will happen in the next moment. An accident or illness can bring on these issues, so we must now deal with them more deeply.

To read this article in Hindi: Euthanasia

We hope you liked our written blogs. You can also read blogs on other legal topics available on our website. You can view our services by visiting our website. If you want any Civil or Criminal guidance or help of any Lawyer regarding the matter, You may reach us via mail at help@vakilkaro.co.in or call us at +91 9828123489 to resolve any legal problem.

VakilKaro is a Best Legal Services Providers Company, which provides Civil, Criminal & Corporate Laws Services and Registration Services like Private Limited Company Registration, LLP Registration, Nidhi Company Registration, Microfinance Company Registration, Section 8 Company Registration, NBFC Registration, Trademark Registration, 80G & 12A Registration, Niti Aayog Registration, FSSAI Registration, and other related Legal Services.