Sunday Interview: ‘The right to die with dignity, is an ideal state’

‘The family should have the right to approach the court, which will appoint a medical team. This is a three-layered process where the family, medical team and the court is involved.’

A fresh debate has been initiated on the subject of euthanasia with the Supreme Court taking up the plea of NGO Common Cause that has sought the right to refuse treatment and the right to die with dignity to be incorporated within the right to life. What are your views on the subject of euthanasia?

I support passive euthanasia because it allows a person to die with dignity, which is a part of right to live with dignity both of which are embraced by Article 21 of the Constitution. The important thing is that the right should be allowed to be actualised or carried out without the possibility of being misused. The right to die with dignity where misuse is eliminated is an ideal state. I don’t think there is any point in carrying on if one becomes a burden on oneself and on others.

A very valid point that’s often raised during the debate on euthanasia is that the statute allowing active/passive euthanasia can be misused. In your opinion, what is the scope of such misuse? What safeguards should be put in place to prevent such misuse by those who may benefit from the death of the patient?

At this stage I would not support active euthanasia, but I would support passive euthanasia with proper safeguards. Misuse can be curbed if the person can give advanced instructions when s/he is conscious. But this should be subjected to certain safeguards. To minimise the risk of misuse, there is a need to have a process where one is allowed to give a “living will”.

In cases where the person cannot give a living will or the person is in a vegetative state, and this is causing sorrow to the family and it is impossible for the family to carry on since it is very painful for both, the family should have the right to approach the court. The court can then appoint a medical team and come to its own assessment. This is called a three-layered process where the family, a medical team and the court is involved. The same was set out in Aruna Shanbaug’s case. This happens in cases in Europe and the US, resulting in minimising the risk of misuse.

In case of a person like Aruna Shanbaug, who has been in a vegetative state for decades, do you think the right to live with dignity is compromised if active euthanasia is not allowed to be performed on her?

No. In her case the nurses feel that they communicate with her, there is a bond and so they want her to continue living. This is a bond of dignity. She may be in the small world which we cannot fathom, but for the hospital staff she is a living human being with whom they have a bond.

Firstly, nobody is saying that she should be put to death; her own family wants her to continue in this state. They have come to the conclusion that she is living so the question of euthanasia doesn’t arise.

Things would have been different if somebody close to her had said that the person is no longer living with dignity. Third thing is the medical aspect, and here even the doctors are not of the view that she should die.

In the Aruna Shanbaug verdict of 2011, the top court legalised passive euthanasia (i.e., life support can be pulled out in case of persons in permanently vegetative state), but disallowed active euthanasia (i.e., administering lethal medicine to cause death in case of patients who are terminally ill but not on life support). Do you think this results in discrimination?

No, not at all. There is a difference between those who are actually in a vegetative state and those who cannot live without life support.

Should euthanasia be allowed only on patients who are in a vegetative state or should the ambit be extendedto those who are terminally ill with no hope of reversal of the disorder?

I think this is a problem area and a very thin line divides the two. The point to consider is whether a person is living with dignity or not, and whether the person would like to continue in this state.

Do you think giving palliative care to terminally ill patients is a better option than euthanasia?

It is not for us to decide. For me, the person has to decide if s/he would like to continue with palliative care, like being on painkillers. The real problem arises when the person is not able to communicate the decision, has no way out and has not left any instructions. We must respect the autonomy of that person; we have to give the decision-making process entirely to the patient. If the person has given a will, that should be respected.

Do you think it is important to fix an age limit?

I don’t think.

While some say it is one’s right to die with dignity, some people are of the view that euthanasia reflects modern mentality of cutting your losses. What are your views?

I don’t think that euthanasia is about modern mentality, rather it is about doing things rationally. Thanks to technology, we are now able to take informed decisions. Science has made it possible for a person to continue living on life support.