Euthanasia. Are Values a Dilemma?

The Proposition:

Mercy killing/ Euthanasia should be legalized in certain situations where there is minimal or no hope to recovery to a qualitative life. Agree or Disagree?

Case Study:

Aruna Shanbaug (real name not changed as it is a well-known registered Supreme Court case), 1948-2015, hailing from Karnataka, India was remarked to be a very smart, young, beautiful lady who was in the late 25’s working as a nurse in King Edward Memorial Hospital, Mumbai, India she was assaulted in 1975 by a ward boy as she was changing her clothes after her shift in the basement room of the hospital. The sudden provocation to the attack was the anger of the ward boy over her for constantly ordering around and castigating him. He choked her with a dog chain and sodomized her. The strangulation led to a hypoxic damage to her brain cells resulting in a cut off in oxygen supply to her brain. During this course of the suffocation, left an irreparable injury to her body and ultimately leaving her paralyzed for the rest of her life. The police registered the case as attempt to robbery with no charges of rape because the initial medical examination showed that she was menstruating at that time. The ward boy however walked free after some years of imprisonment leaving the lady’s state in utter despair. Presently the lady is 64 years and has not showed any sort of improvement in her state, since all these years and is in a desperate- vegetative state. Owing to her condition till date a national award winner journalist and social activist named Pinki Virani filed a case in the Supreme Court asking justice in the form of mercy killing for Aruna in 1999. Unfortunately, the Supreme Court rejected her plea for mercy killing for Aruna’s case in 2011, but passed a judgment on passive euthanasia (The Times of India, 2011 and News Makers: Aruna Shanbaug).

The word Euthanasia was coined by the Greeks from the word Euthanatos where ‘ Eu ’ meant good and ‘ Thanatos meant death. It has also been defined as ‘mercy killing of the hopelessly ill, injured or incapacitated’ (Podgers, 1992). It means that a person can choose to live or end his/her life in dire circumstances. The word euthanasia rings bells as being totally unacceptable. It is a debatable issue where a proper conclusion is possibly not maintained. The decisions vary according to different scenarios. There are different forms of euthanasia-

Active Euthanasia - the person deliberately causes the death of a person.

Passive Euthanasia - letting the patient die on his own by either withholding medical treatment or withdrawing treatment as in switching off the life support machine.

Voluntary Euthanasia - where the patient himself/herself requests for death.

Involuntary Euthanasia - where the patient is not in a state to take decisions on his own- as in a vegetative state.

Indirect Euthanasia - where certain drugs are administered which may reduce the pain but may speed the process of death in the long run. It has its justification according to the doctrine of double effect as the doctor prescribes high dosage of morphine for reducing the pain of the person but knowing that it may speed the death of the individual.

Assisted Suicide - where the patient himself/herself cannot die and requests the help of somebody to accomplish that task it may be in the form of a lethal injection or even keeping deadly medicines within their reach (Forms of Euthanasia, 2013).

Arguments in favor of Euthanasia

In the light of the above mentioned case of Aruna, I would highly suggest that euthanasia would be an appropriate decision in order to end the more than a decade suffering of the lady. There might be concerns that people may advance theories against euthanasia, but taking into account the deterioration of the person both mentally and physically, the traumatizing pain and the dejected solitary life- it must be put to an end in a dignified manner. According to the Article 21, from the Indian Constitution it guarantees a human being the Protection of Life and Personal Liberty (Legal Service, India) which naturally means to live a meaningful life with dignity. This means that human beings depend on a qualitative life than a life with a lump sum of misery, suffering and pain. When a person has full rights to live their life to their full color it is also sensible that the person has rights to end their life appropriately if at all there is no option in front of them. According to Hindu mythology there are instances where taking one’s own life is justified commonly known as Samadhi, which has its roots with ascetics, where it is normally regarded as the unification of the soul with the Almighty. Euthanasia was also practiced among the indigenous group of people mainly to reduce the suffering of people mercifully. The inhabitants of the Grenada islands, the Kalinago have induced herbal poisons to the aged and terminally ill people with the main intention of relieving their pain (Honychurch, 2002). There are many countries in the world that pertains laws in support of Euthanasia- the Death with Dignity Law 1997 enacted in Oregon (Robin, 2004) puts forward certain criteria for ending one’s life- they are against any form of active euthanasia- their criteria involves: the person should be terminally ill that would lead to their death in a period of six months, must be 18 years old and must have the capability to make decisions. Similarly many other countries like Netherlands, Switzerland, Denmark and Japan are in support of Euthanasia. When Sir Thomas Moore, the literary genius published his work Utopia- he wrote about Euthanasia being possible for people who were suffering from terminal illness in his ideal community.

