By Pankajbala R patel

FOR some reason the cause of legal euthanasia, euphemistically called mercy killing sometimes, has never found many takers in India. Perhaps because India is still a young country although it is going to age in the next few decades (according to PRB’s latest analysis by the mid-2050s India will have more people aged 65 and older than under age 15, this is by the US non-profit Population Reference Bureau’s projected data). Undoubtedly since our healthcare system budget is one of the lowest in the world, happy longevity will be the dream of only a few who can afford to take care of themselves and pay all doctor’s home visit and hospital bills! For the many seniors quality of life will be just a dream and will not come true and they will be living in pain here, there and everywhere as long as they can and the quality of family care.
Clearly nobody is addressing future scenarios to do with the elderly population in India! While ironically in the countries of the developed west senior citizens are seeking to end their life because they say they are just tired of living and want assisted death, they are willing to sign the legal papers for to make their last wish of euthanasia come true. These are mostly seniors who say they can continue to prolong their life but have no wish to live anymore, they have made their will and actually want to say goodbye world be it kind or cruel. They are tired, weary of living, they have no ambitions of making it to a centenary birthday by hook or by crook!
In India we are still unused or new to such concepts or ideas as euthanasia or mercy killing although the latter we practice well enough in the case of other animals of the animal kingdom. What does euthanasia mean? It means an act of providing painless death to a suffering individual who doesn’t want to survive on medical facilities and wants them removed – there is “active euthanasia” which entails “killing” a terminally ill patient by injecting a drug. There are definitions of voluntary and involuntarily euthanasia or mercy killing (the kind observed by Nazis as cover for mass murder in human history).
In India any talk of euthanasia positive or negative is still perceived as illegal and any physician assisting such suicide may be punished under Section 306 IPC (abetment to suicide). Some of the legalities were re-defined after the infamous Aruna Ramchandra Shanbaug, a brutal sexual assault case in which the nurse victim was left paralysed and in a coma for something like 41 years during which time hospital staff refused to take her off life-support system and they cared for their colleague in a vegetative state with tender loving care before the end. A constitutional bench of the Supreme Court on January 24, 2023 in a landmark judgement legalised “passive euthanasia by modifying its 2018 order in Common Cause v.Union of India and Anr.

LIVING WILL
WITH this judgement a patient is entitled to something called “a living will” in which he/she has the choice of choosing passive euthanasia. Interestingly, some doctors argue that euthanasia is unnecessary if proper palliative care is given to a patient to improve quality of life; they also say such a law gives too much power to doctors and make patients vulnerable to pressure to end their life and that euthanasia can never be regulated properly! Cynical patients will read that a greedy medical system always seeks to prolong life for maximum billing and this has been observed time and again especially in private hospitals.
Abroad further re-thinking about euthanasia is going on. In Luxemburg (Belgium), Netherlands and some states in the USA like Washington and Oregon, upon request and if the rules permit it a terminally ill patient may legally seek euthanasia. This is being contested by many human rights organisations as well as children of the patients concerned. There is something like positive euthanasia and negative euthanasia, one permitted legally and the other not permitted if the nitty gritty doesn’t support it.
There are those who argue that positive euthanasia is closest to mercy killing as in cases when an animal of the field like horses or animals of the wild are in trouble and suffering agony – when it is easier to put them out of their pain by a gunshot or an injection or drug (pentobarbital?). One is reminded of Sydney Pollack’s 1969 film “They Shoot Horses, Don’t They” which is based on Horace McCoy’s novel of the same name by Horace McCoy first published in 1935 – the storyline of the film is a dance marathon conducted during the Great Depression years in America in which participants danced to win prize money…a very powerful film. The argument being that if we can put animals in distress to death, why can’t we do the same for human beings?
Needless to say in a country like India where life is perceived cheap any euthanasia law will leave room for use and abuse. There should be no loopholes at all when it comes to matters of suicide or death on appeal. It is true that once given the lethal injection a patient goes to sleep peacefully in 30 seconds and never wakes up again. Last wish granted of a patient tired of fighting it out to live but wishing to die for a myriad reasons going from absurd to poignant to rational and perfectly justified!

HOPELESS SITUATIONS
MOSTLY when we think euthanasia or mercy killing we think of seniors in hopeless situations of illness intertwined with no support infrastructure or family watching out for them – usually suffering for want of physical maintenance as well as financial want. In good or bad health it is still money which calls the shots and when the State has nothing to offer such patients without considerations of fear or favour. When push comes to shove it’s the old we think who should be sacrificed the first because they cannot fend for themselves on their own and the young are always around to inherit the spoils of their inheritance through fair or foul play amongst themselves!