Euthanasia and the super rich  

Euthanasia is the process to end a life with a view to relive from pain and suffering.  This is really not relevant to the utmost poor who cannot afford costly medicines and treatment.  They die without treatment and thus are luckier than the super rich whom nature will not allow to live and doctors will not allow to die.  Many industrialists, powerful politicians and others languished for years.  Raj Mata Vijay Raje Scindia, H.K.L Bhagat and Dhirubhai Ambani are relevant cases.   Their name, fame and money were their enemies in their last days.  Not only doctors, even services of  tantriks and priests are arranged to perform Maha Mritunjay Mantra to prolong life of these wretched super rich and powerful.  No euthanasia is available to them.  The poor get euthanasia without asking.  

Historic backgroud and meaning  

Euthanasia  originated in Greece.  This  refers to the practice of intentionally ending a life in order to relieve pain and suffering. The legal definitions and provisions differ from country to country. The House of Lords Select committee in Britain defines Euthanasia as   "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering". 

Euthanasia has been assigned different meanings from time to time and place to place. Historian Suetonius described how Emperor Augustus  - "dying quickly and without suffering in the arms of his wife, Livia, experienced the 'euthanasia' he had wished for.". In medical contest, the term  was used  by Francis Bacon in  the seventeenth century, He referred to an easy, painless, happy death, during which the physician assumed the responsibility to alleviate the physical sufferings .

Genocide or euthanasia in Nazi Germany 

The worst inhuman meaning to euthanasia was given in Nazi Germany. Millions of people including  children  were killed in disguise of mercy killing but this was plain genocide as BBC broadcast described  " Genocide Under the Nazis Timeline". This was  first "state-sponsored euthanasia". Nazi version of "euthanasia" was based on the work of Adolf Jost,  publisher of  The Right to Death (Das Recht auf den Tod) in 1895. Lifton writes: "Jost argued that control over the death of the individual must ultimately belong to the social organism, the state. This concept is in direct opposition to the Anglo-American concept of euthanasia, which emphasizes the individual's 'right to die' or 'right to death' or 'right to his or her own death,' as the ultimate human claim. In contrast, Jost was pointing to the state's right to kill. Ultimately the argument was biological: 'The rights to death are the key to the fitness of life.' The state must own death—must kill—in order to keep the social organism alive and healthy."

Current meaning and international practice 

 In current usage, there is an approach to define euthanasia  as the painless inducement of a quick death  But this may be argued that this approach us faulty as there may be many possible situations that satisfy the definition  but cannot be rightly considered as euthanasia, particularly  painless killing for  personal gain; or quick and painless accidental deaths. 

 The definition in Oxford Dictionary defines euthanasia as  "the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma". However, this approach may also include killing a person suffering from an incurable disease for personal gain. Such cases are simply murder and not euthanasia according to some. 

There is another approach to define euthanasia. Death must be intended and not accidental and should have mercy as motive. Michael Wreen argued that “the principal thing that distinguishes euthanasia from intentional killing simpliciter is the agent's motive: it must be a good motive insofar as the good of the person killed is concerned”. 

Draper argued that euthanasia consists of  four elements: an agent and a subject; an intention; a causal proximity, such that the actions of the agent lead to the outcome; and an outcome. Accordingly, she defined euthanasia as  “ Death that results from the intention of one person to kill another person, using the most gentle and painless means possible, that is motivated solely by the best interests of the person who dies." 

Wreen stressed that euthanasia must  be voluntary  and that "involuntary euthanasia is, as such, a great wrong"     

There is a difference of opinion  within the medical and bioethics literature as to  the non-voluntary or  involuntary killing of patients can be regarded as euthanasia. Wreen did not consider patient’s consent as a criteria, although it may be necessary to justify euthanasia.  However, many others opine that consent is essential condition of euthanasia. .

When patient consents, the euthanasia is classified as voluntary. Active voluntary euthanasia is lawful in Belgium, Luxembourg and the Netherlands. Passive voluntary euthanasia is lawful  throughout the United states. Often, the term Assisted suicide is used. Assisted suicide is legal in Switzerland and the U.S. states of Oregon, Washington and Montana.

Euthanasia may be  passive or active. Passive euthanasia is the act of  withholding of common treatments, such as antibiotics, necessary for the continuance of life. Active euthanasia entails the use of lethal substances or forces, such as administering a lethal injection, to kill and is the most controversial. .

The debate on euthanasia originated in 1870  In Nevertheless, euthanasia was debated and practiced long before that date. Euthanasia was practised in Ancient Greece and  Rome. Hemlock was used to  hasten death on the island of Kea. This technique also employed in Marseilles and  by Socrates in Athens. Socrates supported Euthanasia meaning deliberate hastening of a person's death. Hippocrates was against the practice. He wrote  "I will not prescribe a deadly drug to please someone, nor give advice that may cause his death"   . 

Euthanasia was disfavored in the Judeo Christian tradition. It was argued that  the practice of euthanasia was contrary to  natural human survival instinct.  This view was shared by many including Philipp Jakob Spener, Veit Riedlin and Johann Georg Krunitz However, euthanasia continued to be practised, involving techniques such as bleeding, suffocation and removing people from their beds to be placed on the cold ground.

Suicide and euthanasia were more acceptable under Protestantism and during the Age of enlightenment.Thomas More wrote  of euthanasia in Utopia. Other cultures have taken different approaches: for example, in Japan suicide has not traditionally been viewed as a sin, and accordingly the perceptions of euthanasia are different from those in other parts of the world.

