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Legalization of euthanasia dying with dignity essay

Chaturvedi Find articles by Santosh K. See commentary " Dried blood spot testing: This article has been cited by other articles in PMC. The word euthanasia, originated in Greece means a good death 1.

Euthanasia encompasses various dimensions, from active introducing something to cause death to passive withholding treatment or supportive measures ; voluntary consent to involuntary consent from guardian and physician assisted legalization of euthanasia dying with dignity essay physician's prescribe the medicine and patient or the third party administers the medication to cause death 23.

Request for premature ending of life has contributed to the debate about the role of such practices in contemporary health care. This debate cuts across complex and dynamic aspects such as, legal, ethical, human rights, health, religious, economic, spiritual, social and cultural aspects of the civilised society.

The objective is to discuss the subject of euthanasia from the medical and human rights perspective given the background of the recent Supreme Court judgement 3 in this context. In India abetment of suicide and attempt to suicide are both criminal offences. The accused were convicted in the trial court and later the conviction was upheld by the High Court.

This made the Supreme Court to rethink and to reconsider the decision of right to die.

The Court held that the right to life under Article 21 of the Constitution does not include the right to die 5. Regarding suicide, the Supreme Court reconsidered its decision on suicide.

It has also clearly stated that a person attempts suicide in a depression, and hence he needs help, rather than punishment. Therefore, the Supreme Court has recommended to Parliament to consider the feasibility of deleting Section 309 from the Indian Penal Code 3. Arguments against euthanasia Eliminating the invalid: The practice of palliative care counters this view, as palliative care would provide relief from distressing symptoms and pain, and support to the patient as well as the care giver.

Palliative care is an active, compassionate and creative care for the dying 6. It is the duty of the State to protect life and the physician's duty to provide care and not to harm patients. If euthanasia is legalised, then there is a grave apprehension that the State may refuse to invest in health working towards Right to life. Legalised euthanasia has led to a severe decline in the quality of care for terminally-ill patients in Holland 7. Hence, in a welfare state there should not be any role of euthanasia in any form.

Symptom of mental illness: Attempts to suicide or completed suicide are commonly seen in patients suffering from depression legalization of euthanasia dying with dignity essayschizophrenia 9 and substance users 10. It is also documented in patients suffering from obsessive compulsive disorder 11. Hence, it is essential to assess the mental status of the individual seeking for euthanasia.

In classical teaching, attempt to suicide is a psychiatric emergency and it is considered as a desperate call for help or assistance. Several guidelines have been formulated for management of suicidal patients in psychiatry 12. Hence, attempted suicide is considered as a sign of mental illness 13. In the era of declining morality and justice, there is a possibility of misusing euthanasia by family members or relatives for inheriting the property of the patient.

The Supreme Court has also raised this issue in the recent judgement 3. Hence, to keep control over the medical professionals, the Indian Medical Council Professional Conduct, Etiquette and Ethics Regulations, 2002 discusses euthanasia briefly in Chapter 6, Section 6. There is an urgent need to protect patients and also medical practitioners caring the terminally ill patients from unnecessary lawsuit.

Law commission had submitted a report no-196 to the government on this issue 15. Earlier majority of them died before they reached the hospital but now it is converse. Now sciences had advanced to the extent, life can be prolonged but not to that extent of bringing back the dead one. This phenomenon has raised a complex situation.

The principle is to add life to years rather than years to life with a good quality palliative care. The intention is to provide care when cure is not possible by low cost methods.

Hence, euthanasia for no cure illness does not have a logical argument. Whenever, there is no legalization of euthanasia dying with dignity essay, the society and medical professionals become frustrated and the fellow citizen take extreme measures such as suicide, euthanasia or substance use. In such situations, palliative and rehabilitative care comes to the rescue of the patient and the family. At times, doctors do suggest to the family members to have the patient discharged from the hospital wait for death to come, if the family or patient so desires.

Various reasons are quoted for such decisions, such as poverty, non-availability of bed, futile intervention, resources can be utilised for other patients where cure is possible and unfortunately majority of our patient's family do accordingly.

Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls

Many of the terminally ill patients prefer to die at home, with or without any proper terminal health care. The societal perception needs to be altered and also the medical professionals need to focus on care rather in addition to just cure. The motive for many euthanasia requests is unawareness of alternatives.

However, when patients hear that a lot can be done through palliative care, that the symptoms can be controlled, now and in the future, many do not want euthanasia anymore 16. Commercialisation of health care: Passive euthanasia occurs in majority of the hospitals across the county, where poor patients and their family members refuse or withdraw treatment because of the huge cost involved in keeping them alive.

If euthanasia is legalised, then commercial health sector will serve death sentence to many disabled and elderly citizens of India for meagre amount of money.

