The issue of euthanasia was so far a distant matter being raised in the West, but the case of Aruna Shanbaug, who lies comatose for 37 years at the King Edward Memorial Hospital in Mumbai, has thrust the difficult question right into our midst after a petition by writer-journalist Pinky Virani led a two-judge bench of the Supreme Court to pronounce on the subject on Monday. The subject is particularly difficult.
It raises the question of religious or spiritual beliefs, but also enters the family realm. On one side is the poser: who but God can decide to take away life (in this case through withdrawal of life-support medicines and medical equipment)? However, those who are emotionally close to a patient who is not physically dead but for long shows no signs of stirring and may be what is called “brain dead” have sometimes asked: why allow physical suffering when the limits of medical science allow no hope of revival? The latter course has been referred to as “mercy killing”, which can itself appear presumptuous to some. All societies have sanctioned killing, as in the case of a convicted murderer (although many Western countries have in recent years scrapped the death sentence), upholding the principle of “an eye for an eye” originating in early times. To that extent, society already plays God. But the reply to that is that the case of ordinary, innocent persons is to be judged differently from that of a murderer. Naturally, opinion varies on whether anyone has the right to kill even a murderer. Isn’t that the province of the Almighty in all circumstances? The argument, of course, accepts that there is an Almighty. In short, these arguments are complex and call for debate within a society. Discussions elsewhere are helpful, but cannot replace those within a society in the light of the evolution of a specific society. In the Shanbaug case, the court did not allow Ms Virani’s appeal for so-called mercy killing. It argued that the nurses and doctors of KEM Hospital, who have looked after their former colleague with loving care, oppose euthanasia in her case. But what if that were not the case? The court refrained from entering that discussion. It has thus not ruled on whether all patients in a “permanent vegetative state” deserve to have their life ended in a “passive” manner, that is, through withdrawal of life-support systems in a hospital, provided no foul play is suspected.
Although the Supreme Court has said the contention of “passive” euthanasia can be considered if medical experts can convince a high court that cure or even part-cure is an impossibility, it would appear the nation’s highest court has been unable to lay down a principle. This aspect needs to be given due consideration if and when Parliament considers the issue. An extension of the argument made by the bench implies is that the time, effort and resources spent on someone who cannot be brought back to normal physical existence is a waste of society’s resources. Is this heartless, especially if a patient’s family or friends are ready to foot the bill? And what if those close to the patient are not in a position to pay? Should different rules apply in such cases?
On the question of “active” euthanasia, or injecting drugs that will kill on a patient’s plea, the Supreme Court has said an unambiguous “no”. Most of us are likely to agree. Can this be extended unequivocally to “passive” euthanasia? The point undoubtedly deserves to be considered, and debated across a wide cross-section of society. On Monday, the Supreme Court also took suicide out of the list of crimes. This again is wholesome.