Lavanya Goinka
Euthanasia can be seen in a variety of ways, including as active or passive; nevertheless, the specific meaning of passive euthanasia is sometimes unclear. Whether or not all passive euthanasia includes withholding life-sustaining therapy, it appears that there is some debate about whether such denial of life support should be considered passive euthanasia in its entirety.
Active euthanasia and passive euthanasia have been distinguished in the past. It has long been assumed that the two are so fundamentally different that, while the latter is rarely acceptable, the former is always prohibited. There are a number of reasons to question this doctrine. Indeed, in many circumstances, active euthanasia is a more merciful procedure than passive euthanasia. Furthermore, traditional doctrine may lead to decisions about life and death that are based on inappropriate criteria. The doctrine’s third flaw is that it is based on a morally dubious distinction between killing and allowing someone to die. Furthermore, some of the most commonly used arguments in support of the theory are false.
Active and passive euthanasia have been distinguished in the past. It has long been assumed that the two are so fundamentally different that, while the latter is sometimes acceptable, the former is always prohibited. This doctrine should be questioned for various reasons. Indeed, active euthanasia is more merciful than passive euthanasia in many circumstances. Furthermore, traditional doctrine can lead to life-or-death decisions being made on irrelevant grounds. The doctrine’s third flaw is that it is based on a morally insignificant distinction between killing and letting die. Furthermore, some of the doctrine’s most common defenders’ arguments are deficient.
An overview of euthanasia
What is euthanasia?
Sir Francis Bacon first proposed the concept of euthanasia in the 17th century. It is derived from the Greek terms ‘eu’ and ‘thanatos,’ which respectively indicate ‘good’ and ‘death.’ Its original meaning, however, was a ‘pleasant’ or ‘easy’ death.
The administering of a lethal chemical to a patient in order to relieve the patient’s severe and incurable agony and suffering is referred to as euthanasia. Physicians are usually motivated by compassion and want to alleviate their patients’ suffering. Euthanasia is carried out by doctors and is defined as either active or passive.
Euthanasia comes in a variety of forms.
Euthanasia can take many different forms. Several factors, including one’s point of view and level of consciousness, influence the following types:
Euthanasia and PAS
PAS (Physician-assisted-suicide) is a concept that has already been mentioned. When a doctor knowingly supports someone in ending their life, this is referred to as PAS. This person may be suffering from pain for an extended amount of time. It’s possible that they were given a terminal sickness diagnosis. In the majority of situations, the doctor of such people will examine and determine which operation is the most successful and painless.
Euthanasia, both active and passive
In active euthanasia, a person (ideally a physician) causes the patient’s death directly and intentionally. The patient’s life is not taken directly in the instance of passive euthanasia; instead, they are allowed to die.
Euthanasia can be consensual or non-voluntary (involuntary).
The person who is going to die has the option of requesting voluntary euthanasia. When a person/patient takes the conscious decision to die at the hands of a doctor, this is known as voluntary euthanasia. Such a person/patient must provide his or her full agreement to such life-ending intervention and demonstrate that they are fully aware of the circumstance.
A physician’s opinion: Before participating in PAS, an individual must be cognitively capable of making a decision. Nonetheless, determining someone’s cognitive capacity might be tricky. According to studies, doctors aren’t always able to tell when a person lacks the mental capacity to make a decision.
Ethical considerations include the following:
Physicians who are opposed to PAS are concerned about ethical issues. More than 2,500 years ago, physicians took the Hippocratic oath. Doctors swear to take good care of those under their care and never hurt them by taking this oath.
According to some, PAS improves suffering while causing no extra injury, hence it is supported by the Hippocratic oath. However, some say that it is harmful to the sufferer as well as their loved ones, who must watch their loved one suffer.
Personal preference: The phrase “death with dignity,” according to this viewpoint, refers to a movement that promotes and empowers people to choose how they wish to die during their lives. Some people just do not want to go through a lengthy death procedure, often because they are concerned about the impact on their loved ones.
An introduction to passive euthanasia
As previously stated, passive euthanasia is similar to all other forms of euthanasia in that it involves a wish to expedite death in the patient’s best interests.
Passive euthanasia differs from active euthanasia in that the former hastens death by omitting to supply something that would have delayed death if provided, i.e., passive euthanasia involves the doctor withdrawing or postponing life-prolonging medical therapy. Passive euthanasia can take the form of not administering medication or performing an operation that would save the patient’s life.
As a result, in order for passive euthanasia to take place, three conditions must be met:
Treatments that extend life are being phased out or withheld.
The primary purpose of stopping or delaying therapy is to hasten the patient’s death.
The argument for hastening death is that it was in the patient’s best interests to die, as he would die sooner or later.
However, not all situations in which life-prolonging treatment is withheld or discontinued constitute euthanasia. As we’ve seen, passive euthanasia entails safeguarding patients’ interests when there’s a possibility that their quality of life will deteriorate to the point that they’d rather die than live. There are, however, additional grounds for discontinuing or delaying treatment.
There could be three explanations for this. First, the treatment may be useless and so ineffective, and it may also be ineffective in terms of cost. It is not passive euthanasia, no matter how justified it may be, because it is voluntary.
I’m referring to the third condition. Treatment may be withheld or withdrawn in a third case due to an unreasonable burden or risk. This is not passive euthanasia because it breaches the second requirement mentioned before.
In other cases, the patient may refuse the treatment in question, which might be a fourth reason for stopping or delaying treatment. As a general rule, any adult patient has the right to refuse treatment, and the physician’s compliance with that refusal does not constitute passive euthanasia because the second requirement is not met.
Even if the patient declines treatment, the healthcare provider does not share the patient’s desire to die sooner.
In India, acceptance of passive euthanasia is a step in the right direction.
Religious beliefs in India generally oppose premature death, hence the right to live may exceed the right to die with dignity, which was just recently recognised by the courts in the aforementioned case in 2018.
Despite the Supreme Court’s recognition of the right to die with dignity as a basic right, religious communities in India, which are staunch opponents of euthanasia, could offer significant obstacles.
Passive euthanasia acceptance in India: what’s next?
Because religious beliefs in India strongly oppose premature death, the right to life may overshadow the right to die with dignity, which was just recently granted legal status in the aforementioned case in 2018.
Despite the Supreme Court’s recognition of the right to die with dignity as a basic right, religious communities in India that are opposed to euthanasia may provide significant obstacles.
Conclusion
The ‘Common Cause’ ruling is a landmark judgement with far-reaching effects. The verdict ensures that people who are unable to recover and are deemed medically unfit, as well as those who desire to end their lives, will benefit greatly from passive euthanasia. The Court further stated that families do not misuse this option in order to get rid of those who are not ‘fit’ for their family, and that various safeguards have been put in place to guarantee that this does not happen. The aforementioned landmark judgement has elicited mixed views from India’s palliative care community, which is unsurprising.
The legal stance of India on end-of-life concerns has been regarded as perplexing at best, and an analysis of the language of the new law legalising passive euthanasia has shown numerous glaring inconsistencies.
However, from a different perspective, the Supreme Court’s judgement clarifies the legality of passive euthanasia. legal acceptance of withdrawal/withholding of fruitless treatment and advance directives, according to a University of Glasgow essay, could be considered a first step in the correct way, notwithstanding some ambiguous phrasing. Furthermore, greater clarity is required, as well as open and honest community debates about what provides and preserves dignity towards the end of life.