One of the most heated arguments in the field of medical ethics arises on the subject of euthanasia. Also, known as mercy killing, euthanasia is the act of intentionally ending someone’s life to relieve them from pain and suffering (usually due to some terminal health condition). In fact, the word, derived from the Greek language, literally means “good death”.
Euthanasia can be broadly classified into two types: 1) Active euthanasia, the more controversial form, which entails the direct application or injection of lethal forces or substances to end a life; and 2) Passive euthanasia, referring to withholding or withdrawing treatment necessary for prolonging life. These two categories can each be further subdivided into three more distinctive classes: i) Voluntary, which is conducted with the consent of the patient; the term “assisted suicide” is often used when the patient ends his/her life with the assistance of a physician, ii) Non-voluntary, when the patient is incapable of providing consent (the most prevalent example is that of child euthanasia, which is used on children with grave illnesses or birth defects), and iii) Involuntary when euthanasia is conducted without the consent of the patient (even if the aim is to relieve the patient’s suffering, involuntary euthanasia effectively amounts to murder).
The most prevalent and debatable form, active voluntary euthanasia, is illegal in most countries; in the handful of nations where it is legal (like Switzerland, Belgium), this activity is restricted to certain specific circumstances and is done after consulting a number of doctors and other specialists.
Passive euthanasia, on the other hand, is legal in a number of countries, and this has been accepted by all those religious groups that find euthanasia immoral by their holy scripts. Withdrawing treatment or nutrition to a terminally ill patient who has no hope of ever returning to a normal condition is not unethical for a number of reasons. Unnecessary mounting medical expenses, attempting to prolong a life that will eventually wither and die, and the right of a person to die with dignity, and not crippled to a permanent life-support system, are some of the arguments that have been put forward in favor of passive euthanasia. Even in India, the act has been legalized under special circumstances by an order of the Supreme Court since 2018.
The opponents of euthanasia bring up certain valid non-religious points against this practice, the foremost among them being the ambiguity associated with the term “terminally ill”. Some interpretations of the term include “a disease that curtails life even for a day”, “a condition from which death will occur in a relatively short time”, “expected death within six months or less” among others. The catch here is that even medical experts acknowledge that it is impossible to assign a number or a range to the life expectancy of a patient, in fact, a “terminally ill” patient may even go on to live for years, in which case injecting lethal substances or withdrawing treatment would amount to murder. Some euthanasia activists resorted to using the word “hopelessly ill” to describe harsh physical or psychological pain, mental or physical deterioration, or any quality of life that the patient cannot accept. But this classification would then include anyone with a suicidal tendency, besides those whose lives are almost nearing an end.
Euthanasia could also become a measure to minimize healthcare costs. Refusing necessary treatment or ending the life of a person who requires immense medical care does away with the costs of the same. Family members may be more concerned about minimizing such costs rather than the well-being of the patient. In countries where governments provide for health insurance, authorities themselves might promote passive euthanasia to curtail their expenses.
The moral arguments suggest that legalizing euthanasia and assisted suicide might send out a message to the society that ending one’s life is an effective solution to any problem. They also include the issue of rejecting the importance and value of human life. Opponents of the practice supplement this point by comparing it to killing in self-defense, saying that in the latter, an innocent life is saved, but in euthanasia, there is only the loss of life. These arguments sound fairly convincing, but once we layout the points in support of euthanasia, it will become clear why the issue is such a burning topic of debate.
Proponents of this practice bring forth that every person has the right to live with dignity, as well as the right to die with dignity. This argument especially holds when the patient has been in an incapacitated state for a long period of time, and there are definitely no hopes of recovery. Or even when a patient has been hanging onto life on ventilator support for a long time, and is not likely to surpass his comatose state. Paying for expensive medical care resources by running down one’s life-savings or incurring loans is not worth the pain in these circumstances, and it is much better to relieve the patient and his family members from such suffering.
Many believe that everyone has the right to commit suicide under democracy. Far-fetched and ridiculous as this may sound, there is an iota of reason in it owing to the definition of a democracy. However, this is a failed attempt at an argument because democracy or not, every nation has laws that dictate certain aspects of people’s lives.
If the argument in favor of euthanasia seems weak, let us walk through an example that hits close to home. In 1973, a nurse, Aruna Shanbaug, was strangled and sodomized by a sweeper, leaving her in a persistent vegetative state, kept barely alive through life support system, and gaining nutrition through a tube. In 2011, her friend filed a PIL with the Supreme Court to withdraw her treatment and let her die “with dignity”, but the court rejected the plea. Ms. Shanbaug finally succumbed to pneumonia in 2015 after having been in a comatose state for 42 years. This incident will make everyone question the logic of the court’s judgment, and indeed, a person living in a helpless state of partial awareness deserves to die a peaceful and quick death.
Frankly, there is a very thin line between what is right and what isn’t in such cases. All arguments presented for and against the issue make sense, which is why no one has been able to come to a conclusion on the matter of legality or morality. Even the nations which have legalized passive voluntary euthanasia have imposed a lot of stipulations to guide people and medical experts to come to an informed decision on whether or not to “pull the plug”. We can, therefore, say with conviction that the issue of euthanasia will never see a clear demarcation into right or wrong.