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9 months ago
Passive Euthanasia: What the medical fraternity think about it

On Friday the Supreme Court has passed the judgement stating that a person can make an advance ‘living will’ authorising the withdrawal of all life support system if he/she is suffering from a terminal illness where a cure doesn’t seem possible. In the past, there have been patients and even families who had put up a request for euthanasia but their plea was rejected as taking away a life seemed to be a criminal offence. There had been a lot of hue and cry in the past by various organisations and support groups to allow people to die with dignity if they cannot live a life of pride while fighting an illness.

So, in a landmark judgement, SC has finally passed the bill that recognises ‘right to die with dignity’ if a patient slips into an incurable condition or a vegetable state due to terminal illness. The person has to draft this bill in full consciousness when diagnosed with a life-threatening condition and knows the consequences of leading a healthy life ahead are bleak. A five-judge Constitution Bench headed by Chief Justice Dipak Misra, however, attached strict conditions for executing ‘a living will that was to be made by a person in his normal state of health and mind.’ The bench laid down guidelines on who would execute the will and how nod for passive euthanasia would be granted by the medical board. We spoke to few doctors from the medical fraternity to know what they think about this landmark judgement.

‘This judgement was long due however we also need to weigh the pros and cons of the same before we get too excited about it. It is like a breather for people who have been in a terminal condition and have no hopes of getting back to a normalcy. While the whole move looks too promising there should be some clauses attached to it so that there is minimal misuse of the judgement. A living bill should be written by people in their full consciousness when they are diagnosed with a condition that can only get worse or say diagnosed with a renal failure or stage four cancers where even with the best of medical facilities all one can do is just control the condition and not cure it.

‘Ideally, a person writing a living will be one aged between 70 or 75 unless he/she is suffering from an incurable disease any earlier. But if a condition is manageable then it doesn’t make sense for a person to draft a living will, like if a person is suffering from epilepsy. It is better than before one draft a living will he/she sits with a medical team to know the consequences of one’s illness. Because being in a vegetable state is not justified (both for the patient and family) but life is also precious.’ Dr Meghal Sanghvi, Onco-surgeon from Wockhardt Hospital.

‘This is an outstanding decision taken by the SC. Probably it won’t make sense for a layperson but for people who have a family member lying in the hospital in a terminal condition, this is a great judgement. The key word over here is passive. Certainly, it cannot be active as that would become a criminal offence. So when a patient is just kept on nutrition at a terminal state it creates an emotional and financial burden on the family. It is wise for a person to know what the consequences of his illness can be and draft a living will so the family doesn’t have to face painful situations in future. However, the judgement has just been passed it will take time for people to act on it and eventually we would know how it is benefiting the affected mass.’ Dr Anup Ramani, Uro-Oncological & Robotic Surgeon, Lilavati, Breach Candy, Saifee Hospital.

‘The judgement prohibits active euthanasia meaning thereby actively inducing death by medication administration in similar or other circumstances. However, a patient in terminal phase requiring such care can himself/herself decide the stoppage of treatment by writing a ‘living will’ or if the patient is not in a position to legally consent due to any reason then the closest relatives can decide and request the physicians accordingly. If monitored and administered properly this would help stop what Can be termed as unnecessary and eventually futile prolongation of human suffering, reduce expenses and financial burden on the family. The possibility of misuse as in case of any good measure has to be eliminated by tightly controlling such events.’ Dr R K Deshpande, Onco Surgeon, Asian Cancer Institute.

‘Biggest challenge we doctor’s face is to treat a patient who is on ventilator support or in a vegetative state.  It is the moral and ethical issues of which every doctor has to face. The Supreme Court has approved ‘passive euthanasia.’ This allows a patient to create a living will which permits medical professionals to end his life when he reaches a point of no return.’ Dr Roy Patankar Director of Zen Hospital.

‘I feel this was needed. I have seen many patients who become brain dead and live a vegetative life just because they are not dying. I think this verdict will help such patients. Prolonging life should be our motto as doctors, not just prolonging death and making the patient suffer.’ Dr Pradeep Gadge, Leading Diabetologist, Gadge’s Diabetes’s Care Centre.

‘We welcome the landmark ruling by the Supreme Court stating that those with terminal illness can make a living will for passive euthanasia. At Portea, we provide care to many with chronic illnesses. While the intention is to prolong and enable a productive life by offering the best care possible, living in a persistent vegetative state can be extremely tough for sufferers and their loved ones.  Just like the right to life, every person should have the right to a dignified death as well. Forcing someone to remain on life-support can be very difficult and the increasing costs of stay and care compound the situation. Thus, this decision by the SC needs to be applauded. Portea has always been committed to the best outcomes for patients and this ruling is another step in helping us achieve that.’ Ms Meena Ganesh, MD and CEO, Portea Medical.

Image source: Shutterstock

 

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