INTRODUCTION

The painless killing of any person suffering from an incurable and painful disease or an irreversible coma can be defined as Euthanasia. Different practices fall under the label of “Euthanasia,” mercy killing, assisted suicide fall under the same. Here are some distinctions demarcating different versions:

Active Euthanasia: This means killing a person by active means, such as injecting a lethal drug dose. It is also known as “Aggressive Euthanasia.” Today, this practice is illegal in most countries, including India.

Passive Euthanasia: It is letting the person die by intention. It includes the removal of artificial life support. This type of Euthanasia has been declared legal in India.

Euthanasia can also be classified as:

 Voluntary Euthanasia: It means giving Euthanasia with the consent of the patient. ‘Living will’ is a written statement provided by the patient before the treatment starts to provide direction for future events they might not express. Many other times, when a person is in an inadequate space and wants to end their life, they ask for Euthanasia. 

Non-voluntary Euthanasia: It means giving Euthanasia without knowing the wishes of the person. In this situation, the decision is taken by the patient’s family. They have to sign a written contract with the hospital, and after fulfilling other formalities, Euthanasia is granted.

There can be different combinations of the types as mentioned above. This type of Euthanasia may sound morally wrong, but it is provided to end the long ordeal that the person is going through. ^[1]

In the early 1940s, Adolf Hitler carried out a program about exterminating children with disabilities to reduce the cost of society and improve the Aryan “race.” It is known as involuntary Euthanasia, which is performed against the will of a person.

CONTENTS

In ethics, ‘consequentialism’ is the doctrine that says actions should be judged as right or wrong based on their consequences. According to consequentialism, it is not necessary to focus on actions every time. It focuses more on the outcomes. The simplest form of consequentialism is old-style utilitarianism, which affirms that an activity is right or wrong as indicated by whether it maximizes the net equilibrium of joy over torment in the universe.

The consequentialism of G.E. Moore, known as “ideal utilitarianism,” recognizes beauty and friendship, as well as pleasure, as intrinsic goods that one’s action should aim to maximize. As indicated by the “preference utilitarianism” of R.M. Hare, activities are correct if they maximize the fulfillment of inclinations or wants, regardless of the preferences they may be for. Consequentialists, likewise, vary about whether every individual action ought to be decided based on its results or irrespective of whether rather general principles of lead ought to be agreed along these lines and individual actions judged simply by whether they accord with a general rule. The former groups are known as “act-utilitarians” and the latter as “rule-utilitarians.”^[2] Bentham’s utilitarianism theory focuses on which actions most likely make people happy; he also developed a calculator to determine which activities were better or worse, known as the ‘felicific calculus.

‘When we look at Euthanasia in the context of consequentialism, there are two aspects to it. This is because consequentialism is a result-based ethical theory. The first aspect is from the patient’s point of view. Giving Euthanasia will hold good as it maximizes the net pleasure, the patient is relieved from all the prolonged suffering and agony; The second aspect is from the patient’s family. They have lost a loved one. It is an irreplaceable loss. Consequentialism, on this side, would hold Euthanasia as a way of relief but entangled with sadness.

Physician-assisted suicide or PAS is another type of Euthanasia where a person is assisted in committing suicide by a medical practitioner with certain drugs or appropriate medication on the person’s demand. One of the most landmark case laws relating to suicide is ‘Gian Kaur vs. the State of Punjab, ‘ where Gian Kaur and her husband, Harband Singh^[3], were convicted for abetment to suicide. Here, the previous ruling of P. Rantinam’s case, which dealt with section 309 of the IPC, was overruled, and it said that the right to life does not include the right to death. The Court further defended the sanctity of life, stating that the unnatural taking of life can never be justified. Constitutionalizing both Section 309 and 306 of the IPC, although attempt to commit suicide and abetment to it, is criminalized. Still, under the Mental Healthcare Act 2017, several restrictions have been put on section 306, essentially decriminalizing it.^[4]

Mercy killing, i.e., Euthanasia though seems to be justified morally and is practiced in many countries like the Netherlands, Belgium, Australia, etc., because the suffering and pain of a patient due to illness is given priority over the patient’s life.^[5] Still, no law can indeed provide a guarantee over the abuse concerning the lives of critically ill patients who do not desire to end their lives. 

