Euthanasia: India
This is a collection of articles archived for the excellence of their content. |
Contents |
Supreme Court guidelines on Euthanasia
The Hindu, May 23, 2015
Active euthanasia : Administering of lethal injection to snuff out life is illegal in India Parents, spouse, close kin, "next friend" can decide, in best interests of the patient, to discontinue life support. The decision must be approved by a HC.
In dealing with such a plea,
» Chief Justice of High Court must create a Bench of at least 2 judges to reach a decision.
» Bench must nominate three reputed doctors
» A copy of the doctors's panel report must be provided to close kin and State govt. Only then can verdict be reached.
Passive euthanasia : Withdrawing life support, treatment or nutrition that would allow a person to live, was legalised by way of SC guidelines in 2011.
Mercy killing: Prevalent in parts of Tamil Nadu
The Times of India, May 24 2015
Padmini Sivarajah
Thalaikoothal
Mercy killing is illegal in India, but in parts of Tamil Nadu, it is alive in the form of a gruesome tradition
A very crude form of `mercy killing' still survives in some villages in south India.Here, people take it upon themselves to `cull' elderly persons who are bedridden and considered a burden to the family , with something as innocuous as oil and coconut water. And though villagers claim they've buried the gruesome tradition, social activists say they haven't seen the last of it yet. “We no longer do it, but it was called `thalaikoothal',“ says G Anusha of Innam Reddiarpatti in Virudhunagar district. “ A person who was suffering and bedridden was given an oil bath at dawn and then plied with multiple glasses of tender coconut juice, which resulted in the body cooling considerably , eventually causing high fever. In a day or two they died,“ she says, insisting that the practice has now dwindled. Her neighbour Kuruvamma credits improved facilities like transport and medical support for the decline of the tradition. “I myself look after two elders in the family . We want them to live as long as they are destined to,“ she claims.
Seventy-five-year-old, bespectacled Sankaramma sits rolling paper tubes for a fireworks factory . “I have to work as long as I can to be able to eat,“ she says, insinuating that she literally has to safeguard her living. But then she cautiously mentions that she has known elderly people who were given thalaikoothal deaths. “But that was then, she hastily adds.
Is this staunch denial really an eyewash? A social activist from Usilampatti, M P Raman, concedes that this indigenous form of mercy killing still prevails, but is kept under wraps for fear of prosecution. His words are echoed by C Radhakrishnan, senior manager at Help Age India, Madurai. “Though villagers claim it isn't practiced anymore, thalaikoothal is more prevalent now than ever before,“ he states, citing greater employment as one of the reasons. “Unlike those days when at least one member of the family was at home to look after the elderly, everybody in a household today is employed and a bedridden person becomes a big responsibility,“ he explains.
Apparently thalaikoothal is no random act of extermination, but a well-oiled death ritual provoked by poverty and abetted by custom. An old, ailing individual, with an already weakened immune system is pushed over the edge with oil baths and coconut juice guaranteed to induce a fever that will eventually do the person in. And even as preparations for the thalaikoothal are under way , family will start arranging for the funeral as well.
“I came to know that invalid elders are given a final oil bath and forced to drink tender coconut juice, followed by tulsi juice and then milk (a customary predeath drink), with the relatives standing around chanting, `kasi', `kasi',“ Radhakrishnan says. But they are not the only devices employed. In some cases, hard pieces of murukku (a savoury) are forced down a resistant individ ual's throat, causing him or her to choke to death. Mud mixed with water is also used, with hopes that the watery Hemlock would cause indigestion -almost surely fatal to an already compromised body .
According to Dr N Raja, a geriatrician and private practitioner in Madurai, an oil bath followed by tender coconut juice, a coolant, results in the body's temperature falling to 94 or 92 degrees F from the normal of 98.4 degrees F. “It can also cause electrolyte imbalance, which can play havoc with the body's metabolism. And for a person who is already sick, it can even lead to cardiac arrest,“ he says.
