Govt opposes ‘living will’: All you need to know about euthanasia, Right to Die with dignity.
Centre has informed the Supreme Court that it is examining a draft law to permit “Passive Euthanasia” — The Medical Treatment of Terminally ill Patients (Protection of Patients and Medical Practitioners) Bill — but that it is against letting people make “Living Wills”, by which they can direct that they not be put on life support in case of terminal illness. The draft Bill was released by the Health Ministry in 2016, based on the Law Commission of India’s Report No. 241 (August 2012).
According to 241st Report, the Law Commission under the chairmanship of P.V. Reddi had said that withdrawing life support for certain categories of people—such as those in persistent vegetative state (PVS) or in irreversible coma or of unsound mind, who lack mental faculties to make decisions for themselves—should be allowed.
The Law Commission report followed a March 2011 decision by the Supreme Court which differentiated between active and passive euthanasia in the case of a nurse, Aruna Shanbaug. Shanbaug was in PVS for several decades following a brutal rape. She died on 18 May 2015.
Now Question Arises :-
- What is euthanasia, and how does a Living Will differ from it?
- What is the draft law, and why is it needed?
Ans :-1) The painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma. There are Active & Passive Euthanasia.
- Active Euthanasia :- The intentional act of causing the death of a patient in great suffering. It entails deliberately causing the patient’s death through injections or overdose.
- Passive Euthanasia :- the withdrawal of medical treatment with the deliberate intention to hasten a terminally ill patient’s death.
Where as Living will defines, where a patient can give consent that allows withdrawal of life support systems if the individual is reduced to a permanent vegetative state with no real chance of survival.
It is a type of advance directive that may be used by a person before incapacitation to outline a full range of treatment preferences or, most often, to reject treatment or in other words i say “he or she… shall or shall not be given medical treatment in future when or he she becomes terminally ill”.
A living can detail a person’s preferences for tube-feeding, artificial hydration, and pain medication when an individual cannot communicate his/her choices.
Ans :-2) According to “The Medical Treatment of Terminally ill Patients (Protection of Patients and Medical Practitioners) Bill” or “Passive Euthanasia Bill”
It seeks to allow a patient faced with terminal illness to decide whether he/she wishes to continue medical treatment in the form of life support or medication. A “competent person” aged 16 or more can decide, with the consent of spouse or parents. The medical practitioner is supposed to inform the patient of all treatment options, and can provide palliative care to make the end of life less painful.
Need of this bill shows an example of Aruna Shanbaug case, the victim who had suffered for 36 years after brutal rape in 1973 was in permanent vegetative state and her friend appealed for her death peacefully and her death was allowed under Passive Euthanasia.
Lets have a look at the history how it all started ?
- According to an explanatory note by the Health Ministry, euthanasia was examined in 2006, based on the 196th Report of the Law Commission, but it was decided not to formulate a law.
- In Aruna Shanbaug, the Supreme Court permitted passive euthanasia and laid down comprehensive guidelines. The 2012 Law Commission Report recommended legislation on passive euthanasia and drew up a draft Bill — The Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill — but warned that a Living Will may be misused.
- The case before the Supreme Court, filed by NGO Common Cause, is old — and was referred to a Constitution Bench in 2014. Over the last few years, an umbrella group called End of Life Care in India Task Force (ELICIT) has drafted an alternative Bill on legalising Living Wills. In 2016, ELICIT came out with its “Mathura Declaration”, emphasising the need to discuss “end-of-life care” in India.
Despite the 2011 judgement, hospitals often refrain from pulling the plug, fearing medico-legal consequences.
- What is End of life care ?
It is a holistic approach to relieve a patient from suffering, which may or may not lead to immediate death. For instance, end-stage cancer patients may have only months to live, but require pain management
Whereas, Passive euthanasia is the removal of life support with intent to end life, and thereby suffering, of vegetative or terminally ill patients. But both allow removal of life support to permit natural death.
From now on Situation will be :- That living will may be held credible if a medical board certifies that the patient’s medical condition is irreversible. Even though the court reserved its judgement, its observations may nudge the central government to reconsider the current draft, which disallows Living Will.