As medical science progresses at an unprecedented pace, offering new treatments and technologies, society is increasing with ethical dilemmas. Among these lies the question of euthanasia or physician-assisted suicide (PAS), which has emerged as a deeply argumentative debate surrounding terminal illness and end of life care. The moral, legal, and medical consequences of individuals right to chose death over prolonged suffering has raised questions about the value of life, autonomy and the role of medical professionals in shaping a dignified death.
Euthanasia has been derived from the Greek word ‘Eu’ meaning good and ‘Thanatos’ meaning death. (Annadurai et al., 2014). Euthanasia is referred to as quickening the death of a patient to put an end to their suffering. The debate surrounding euthanasia often revolves around the devaluation of vulnerable lives. The choice of euthanasia questions the dignity of individuals and puts into question whether their lives are worth living. Euthanasia is conducted in two forms; Active euthanasia is where the physician deliberately administers the use of lethal drugs to foster the death of a terminally ill patient and passive euthanasia refers to withholding or withdrawing any support that is used to facilitate the life of a terminally ill patient (Annadurai et al., 2014).
The three landmark cases that decided the trajectory of Euthanasia in India: Gian Kaur v. State of Punjab 1996, Aruna Shanbaug v. Union of India 2011, and Common Cause v. Union of India 2018. The Supreme Court of India made a clear distinction between active and passive euthanasia and restated that in passive euthanasia the death of the patient is caused by the disease itself on withdrawal from life-supporting measures (Centre for Law & Policy Research, 2023). In the Common Cause[1] case, the Supreme Court was faced with the question of the ‘right to die with dignity’ as Article 21 of the Indian Constitution encompasses the right to life. In the K.S. Puttaswamy & Anr. v. Union of India & Ors the SC upheld the decision that the right to die with dignity is a fundamental right under Article 21. To execute the decision Advanced Directives[2] (AD) were made which is a set of documents with details on treatment and who is eligible to make decisions on behalf of the patient.
Advocates of physician-assisted suicide harbor the opinion that an individual’s right entitles them to have an option of painless death. As human beings who have control over their birth, the decision to die a painless death lies with the individual. The contradictory viewpoint states that the physician’s role in the death of an individual violates the oath taken by medical professionals (Sinha et al., 2012).
The concept of devaluation of life emanates from religious beliefs. Religious beliefs play a crucial role in preventing the legalization of active euthanasia in India. In Hinduism, the spiritual aspect of the soul, rebirth, death, and life is valued very highly. Hinduism considers the soul to be sacred and believes that after death the soul lives on. Life in Hinduism does not begin and end with death itself. The concept of good death and bad death stems from the view that a person should die when it is the right time to die. A premature death is viewed as a bad death and the legalization of euthanasia is bringing about untimely death (Groove et al., 2022).
Robert Nozick an American and libertarian philosopher accentuates individual rights, he implies that having free will does not constitute the ability to act freely. Nozick believes that each individual is unique and should have the right to choose. He centralizes his theory on the principles of self-ownership and argues that individuals have the right to their bodies. Nozick bestows euthanasia with a unique lens where without the economic burdens faced by the family the patient’s life might not be devalued, while on the other hand if the patient chooses euthanasia solely due to economic burdens the autonomy of that individual is violated.
With an emphasis on self-ownership individuals have the right to decide on their bodies, including the decision to end their life. The legalization of euthanasia respects the autonomy of individuals to decide and choose, however, that is only possible if everyone has a level playing field and poverty distorts that vision. The Nozick ideology would promote a situation where vulnerable individuals are not concerned about economic burdens and safeguard a situation where individuals are not compelled to choose euthanasia. Nozick would assess the legalization of euthanasia with an ethical aspect which might devalue the lives of individuals if they are forced to choose that as an option due to economic burdens. While having a strong sense of individual autonomy, Nozick would also take a stand against individuals being manoeuvred into deliberately choosing euthanasia. Poverty distorts the vision that Nozick has as it plays on the vulnerability of poor individuals. The elite class will stand a chance to choose their death while the poor might lose out on that choice.
The movie ‘Me Before You’ by Jojo Moyes[3] portrays the protagonist Will Traynor choosing euthanasia. The movie depicts love and suicide and how love cannot save one from choosing death. Will Traynor’s life before he met with an accident that left him paralyzed was one full of adventures. With his paralysis, he was living a life he had never imagined for himself. The title of the movie represents the choice made by Will Traynor when he chose himself above all else. This movie brings into perspective the ideology of Nozick (Mustofa & Jumino, 2021). The protagonist chose to die with dignity and the choice was his to make. Traynor has the option to end his life, and this is what resonates with Nozick, self-ownership and the right to choose. Traynor before his accident had a very adventurous life and had a very difficult time adapting to quadriplegia. Nozick advocated for a life that an individual wanted to live. In Traynor’s case, he had convinced himself that the life was living was not worth it and was devaluing his life by simply existing and not living the life he had imagined. Choosing physician-assisted suicide also emphasized that despite people around him being hurt by his choice, he valued his life by choosing to end it. He did not want to live a life of depression and one plagued by quadriplegia (Mustofa & Jumino, 2021).
Euthanasia brings out the moral question of devaluation of life and the sacred beliefs devoted to it. Nozick advocated that individuals should not be compelled to choose euthanasia if it is not of their free will. The choice should lie with the individuals, and they should have the autonomy to make that choice. Economic burdens should not be the sole factor in considering euthanasia as it will distort the perception of life and put the individual in a state of dilemma. Legalization may inadvertently influence society to believe that the option of choosing to end life permanently would devalue the lives of the elderly, disabled, and terminally ill. This perception can deepen existing inequalities and marginalization, as individuals in these groups may feel pressured to consider euthanasia as a solution to avoid burdening others or due to a lack of support. Individuals do not have any control over their birth but should be given the autonomy to choose how they prefer to die.
Footnotes
1. Common Cause is an NGO which brought to court the petition of right to die with dignity.
AD guidelines were amended in 2023. Each AD is subjected to the opinion of two medical boards and the decisions made by the medical board can only be challenged by a writ petition under Article 226. Each AD also must be notarized in front of a judicial magistrate
The movie Me Before You is adapted from a book with the same name which showcases the story of the male protagonist whose life is put on hold after he was diagnosed with quadriplegia. The movie depicts the effort of a female nurse who as the movie progresses also becomes the love interest of the protagonist. The movie shows despite the best efforts of the female protagonist to emphasize that life with quadriplegia can be beautiful, Traynor chooses to end his life because that is not the life he had imagined for himself
コメント