Tirunelveli N Kannan, pro fessor of sociology , Manonmaniam Sundaranar University, says that this was an age-old practice which was not confined to any specific community. “I have heard people doing it in villages in Virudhunagar and also Usilampatti in Madurai, he says. “If closely researched we may see similar practices in many countries. “The issue of the person's consent in this practice, did not rise as in many cases he or she was terminally ill and almost unconscious. No person would willingly agree to being killed, but the community as a whole took the decision on his behalf, and went ahead with it,“ says Kannan. This was something that had social acceptance, he added.
S Alagarsamy , 78, says he has no fear of forced death. Although age has restricted his mobility , he believes he won't be a burden to his widowed daughter because of the free rations doled out by the state. “Mercifully the government provides us with free rice. Moreover, my daughter looks after me well, otherwise I would have feared the thalaikoothal, he says.
Radhakrishnan points out that death by thailakoothal is almost always signed off by a certifying doctor as death due to natural causes -old age in their case. “The truth will emerge if these deaths are better investigated,“ the NGO worker claims.
Incidentally , when Dr Raja discharges a patient in his care -one who may not have long to live -the patient's relatives sometimes ask him if they could perform the oil bath ritual. These people usually come from places like the rural pockets of Madurai, including villages in and around Usilampatti. “I tell them that it is illegal and that it should never be done, but I do not know if they follow my counsel.“
February 2016
The Hindu, February 2, 2016
Towards a law on euthanasia
The Union government has informed a Constitution Bench of the Supreme Court that its experts are examining a draft Bill proposed by the Law Commission in its 241st report. However, it has been advised by the Law Ministry to hold back its enactment now, as the matter is pending before the court. Over a decade ago, the government felt that legislation on euthanasia would amount to doctors violating the Hippocratic Oath and that they should not yield to a patient’s “fleeting desire out of transient depression” to die. The government’s latest stand represents forward movement in the quest for a legislative framework to deal with the question whether patients who are terminally ill and possibly beyond the scope of medical revival can be allowed to die with dignity. The question was raised with a great deal of passion in the case of Aruna Shanbaug, a nurse who lay in a vegetative state in a Mumbai hospital between 1973 and 2015. In a landmark 2011 verdict that was notable for its progressive, humane and sensitive treatment of the complex interplay of individual dignity and social ethics, the Supreme Court laid down a broad legal framework. It ruled out any backing for active euthanasia, or the taking of a specific step such as injecting the patient with a lethal substance, to put an end to a patient’s suffering, as that would be clearly illegal. It allowed ‘passive euthanasia’, or the withdrawal of life support, subject to safeguards and fair procedure. It made it mandatory that every instance should get the approval of a High Court Bench, based on consultation with a panel of medical experts.
The question now before a Constitution Bench on a petition by the NGO Common Cause is whether the right to live with dignity under Article 21 includes the right to die with dignity, and whether it is time to allow ‘living wills’, or written authorisations containing instructions given by persons in a healthy state of mind to doctors that they need not be put on life-support systems or ventilators in the event of their going into a persistent vegetative state or state of terminal illness. The government’s reply shows that the Directorate-General of Health Services has proposed legislation based on the recommendations of an Experts’ Committee. The experts have not agreed to active euthanasia because of its potential for misuse and have proposed changes to a draft Bill suggested by the Law Commission. However, there seems to be no support for the idea of a ‘living will’, as the draft says any such document will be ‘void’ and not binding on any medical practitioner. It is logical that it should be so, as the law will be designed specifically to deal with patients not competent to decide for themselves because of their medical condition. This has to be tested against the argument that giving those likely to drift into terminal illness an advance opportunity to make an informed choice will help them avoid “cruel and unwanted treatment” to prolong their lifespan. To resolve this conflict between pain and death, the sooner that a comprehensive law on the subject is enacted, the better it will be for society.
