What is the issue ?
- Supreme Court has legalised passive euthansia and approved the 'living will' concept to provide terminally ill patients and those in a vegetative state a dignified death.
Opinion of the Supreme Court :
- The fundamental right to life and dignity under Article 21 of the Constitution includes the “right to die with dignity.”
- Dignity is lost if a man is allowed or forced to undergo pain and suering because of “unwarranted medical support.”
- “The right of a dying man to die with dignity when life is ebbing out and in the case of a terminally ill patient or a person in permanent vegetative state, where there is no hope of recovery, accelerating the process of death for reducing the period of suffering constitutes a right to live with dignity.”
What is a 'living will' ?
- Document where individuals can express their wish at a prior point in time, when capable of making an informed decision, regarding their medical treatment in future.
Who can execute a 'living will' ?
- An adult of sound and healthy mind
- The living will must be voluntarily written, without coercion or compulsion.
- The living will must be in writing, stating when treatment may be withdrawn or no specific treatment shall be given that death can delay.
What should the living will contain ?
- Circumstances in which to stop treatment.
- A mention that the patient can change their mind at any time.
- Name of the relative/guardian who, in the event of the individual not in a position to take a decision, can consent to stopping treatment.
How is the living will kept on record ?
- Must be signed by the individual in the presence of two witnesses.
- Countersigned by a Judicial Magistrate of First Class.
- JMFC to keep a copy and forward a copy to the District Court
- Immediate family members to be informed.
The actual process involved :
- If the executor of the living will becomes terminally ill with no hope of recovery or cure, treating physician must check the authencity of the living will.
- Doctor to inform family members of the illness, treatment and consequences of remaining untreated.
- Hospital to setup a medical board comprising head of treating department and three doctors with atleast 20 years experience who shall decide if treatment is to be withdrawn. If the board declines plea, an application can be made to the DC's medical board.
- Hospital shall inform the District Collector is treatment is decided to be withdrawn by the medical board.
- Collector to immediately constitute a medical board comprising Chief Medical Officer and three expert doctors.
- If given the go ahead by the DC's board, the JMFC may allow the living will to be followed through.
- If permission is denied the family members can approach the High Court.
What is passive euthansia ?
- The term 'passive euthansia' is used when a patient dies because physicians stop doing something (treatment, life support) that keeps the patient alive.
Forms of euthansia :
1. Voluntary active euthansia :
- When a physician administers a medication, such as a sedative and a neuromuscular relaxant, to intentionally end a patient's life with the mentally competent patient's explicit request.
2. Active euthansia :
- When a physician administers a medication to intentionally end a patient's life but without the patient's request.
- This practice is allowed in the Netherlands.
3. Physician assisted suicide :
- When the physician provides medication at the explicit request made by a patient with the understanding that it will be used to end life.
- This practice is allowed in Germany.
Some facts that you should know :
- Netherlands became the first country to legalise euthanasia and assisted suicide in 2002.
- Euthansia is illegal in the United Kingdom, Australia, New Zealand and the Philipines.