In the Common Cause vs. Union of India^[6]  the Supreme Court of India ruled that any individual has a right to die with dignity as a part of their right to life and personal liberty under Article 21 of the Indian Constitution^[7]. This ruling,^[8] thus, permits the removal of life-support systems for the terminally ill or those suffering from incurable comas, thus proving the concept of consequentialism. The Court further allowed individuals to decide against artificial life support and recognized the need for creating a living will.

In this particular case, the Court further laid down certain propositions regarding the procedure for execution of Advance Directives and provided the guidelines thereof to effect passive Euthanasia. This verdict added on and made clarifications on the 2011 verdict of the ‘Aruna Shanbaug vs. Union of India^[9]‘ case where passive Euthanasia was legalized in two cases: 1) where the patient was in a permanent vegetative state and 2) where the said patient was brain dead, and so they can be let off the ventilator, also giving the concept of next friend. According to this concept, if any family member is absent, a third person close to the patient can be the next friend. In this case, the king’s Edward memorial hospital nurse, who had attended to her after she had gone into a coma, took the position of next friend and performed the duties.^[10] Appling consequentialism here, we conclude that since Aruna Shanbaug was in a coma for 42 years, it was ethically correct to relieve her of all her sufferings prolonging the life of a person who is not capable of being conscious is not only painful for the individual but for their family and close ones as well, as they are watching a loved one in such pain.^[11] So, isn’t ending her life the correct thing as the consequence of this would maximize happiness for everyone? “Aruna’s prolonged existence violates her right to live with dignity.” This later expanded to include the right to die with dignity. Although Aruna died of natural death, this case clarified the issues revolving around Euthanasia in India and laid down guidelines concerning passive Euthanasia. 

Conclusion

“Tube fed for almost a year, feels like a dog with a leash,” said an elderly man suffering from cancer in Belgium. Belgium is one of the countries which are very liberal regarding Euthanasia. It is considered that pain is the ultimate reason that urges a patient to ask for Euthanasia, but only 1/3 times the cause is pain. Terminally ill people can have their quality of life severely damaged. There can be physical conditions such as incontinence, nausea, paralysis, and difficulty in swallowing. “I don’t want to die in a place which smells like piss,” another lady said. People don’t want the disease to take charge of when they would die; they want to take the decision by themselves.

The intention is never to put someone on the machine and run it forever. It is life support, not prevention of death^[12]. We support life because we think one day it will recover and be ALIVE. But, what is to be done when life is not manifested by the body? When consequentialism comes in, how to handle this type of situations cannot be given as it is, because there are individual sensitivities. There is no particular way to act. But all we can do is let all the doors be open, judge the consequences, and take a decision accordingly. Because as Rajesh Khanna said, “Prolong life is not what matters, but the quality of life does.”  

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^[1]Medicine.missouri.eduhttps://medicine.missouri.edu/user/login?destination=/centers-institutes-labs/health-ethics/faq/euthanasia, (October 20, 2021)

^[2]  britannica.com://www.britannica.com/topic/consequentialism ( October 18, 2021)

^[3] Gian Kaur v. State of Punjab, (1996) 2 SCC 648

^[4] Legalservicesindia.comhttps://www.legalserviceindia.com/legal/article-4135-the-status-of-euthanasia-under-the-light-of-aruna-ramchandra-shanbaug-vs-union-of-india-ors-.html( October 19, 2021)

^[5]bnblegal.comhttps://bnblegal.com/article/right-to-die-with-dignity-euthanasia/](october20 2021)

^[6] Common Cause (A Registered Society) v. Union of India, (1996) 2 SCC 752

^[7]nhrc.nic.inhttps://nhrc.nic.in/press-release/important-judgment-supreme-court-india-1#:~:text=215%20of%202005%20%2D%20Common%20Cause,execute%20an%20advance%20medical%20directive.&text=The%20judgment%20has%20paved%20the,under%20a%20%22living%20will%22. ( October 20, 2021)

^[8] Vini Singh,on advance directives and attorney authorisations – an analysis of the judgment of the supreme court in common cause (a regd. society) v. union of India, CALQ Vol. 4.2,(2018),http://docs.manupatra.in/newsline/articles/Upload/E4A68ACB-DCC1-4003-88DC-F41D7AA65A59.pdf