This has been highlighted in the Supreme Court Judgement 317. Research has revealed that many terminally ill patients requesting euthanasia, have major depression, and that the desire for death in terminal patients is correlated with the depression 18.

  • Some patients therefore achieve comfort at light levels of sedation, allowing them to continue interacting with family; in others, comfort is achieved only at deep levels of sedation;
  • It is a liberty which cannot be denied because those who are dying might want to use this liberty as a way to pursue their happiness;
  • The role of nurses in physician-assisted deaths in Belgium.

In Indian setting also, strong desire for death was reported by 3 of the 191 advanced cancer patients, and these had severe depression 19. They need palliative and rehabilitative care. Palliative care actually provides death with dignity and a death considered good by the patient and the care givers.

Counterargument of euthanasia supporters Caregivers burden: This argument is further defended for those, who have chronic debilitating illness even though it is not terminal such as severe mental illness. Majority of such petitions are filed by the sufferers or family members or their caretakers.

The caregiver's burden is huge and cuts across various domains such as financial, emotional, time, physical, mental and social. Hence, it is uncommon to hear requests from the family members of the person with psychiatric illness to give some poison either to patient or else to them. Right to refuse medical treatment is well recognised in law, including medical treatment that sustains or prolongs life.

For example, a patient suffering from blood cancer can refuse treatment or deny feeds through nasogastric tube. Recognition of right to refuse treatment gives a way for passive euthanasia.

Euthanasia: Right to life vs right to die

Many do argue that allowing medical termination of pregnancy before 16 wk is also a form of active involuntary euthanasia. This issue of mercy killing of deformed babies has already been in discussion in Holland 20. Many patients in a persistent vegetative state or else in chronic illness, do not want to be a burden on their family members.

Encouraging the organ transplantation: Euthanasia in terminally ill patients provides an opportunity to advocate for organ donation. This in turn will help many patients with organ failure waiting for transplantation. On the contrary, the state does not own the responsibility of promoting, protecting and fulfilling the socio-economic rights such as right to food, right to water, right to education and right to health care, which are basic essential ingredients of right to life.

Till date, most of the States has not done anything to support the terminally ill people by providing for hospice care. If the State takes the responsibility of providing reasonable degree of health care, then majority of the euthanasia supporters will definitely reconsider their legalization of euthanasia dying with dignity essay. We do endorse the Supreme Court Judgement that our contemporary society and public health system is not matured enough to handle this sensitive issue, hence it needs to be withheld.

However, this issue needs to be re-examined again after few years depending upon the evolution of the society with regard to providing health care to the disabled and public health sector with regard to providing health care to poor people.

The Supreme Court judgement to withhold decision on this sensitive issue is a first step towards a new era of health care in terminally ill patients. The Judgment laid down is to preserve harmony within a society, when faced with a complex medical, social and legal dilemma. There is a need to enact a legislation to protect terminally ill patients and also medical practitioners caring for them as per the recommendation of Law Commission Report-196 15. There is also an urgent need to invest in our health care system, so that poor people suffering from ill health can access free health care.

Assisted suicide in US and Europe. Oxford University Press, Inc; 2011. The euthanasia movement in modern America. Oxford University Press, Inc; 2003.

  1. Am J Hosp Palliat Care. On the other side of the issue, however, people who are against assisted suicide do not believe that the terminally ill have the right to end their suffering.
  2. House of Representatives passed "The Pain Relief Promotion Act," which encouraged doctors to take all possible action to relieve the pain of terminally ill patients, short of prescribing lethal doses of medication, however, currently Oregon is the only state that has legalized physician-assisted suicide.
  3. This article has been cited by other articles in PMC. Union of India, 1994 3 SCC 394 5.
  4. Patients are also vulnerable to the level of training and experience that their physicians have in palliative care and to the personal views of their physicians about the topic. In 2006, legislators in Belgium announced their intention to change the euthanasia law to include infants, teenagers, and people with dementia or Alzheimer disease 36.

Aruna Ramchandra Shanbaug vs. Writ Petition Criminal no. Union of India, 1994 3 SCC 394 5. State of Punjab, 1996 2 SCC 648 6. Terminal care in medical oncology. Now the Dutch turn against legalised mercy killing.

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Long term suicide risk of depression in the Lundby cohort 1947-1997-severity and gender. Campbell C, Fahy T. A prospective investigation of suicide ideation, attempts, and use of mental health service among adolescents in substance abuse treatment.

Suicide in patients treated for obsessive-compulsive disorder: A prospective follow-up study. Guidelines for assessment, management, and treatment. Oxford University Press; 1992. The Oxford textbook of suicidology and suicide prevention. Oxford University Press; 2009. Major psychiatric disorders in suicide and suicide attempters; pp.

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