Monday, July 28, 2014

Euthanasia - to be or not to be

After Supreme Court called for a nation-wide debate on euthanasia, there is lot of talk in the country around the issue. Given the morally ambiguous nature of euthanasia, it’s little wonder that multiple school of thoughts is emerging on it.

According to me, the Supreme Court’s suggestion for a nationwide debate is in acknowledgement of two facts. One is euthanasia has been in public discourse for many years. There is varied level of public awareness about it. Some may have a vague about about it, others may know a little more about it - that it exists in some parts of the world as an accepted practice followed when a patient is above all possibilities of survival. Awareness is not a problem.

But the other fact of the two is more interesting. If we debate euthanasia threadbare and it’s taken up by the media, more clarity will emerge and maybe the smoke around euthanasia, which gives it a sinister feel, making it something you are comfortable discussing but not accepting as a medical means which can be applied to a family member - will dissipate.   

Let us look at why we are resistant to this idea if we are aware of its existence and also accept its merit at least at an intellectual level. This idea flies in the face of the filial values we grow up with. At some level, we believe this may leave us to decide, one day, when and whether to withdraw life support to our parents, a decision which may leave us with a lifelong sense of guilt.

But this is where we are wrong. Whether life support will be withdrawn to a patient or not, is not decided by the close relations of the patient at the eleventh hour, but by the patient himself/herself when the patient is in a sound mental and physical condition to decide whether he/she would like to continue life, enduring unbearable physical pain when all possibilities of recovery are over, or terminate life by withdrawal of life support.

If someone decides to go for euthanasia, the person signs a contract called Living Will which includes such details as how and in what circumstances life support should be withdrawn, what kind of life support the person would be given, where etc. The Will may be signed by a person at any age, any time when he/she is eligible to sign a legal document.

But is it possible to foresee so many details about a health situation that is nowhere on the horizon when you are signing a Living Will?  Probably advocates of Living Will will say you are free to sign a Living Will when standing on the threshold of a treatment, a position that allows you to foresee, to a great extent, how a treatment can unfold and arrange details around it. 

Maybe but, with some health conditions, the course of a treatment may depart radically from what was envisaged before the treatment had started. Being a speculative document, how accurate can the Living Will be about a situation which it considers only hypothetically? Things become foggier if you consider the school of thought which argues that medical science is advancing every day and what is irreversible today may not be so sometime later. 

These questions would have to be considered very carefully before euthanasia was accepted as an alternative to continuity of life through support. 

3 comments:

pranav said...

With quite a few hospitals as my clients, I can say that euthanasia is undertaken when the person has reached a vegetative state. And there have been so many cases of people coming out of comma after years. Yes, to save the family from financial ruin...insurance companies should pick the tab for such patients rather than going in for medically supervised killing. Euthanasia was discussed at length in the 1980's and most countries arrived at the conclusion that it is wrong.Doctors and pharma companies should be given incentives to cure rare diseases and given assistance for rare drug development.

pranav said...

With quite a few hospitals as my clients, I can say that euthanasia is undertaken when the person has reached a vegetative state. And there have been so many cases of people coming out of comma after years. Yes, to save the family from financial ruin...insurance companies should pick the tab for such patients rather than going in for medically supervised killing. Euthanasia was discussed at length in the 1980's and most countries arrived at the conclusion that it is wrong.Doctors and pharma companies should be given incentives to cure rare diseases and given assistance for rare drug development.

Anonymous said...

Ya, it's not a bad idea and should be explored.

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