^[9] Aruna Ramachandra Shanbaug v. Union of India, (2011) 15 SCC 480

^[10]Economictimes.indiatimes.com thttps://economictimes.indiatimes.com/news/politics-and-nation/the-aruna-shanbaug-case-which-changed-euthanasia-laws-in-india/a-landmark-verdict/slideshow/63231071.cms  (October 19, 2021)

^[11]Thehindu.comhttps://www.thehindu.com/opinion/op-ed/should-euthanasia-be-allowed/article22524514.ece(october17,2021)

^[12]Legalservicesindia.comhttps://www.legalserviceindia.com/legal/article-3563-euthanasia-right-to-die-with-dignity.html    (October 21, 2021) 

Nutrition and hydration are essential. People who consume a well-balanced diet have stronger immune systems and are less likely to get chronic illnesses and infectious diseases. To acquire the vitamins, minerals, dietary fibre, protein, and antioxidants your body need, you should consume a variety of fresh and unprocessed foods every day. Drink plenty of water. Reduce your risk of obesity, heart disease, stroke, diabetes, and certain types of cancer by avoiding sugar, fat, and salt.

Every day, eat fresh, unprocessed meals.

Consume fruits, vegetables, legumes (e.g. lentils, beans), nuts, and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice, or starchy tubers or roots like potato, yam, taro, or cassava), as well as animal-derived foods (e.g. meat, fish, eggs and milk).

2 cups fruit (4 servings), 2.5 cups vegetables (5 servings), 180 g grains, and 160 g meat and beans (red meat 12 times per week, poultry 23 times per week) should be consumed on a daily basis.

Snack on raw vegetables and fresh fruit rather than high-sugar, high-fat, or high-salt items.

Overcooking vegetables and fruit can result in the loss of essential vitamins.

 

Choose canned or dried veggies and fruit that haven’t been salted or sugared.

Every day, drink plenty of water.

Water is required for survival. It distributes nutrients and chemicals through the bloodstream, controls body temperature, eliminates waste, and lubricates and cushions joints.

Every day, drink 8–10 cups of water.

Water is the best option, but other liquids, fruits, and vegetables that contain water, such as lemon juice (diluted in water and unsweetened), tea, and coffee, are also acceptable. However, excessive caffeine use should be avoided, as should sweetened fruit juices, syrups, fruit juice concentrates, fizzy and still drinks, which all contain sugar.

 

Consume fat and oil in moderation.

*Instead of saturated fats, consume unsaturated fats (such as those found in fish, avocado, almonds, olive oil, soy, canola, sunflower, and maize oils) (e.g. found in fatty meat, butter, coconut oil, cream, cheese, ghee and lard).

*Rather to red meat, choose white meat (e.g. poultry) and fish, which are often low in fat.

*Avoid processed meats due to their high fat and salt content.

*Select low-fat or reduced-fat milk and dairy products whenever possible.

*Avoid trans fats made in a factory. Processed foods, fast food, snack foods, fried foods, frozen pizza, pies, cookies, margarines, and spreads are all common sources.

Reduce your salt and sugar intake.

*Use less salt and high-sodium condiments while cooking and preparing food (e.g. soy sauce and fish sauce).

*Use iodized salt and limit your daily salt intake to less than 5 g (about 1 teaspoon).

*Salty and sugary foods (such as snacks) should be avoided.

*Reduce your sugar intake by avoiding soft drinks, sodas, and other sugary beverages (e.g. fruit juices, fruit juice concentrates and syrups, flavoured milks and yoghurt drinks).

*Sweet snacks such as cookies, cakes, and chocolate should be replaced with fresh fruits.

 

Eat at home as much as possible.

Reduce your interaction with other individuals and your chances of contracting COVID-19 by eating at home. Maintain a 1 metre gap between yourself and someone who is coughing or sneezing. In crowded social environments such as restaurants and cafes, this is not always practicable. Droplets from sick persons may land on surfaces and people’s hands (e.g., customers and employees), and with so many people coming and going, it’s impossible to detect if hands are being washed frequently enough, and surfaces are being cleaned and disinfected quickly enough.

 

 

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