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The right to life or the right to die?

Time and again, the legal position on an individual's right to die has sparked debate only to die down until the next case. LINA MATHIAS



DIFFICULT CHOICE: Euthanasia is an issue that elicits powerful emotions. PHOTO: AP

THE President of the Indian Society for the Right to Die with Dignity, Sadanand Varde recalls the bill he had moved in 1984 in the Maharashtra legislature seeking to legalise mercy killing. Varde, then an MLC, and later education minister, says the bill itself faced "involuntary euthanasia" when he allowed it to lapse since the House was not in favour. The petition by Bihar's Tarkeshwar Chandravanshi in early April to the State governor asking for mercy killing for his wife Kanchan Devi, set off Varde's memories of his doomed attempt. Chandravanshi's petition in the court was rejected, forcing him to appeal to Bihar's Governor, Buta Singh. Kanchan Devi is in a coma since 1999 and her husband has run through all his property and other financial assets in taking care of her.

A few months before the Terri Schiavo case in America became the subject of such intense debate round the world, India's imagination was caught by the case of 25-year-old K. Venkatesh. A patient of muscular dystrophy since the age of 10, he was bedridden and wanted his organs to be donated after death. However, only a brain dead patient's organs (kidneys and liver) can be taken for transplant and Venkatesh's doctors had turned down his plea to take him off the life support system. His mother, K. Sujata, filed a petition in the Andhra Pradesh High Court seeking permission for the harvesting of his organs. Since his organs were in working condition then, they should be harvested before infection set in and he died a natural death, she said. Venkatesh died naturally on December 17, two days after the court rejected his mother's plea. Had the court allowed the plea, it would have contravened the Transplantation of Human Organs Act that prohibits the use of organs before a patient is brain dead. Secretary of the Indian Society for the Right to Die with Dignity and cancer specialist, Dr. Nagraj Huilgol says the focus should clearly be on the person's right to govern his own life versus the State's right. "Science and the State must not be arrogant. The former cannot tell the person to suffer unbearable pain till a cure is found and the latter cannot insist that it has the right to decide whether the person should live or not," he says. However, doctors should be given the right to decide whether they agree or refuse to participate in a person's decision to be subjected to mercy killing, he cautions. Other doctors point out that when as often happens, families of terminally ill patients are told to take them home as "nothing more can be done", it is a form of euthanasia. This practice is widespread and is not considered unusual, they say. Time and again, the legal position on an individual's right to die has sparked debate only to die down until the next case.

In Kerala

In 1999, four senior citizens in Kerala had filed lawsuits asking for the legalisation of assisted suicide in the country. In 2000, a division of the Kerala High Court had held that voluntary termination of one's life either by those who are frustrated or those who had achieved their life's mission would both amount to suicide. While euthanasia is clearly illegal in India, under section 309 (attempt to commit suicide) and 306 (abetment to suicide) of the Indian Penal Code (IPC), those who survive suicide attempts can be prosecuted for the "crime" as also those who abet the attempt. The petitions were originally filed by two retired schoolteachers, C.A. Thomas (then 80 years) and Mukundan Pillai (then 69) saying they had no further desire to live. But as law-abiding citizens, they did not want to commit suicide, they added. They wanted to voluntarily end their lives or donate bodily organs to facilitate voluntary death. Thomas' petition said that freedom to choose the method of one's death was part of the right to life as guaranteed by Article 21 of the Constitution.

A few months after the HC dismissed his petition, "Thomas Master" committed suicide.

Child euthanasia

In the first week of December 2004, the first country to legalise euthanasia, the Netherlands, witnessed a major controversy over the issue of child euthanasia. The Groningen Academic Hospital said that with the permission of parents and independent doctors, it had carried out involuntary euthanasia on four severely disabled and terminally ill babies in 2003. This is known as neo-natal euthanasia or post-birth abortion. The hospital authorities defended their action pointing out that these babies had been born with such serious and incurable defects that the "most humane" action was to assist or allow them to die. Besides, parents and relatives end up doing this in secret anyway and so why not legalise it, they argued. Referring to the draft bill he had circulated 21 years ago, Varde points out "If a terminally ill patient cannot be treated with the existing medical technology and doctors have declared the disease is incurable, his wish made with a sound mind and in the presence of two witnesses to be subjected to mercy killing should not be considered a crime." He says that the pioneer of the campaign to advocate mercy killing, Minoo Masani asked him to let his bill lapse rather than have it voted out because that would do the cause a major disservice. However, it was the only bill to have been circulated for one whole year to elicit public opinion and 75 per cent of the respondents wanted either a longer debate on it or outright agreed with it, he says.

The arguments for and against euthanasia are too well known to be repeated here. However, there are three main terms involved in this. "Terminal sedation" is when the patient is sedated to unconsciousness and all life saving interventions are withheld, "voluntary active euthanasia" means a physician provides the means and physically helps the patient end his life and "physician-assisted suicide" is when a doctor provides the means but not the actual bodily help.

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