Sunday, March 13, 2011

Euthanasia, should we allow it?

The word euthanasia means 'good death' from the Greek word eu for good, andThanatos for death. In common parlance, however, it is rarely used in this literal sense which emphasises the type of death experienced, and is usually employed to refer to the act of deliberately inducing the death of a patient who is in severe pain and distress as a result of a terminal or incurable illness. There are two distinctions in euthanasia: active euthanasia and passive euthanasia.

Active euthanasia can be defined as a deliberate act of ending the life of a patient with a terminal or incurable disease. Passive euthanasia is the deliberate withholding or withdrawing of life-prolonging medical treatment with the object of hastening the patient's death, as a result of which the patient dies earlier than he/she would have diedhad treatment been continued. (Otlowski, Margaret, Voluntary Euthanasia and the Common Law, Oxford University Press.)

Many arguments have been advanced by scholars, human rights philosophers and law thinkers advocating legalisation of euthanasia all over the world. These were made on the basis of moral, human rights, and utilitarian grounds. The moral ground is that it is against morality to leave someone in severe pain and do nothing for his/her relief. The human rights angle is that leaving a patient in severe pain would amount to directly challenging the fundamental right of the individual i.e., the right to a dignified life. The utilitarian principle believes in the greatest degree of happiness to the maximum number of people. According to this, if anyone is terminally ill, lying in hospital and is in severe pain, then it would not bring his/her family happiness and it will suffer because of his/her pain. So, utilitarian thinkers argue that an act or abstaining from an act which does not give happiness to anyone is wrong.

Exercising the euthanasia option in any respect is wrong. First of all, it is in contradiction with the moral basis and beliefs of all religions. Every religion states that no one except God reserves the right to take a person's life. Secondly, it prompts doctors to go against their moral duty of always serving and safeguarding the patients irrespective of the severity of their health.

According to the utilitarian principle, provided there is a balance of pain over pleasure, active euthanasia would be justified if it maximises the benefits for all, regardless of whether the patient can or cannot give consent. Thus, the interests of the individual are subordinated to the interests of the majority. Because of this possible manipulation of utilitarian arguments toward non-voluntary and involuntary euthanasia, it ought to be rejected as a moral theory justifying only active voluntary euthanasia.

The basis of active voluntary euthanasia is to relieve patients of their pain by killing them with their consent. But the subjective assessment by the patient of his/her own circumstances can be motivated by a fear of pain, suffering, dependency, undue influence or other causes. These factors combined together provide enough room for manipulation by external agents, which may benefit from the process of euthanasia. Thus, a patient might be unable to provide free and unbiased consent in his/her interest. And considering the weak hold of India's administration and judicial system in rural areas, the chances of prohibiting the misuse of euthanasia are slim. Thus legalising active voluntary euthanasia poses a major risk.

The shortcomings of active voluntary euthanasia are further exposed in a hypothetical situation where the patient wants to die and gives his/her consent for euthanasia but the doctor knows that by taking some positive steps the life can be prolonged. In such cases whose consent is to be considered?

Another major flaw appears in cases where the patients are either too old or are not in a state to give their consent. This poses a grave challenge to the idea as these cases abound everywhere. In such situations, involuntary euthanasia might be considered an option. But it can be realistically seen that it is more prone to misuse than active voluntary euthanasia. In cases where passive involuntary euthanasia is legal, Baylor said that a doctor would be free to accept or reject a patient's consent. If the physician accepts a patient's wish and undertakes treating him/her, the law imposes a duty on the physician to continue treatment as long as the case requires. Then at least theoretically, if the doctor voluntarily omits to do an act, such as withholding medical treatment from a severely retarded or defective infant, knowing that such omission will cause death, he/she will not be criminally liable under the euthanasia principles. I say theoretically because even though at least once a week a doctor somewhere in the Washington Metropolitan area decides that one of his/her infant patients has no chance of a meaningful life and withholds treatment needed to keep the child alive; and even though one-third of the 24 infants died in the D.C. General Hospital in 1973 because doctors decided to withhold treatment, as of 1973, several researchers have concluded that there has never been a case dealing with this issue. (Article: Physician's Criminal Liability for the Practice of Euthanasia. The Foreman, perey 27, Baylor L Rev.54 1975). Thus it is apparent that the doctors cannot be questioned in such cases. This gives the doctors more than permissible control over the fate of the infants under their care.

So if you allow active euthanasia to be legalised then the flaws that will result are that in a majority cases, consent will not be free because consent could be motivated by a fear of pain, suffering or dependency. Also active euthanasia will not cover the width of arguments proposed by human rights activists and moral activists because most of the cases of patients with an incurable disease and those who are too old will not be in a position to give their consent. Consequently, this condition will increase the apprehensions over legalisation of passive euthanasia.

Passive euthanasia will cover infants and unborn babies. We have the example of the Netherlands, where all these acts were legalised. As a result, Netherlands lost more than one-fourth of its population and it badly affected unborn babies with a high fall in birthrate in that country. This is evident from its population statistics. There is an important lesson to every country that is considering following this proponent country and legalising euthanasia. Euthanasia is impracticable in India given its susceptibility which makes it prone to misuse.

http://www.thehindu.com/opinion/open-page/article1532408.ece

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