Arguments against Euthanasia:

Many people vote against euthanasia mainly on religious backgrounds- all the religions are against mercy killing thinking that life has been given to us by the Almighty and that he should choose when to die. Many people fear that if euthanasia is legalized people would prefer not to have options on the medicinal grounds and the fear of pain will take people to resort to this as a first option. The secular views are that the decision of mercy killing affects and rests mostly on their kith and kin. The eighteenth century philosopher Immanuel Kant proposed that man has no rights to end his life (Kant, 1986, p. 148). He is of the view that man should act according to his reasons, a person is morally worthy only if he discharges his duty and this duty cannot be delivered if he is swayed by his emotions or feelings (Shaw, 1993). All the religions consider human life sacred and something which has dignity, so man has no rights to take his own life whatever may be the circumstances. Kantian philosophy reminds that man is a rational being which distinguishes him from an animal, being that he has no rights to end his life even when he is in a deplorable state. Consequentialist and deontological theories are often against euthanasia, while on the grounds of Utilitarianism and Hedonistic approaches it is applicable. The non-religious arguments against euthanasia are that legalizing euthanasia would result in over usage or even be practiced frequently. It would also prove to be placing huge amounts of social pressure on the most vulnerable people in the society. There is also high risk of undermining relationships with elderly people seeking this as an alternative to life and presently there are no legal systems to safeguard this law (Beale, N and Horner, S). But like any other law euthanasia can also be legalized provided the case has strong areas to claim it- we have laws to prevent crime or burglary but it doesn’t mean that both these things never happen.

Looking back into the case of Aruna evaluation is necessary on both sides:

The Supreme Court judge who watched a CD produced as an exhibit to Aruna’s case which demands that she seems to respond to her favorite food with a smile, gets agitated if there are strangers in her room but becomes calm when gently touched, it naturally suggests that she is not brain dead (NDTV, 2011). Taking into account Aruna’s case- the journalist who filed the case was of the view that passive euthanasia will create more persistent harm to the lady than good. The staff of the hospital where she is been nursed were rejoicing over the verdict. The staffs say that they have been looking after her well with all the care needs met and they claim that they are happy to look after her and doubtful why is there a third party like the journalist so interested in her case. The hospital authorities claim that this care is a testimony of excellent care provided by the KEM hospital which is out of love, dedication and professionalism. The multi professional medical team who assessed her also claims that she is not living a miserable life. But the family members, her brother has a different opinion as he wanted her to have a peaceful death so that it gives an end to her unending ordeal (Raghuram, 2011). One of Aruna’s sisters wants her to be dying of natural causes and not being passively euthanized (NDTV, 2011). When the court pronounced a rejection of Aruna’s plea to die, the petitioner’s learned senior counsel Shekhar Naphade’s point of argument is worth mentioning here as he says ‘Life is not mere living but living in health. Health is not the absence of illness but a glowing vitality’ (SCC 734, State of Bihar, 1988).

The contradictory views just escalate the ethical dilemmas; in Aruna’s case her autonomy is not seen to be respected as she is not been given any choices of her life. Culturally and religiously people believe that they are doing well by acting as a beneficiary on her behalf, by feeling that they will be blessed by the Almighty because of their good and empathetic deeds. But on the other hand, a few believe that the staffs are acting according to their personal interest- in order to get a blessing or boon they seem to undermine the suffering and trauma of the lady for three and a half decades. They are acting on their emotional instincts, but Aruna being a living being is neglected to be treated like one, even though she receives fantastic care services. There is no medical assurance to finalize that Aruna would reform to her formal state and the patients quality of life is been questioned. Even though medical sciences have improved a lot in terms of new drugs none of them promises a better life for Aruna since three and a half decades. She is not been able to do anything on her own and constantly needs one to one support from a carer. As her state is more or less vegetative her family has stopped visiting her. This proves that she is having restricted social inclusion by doing nothing to contribute to the society. She might feel dejected about her life but currently unable to express them verbally. The effectiveness and efficiency of the actions of both the hospital and government need to be analyzed- according to the hospital they are striving for a noble cause: and the government feels they have exercised their duty to protect their citizens from any harm; but ultimately both these analysis proves to be fatal for Aruna, as her situations, pain, agony, distress, anguish and dolor have been turned down. Aruna is more or less in a vegetative state incapable of doing anything productive, it is here that the question arises about the aim of living. In the light of humanitarian concept I would rather suggest that Euthanasia is the only possible solution to release Aruna from the bonds and chains of this deplorable and tormented life. This explication might seem mysterious to many who are against euthanasia but it is always better than having an excruciated life with unlimited vexation and worry. Four years after the verdict being pronounced, Aruna contracted pneumonia and died a natural death in 2015. May the good soul rest in peace who has lived and pained through the battle of life.

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