• UGI USER
  • May 08, 2024
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A DIGNIFIED PEACEFUL PASSING IS EVERYONE’S RIGHT

SYLLABUS:

  • GS 2: Constitution of India —historical underpinnings, evolution, features, amendments, significant provisions and basic structure.
  • Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

Focus:

  • World Health Day (April 7) has passed and the theme for 2024 was “My health, my right”.

The Importance of a Dignified Peaceful Passing

  • Universal Right: A dignified peaceful passing is considered a fundamental human right, emphasizing the importance of respect and compassion at life’s end.
  • Quality of Life: Ensuring a peaceful death contributes to maintaining the quality of life even in its final stages, allowing individuals to die with dignity and peace.
  • Emotional Comfort: A dignified death provides emotional comfort to both the dying individual and their loved ones, making the process less traumatic.
  • Ethical Considerations: It aligns with ethical medical practices that prioritize patient wishes over prolonged suffering through unnecessary interventions.
  • Cultural and Personal Values: Respecting personal and cultural values at the end of life supports a broader range of end-of-life care options that honor those values.
The evolution of the concept of ‘Living Will’ in India can be traced through significant legal milestones:

  • Law Commission of India (2006): In its 196th Report titled ‘Medical Treatment to Terminally Ill Patients (Protection of Patients and Medical Practitioners)’, the Law Commission clarified that a patient’s decision to refuse medical treatment did not constitute an act of suicide under Section 309 of the Indian Penal Code (IPC). Furthermore, it stated that a doctor who abides by the instructions of a competent patient to withhold or withdraw medical treatment does not breach their professional duty.
  • Aruna Shanbaug case (2011): In this case, the Supreme Court of India allowed passive euthanasia for Aruna Shanbaug, a nurse who had been in a vegetative state for several years at a hospital in Mumbai. This decision marked a significant legal precedent regarding end-of-life care in India.
  • Puttaswamy case (2017) / Right to Privacy case: The Supreme Court, in its landmark judgment on the Right to Privacy, held that Article 21 of the Constitution includes the concept of individual dignity. This recognition laid the foundation for acknowledging passive euthanasia as a component of the right to privacy.
  • Common Cause case (2018): In this case, the Supreme Court of India legalized passive euthanasia and established guidelines for the implementation of living wills. The court’s decision provided a framework for individuals to express their end-of-life preferences in advance through living wills, ensuring that their wishes are respected in medical decision-making processes.

Case stidy for Comparison of End-of-Life Experiences

Ronald Reagan’s Passing:

  • Family Presence: Died at home surrounded by family, highlighting the comfort of familiar surroundings.
  • Personal Wishes Honored: His end-of-life care respected his personal wishes, as reflected by his wife’s statement about his peaceful passing.
  • Dementia Management: Managed a long-term illness (dementia) with dignity at home.
  • Public Perception: His passing was seen positively and as a model for dignified dying.

Atal Bihari Vajpayee’s Passing:

  • Hospital Setting: Spent his last days in a hospital, contrasting with a home setting.
  • Life Support: Died on artificial life support, indicating a more medicalized approach to end-of-life care.
  • Isolation from Family: Lacked the immediate comfort of family in his final moments, as he was alone in the ICU.
  • Ethical Questions: Raises questions about the ethical implications of prolonged life support without clear benefits.
  • Public Policy Impact: His death highlights differences in end-of-life care practices between countries and could influence future healthcare policies.
Active euthanasia V/S Passive euthanasia

  • Active euthanasia refers to the deliberate and direct intervention to end a person’s life using substances or external forces, typically exemplified by the administration of a lethal injection by a medical professional.
  • Passive euthanasia, also known as negative or non-aggressive euthanasia, involves the withholding or withdrawal of medical care necessary for sustaining life. This could include the denial of treatments like antibiotics when they are deemed futile or when the patient’s condition is terminal and inevitable.

Cultural and Systemic Differences in End-of-Life Care

  • Advance Directives: In Western countries, there is a growing adoption of advance medical directives to ensure that end-of-life care respects individual wishes.
  • Palliative Care: Western healthcare often transitions to palliative care when recovery is unlikely, focusing on comfort rather than cure.
  • Legal Frameworks: Western countries typically have clearer legal frameworks supporting the withdrawal of life support in futile situations.
  • Public Awareness and Acceptance: There is greater public awareness and acceptance of end-of-life care options, including the right to die with dignity.
  • Contrasts with India: In India, there is a higher prevalence of life support use in terminal cases, less use of palliative care, and significant legal and ethical challenges in end-of-life care decision-making.

This structured outline provides clarity on the importance of a dignified passing, how different cultural and systemic settings impact end-of-life experiences, and the specific cases of Ronald Reagan and Atal Bihari Vajpayee.

Various countries have diverse laws regarding euthanasia and assisted suicide:

  • In the Netherlands, Luxembourg, and Belgium, both euthanasia and assisted suicide are permitted for individuals experiencing “unbearable suffering” with no chance of improvement.
  • Switzerland prohibits euthanasia but permits assisted dying under the supervision of a doctor or physician.
  • Canada initially announced plans to allow euthanasia and assisted dying for mentally ill patients, but this decision faced widespread criticism.
  • The United States has varying laws across different states. Euthanasia is legal in states such as Washington, Oregon, and Montana.
  • The United Kingdom deems euthanasia illegal and considers it equivalent to manslaughter.

Source:The Hindu

Mains Practice Question:

“Discuss the significance of ensuring a dignified peaceful death for terminally ill patients in the context of differing global practices. Illustrate your argument with the contrasting end-of-life experiences of Ronald Reagan and Atal Bihari Vajpayee. Additionally, evaluate how cultural, ethical, and legal factors influence the choices and implementation of end-of-life care in different countries.”

Associated Articles:

https://universalinstitutions.com/living-wills-status-of-euthanasiain-india/#