Use of morphine emerged in nineteenth century to treat  "the pains of death". Bullar revealed similar use of chloroform  in 1866. But it was not recommended for use  to hasten death.

 Lionel Tollemache wrote in favour of euthanasia. So  did Annie Besant who later became involved with the National Secular society considering it a duty to society to "die voluntarily and painlessly" when one reaches the point of becoming a 'burden'. Popular Science also analyzed the issue in May 1873, assessing both sides of the argument.[ Nevertheless, Kemp notes that at the time, medical doctors did not participate in the discussion; it was "essentially a philosophical enterprise... tied inextricably to a number of objections to the Christian doctrine of the sanctity of human life".

 Robert Ingersoll stated  in 1894 that where someone is suffering from a terminal illness, such as terminal cancer, they should have a right to end their pain through suicide. Felix Adler offered a similar approach.  Alder argued that those suffering from overwhelming pain should have the right to commit suicide, and, furthermore, that it should be permissible for a doctor to assist – thus making Adler the first "prominent American" to argue for suicide in cases where people were suffering from chronic illness. Both Ingersoll and Adler argued for voluntary euthanasia of adults suffering from terminal ailments.[ However, Dowbiggin argues that by breaking down prior moral objections to euthanasia and suicide, Ingersoll and Adler made it possible for others to stretch the definition of euthanasia.

First attempt to legalize euthanasia in America  was seen when Henry Hunt introduced legislation into the General assembly of Ohio in  1906. Hunt was inspired by Anna Hall, a wealthy heiress ,  a major figure in the euthanasia movement during the early twentieth century in the United States. Hunt's bill called for the administration of an anesthetic to so as to  bring about a patient's death, so long as the person is of lawful age and sound mind, and was suffering from a fatal injury, an irrecoverable illness or great physical pain. It also required that the case be heard by a physician, required informed consent in front of three witnesses, and then required the attendance of three physicians who had to agree that the patient's recovery was impossible. The bill could not be passed.

In January 1936, a fatal dose of morphine and cocaine  was given to King George V  to hasten his death. He was suffering from cardio-respiratory failure. The decision to end his life was made by his physician, LORD Dawson. This remained a secret for over 50 years. The death of George V coincided with proposed legislation in the House of Lords to legalize euthanasia. The legislation came through the British Volunteer Euthanasia Legalization Society (now known as dignity in dying). 

West's Encyclopedia of American Law states that "a 'mercy killing' or euthanasia is generally considered to be a criminal homicide"  and is normally used as a synonym of homicide committed at a request made by the patient. 

The judicial sense of the term "homicide" includes any intervention undertaken with the express intention of ending a life, even to relieve intractable suffering. Not all homicide is unlawful.  Two designations of homicide that carry no criminal punishment are justifiable and excusable homicide.[  In most countries this is not the status of euthanasia. The term "euthanasia" is usually confined to the active variety Some governments around the world have legalized voluntary euthanasia but generally it remains as a criminal homicide. In the Netherlands and Belgium, where euthanasia has been legalized, it still remains homicide although it is not prosecuted and not punishable if the perpetrator (the doctor) meets certain legal exceptions.

The Indian context 

There is very thin dividing line between suicide, murder and euthanasia. There is lot of greed and corruptiuon in India. The Provision of euthanasia can be misued by unscrupulous elements/ relatives to get rid of ailing sickly person and bequeath his property. So, there is need to take utmost care.

There is thin dividing line between murder and euthanasia. An active process to end life like administering lethal injection may constitute murder. But the passivity of not supporting life by medicines or life support system would stand on a separate footing. Possibly, supreme court had this in mind while deciding thecase of aruna shanbag, who is a nurse working at the  KEM Hospital in Mumbai   A sweeper strangled and sodomized her.  She is undergoing treatment at KEM since the incident and is kept alive by feeding tube. On her behalf, her friend Pinki Virani, a social activist, filed a petition in the Supreme Court arguing that the "continued existence of Aruna is in violation of her right to live in dignity". The Supreme Court rejected the plea to discontinue Aruna's life support but issued a set of broad guidelines legalising passive euthanasia in India. The Supreme Court based the decision on the fact that the hospital staff  treating and taking  care of her did not support euthanizing her. 

The apex court issued some  guidelines for passive euthanasia which involves withdrawal of treatment or food that would allow the patient to live. Forms of active euthanasia, including the administration of lethal compounds, are legal in a number of nations and jurisdictions but still illegal in India. 

Active euthanasia is unlawful almost at all places.  As regards  passive euthanasia, the legal position differs from nation to nation.  As India had no law about euthanasia, the Supreme Court's guidelines are law until and unless appropriate legislation is passed by Parliament. There is need for debate on this issue. The apex court ruled that a decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend. It can also be taken by the doctors attending the patient. However, the decision should be taken bona fide in the best interest of the patient. The court also directed that a decision by near relatives and doctors to withdraw life support needs approval from High Court.  Chief Justice of High court should constitute a bench of two judges minimum for deciding the approval.  

The religious view

Christians and the Jains accept passive euthanasia under some circumstances. Jains and Hindus have the traditional rituals Santhara and  Prayovesa respectively, wherein one can end one's life by starvation, when one feels their life is complete. 

Conclusion

This is a very controversial matter. Suicide and murder both are unlawful as well as religions prohibit. But it may be well argued that what is the use of life that is worse than death. Mere breathing and suffering immense pain cannot be life in real sense. Euthanasia is justified in such cases. In fact, this is neither murdernor suicide. Nature really wants to kill the patient. He is incurable. In fact, attempt to prolong life is an act against nature and may be God, if you believe. So not kill but also do not add to misery by artificially keeping alive.  


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