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Vijaya Pushkarna
Vijaya Pushkarna

Right to death

Living will: Granting the right to depart with dignity

Living will: Granting the right to depart with dignity (File photo) Representational image

It was pre-Diwali season many years ago. Chandigarh's prominent Sareen family was torn between celebrating Diwali or letting it be a quiet, dark festival of lights. The head of the family was for months in the PGI (Postgraduate Institute of Medical Education and Research) on a ventilator, with little hope of pulling through. Theirs was a highly educated family and the sons in different parts of the world were landing in the city to take a decision on whether to let him be in the hospital, or bring him home—a passive euthanasia of sorts. Before all the brothers could be in the city, senior Sareen breathed his last, almost as if he had wrested his dignity. And soon was born the Voluntary Euthanasia Society of Chandigarh, the country's second after the one in what was then Bombay.

Call it voluntary euthanasia or the right to die with dignity, many have wanted it for their dear ones, some have wished it for themselves should they go into a vegetative state where there is no light at the end of the tunnel, in the future. It is all about stopping treatment when a patient is simply not going to come out of that vegetative state where as one doctor described, “there is biology but no biography.”

A whole lot of literature on how to snuff life out of oneself or make the final exit have been published, banned in some countries including India, only to be read stealthily. But it is an issue that has not been resolved.

In 2006 there was a bill regarding this. Titled 'Medical Treatment of Terminally Ill Patient (Protection of Patients and Medical Practitioners) Bill 2006', it never became a law. Ten years later, the Law Commission, in its 241st report, favoured passive euthanasia with proper safeguards—clearly to ensure that the elderly were protected from greedy children wanting a quick inheritance or, not wanting to care of the ailing parents.

The Supreme Court, which was hearing a PIL filed in 2005, on Thursday decided more or less to let a medical board take the final call, on a case-to-case basis. A five-judge bench, headed by Chief Justice Deepak Mishra, however, reserved its plea seeking recognition of a living will made by terminally ill patient, for passive euthanasia. Conceding that right to die peacefully is part of fundamental right to life under Article 21 of the Constitution, the apex court said there should be “adequate safeguards and implementation of living will would be subject to medical boards certifying that the patients' comatose state is irreversible.”

In fact, the Supreme Court is of the view that there should be medical boards constituted for this purpose across the country, and it should be obligatory.

Doctors or medical boards are likely to be reluctant to do that. While they will be guided by their professional bodies, one senior doctor explained that “being a doctor means never giving up hope,” and recalled a woman patient whose family had taken her “to die peacefully at home from a cancer hospital” had miraculously survived. “I saw her three years after they took her away,” said the doctor.

“One cannot say that you have a right to die, but you have a right to dignified death. If we recognise the right to dignity in death, then why not dignity in dying”, the bench observed .

A living will is made by a person when he/she is healthy physically and mentally, and loosely directs against medical intervention to prolong life when there is no dignity left in that state of living, and when there is no chance of survival.

Even as the debate is raging in court rooms and societies in many parts of the world, in countries like India, passive euthanasia is practised unknowingly. When a terminally ill patient's family is advised to take the patient home, the hospital is not just trying to free precious ventilators and hospital beds for others who may pull through with the help of such support systems. They are withdrawing medical treatment, knowing that the patient's chances of survival are bleak.

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