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WHOSE CHOICE IS IT, ANYWAY? Kerala Law reforms commission's recommendation to legalise euthanasia sparks off right-to- die debate. In a country where people die in protest demanding their right to live, the endless debate on euthanasia curiously mix with religion, ethics, human dignity and politics finally reaching a


K R Ranjith


talian society suddenly locked in a heated debate over a fresh case of euthanasia while the world is talking away the worst economic crisis in history . The life and death row has further widened the rift between the Premier Silvio Berlusconi and President Giorgio Napolitano. The centre of the debate is Eluana Englara, a 38 year old woman who had been comatose for 17 years after a traffic accident. In a fiercely disputed case that polarised the Italian society, the leftist president backed a court order to allow doctors to remove her feeding tubes. But the centre right conservative prime minister and the Vatican vehemently opposed what they termed as an 'abominable assassination' attempt. ELuana's father had been leading a protracted legal battle since the tragedy in 1992 to disconnect her feeding tubes which he finally won a few months back. But the Burlusconi government hurriedly passed a law not to allow doctors to remove the life support system. Defying the Prime minister, the President sat on the emergency decree eventually allowing doctors to assist Eluana in death. She died in a private hospital (the government had asked all the state run hospitals to provide life support system to Eluana in case she

was admitted there.) in the first week of t h e L a w R e f o r m s C o m m i s i o n February shortly after the feeding tubes constituted by the state government mooted a law amendment to allow were removed. euthanasia. The committee headed by The death ignited a fresh round of former Supreme Court Judge Justice V controversy. Burlusconi accused the R Krishna Aiyer have a few radical President of 'Murder'. “Eluana did not recommendations that would give the die a natural death, she was killed,� He conservative brigade an opportunity to said. The after-tremors of the death have hit the streets The news of the draft not died down yet. The fact that recommendations has already upset the Burlusconi set aside the woes of a religious corners, especially the Church. devastating financial turmoil the While the law and medical experts point country is trapped in, to debate an to the extremely complex issues that emotional issue with strong religious arise out of legalising the right to die. undertones, have not gone unnoticed though. French President Nicholas Sarkozy has had to face the same question during the first phase of his presidency. He was suave enough to keep a moderate double stand not to upset religious sentiments. Though he personally supported the plea of the 52 year old school teacher Chantal Sebire, suffering from a rare malignant neoplasm of the nasal vault, to subject her to an assisted suicide, Sarkozhy said that it was not in his capacity to change the laws for that matter. The debate on euthanasia, it seems, would go on endlessly as ever and forever. Back home, the life-and-death debate got a fresh lease in Kerala recently as the Law Reforms Commision constituted by the state government mooted a law

An Indian's right to death The pro-euthanasia discourses in India got a fillip as the National Law Commision suggested 'the government repeal Section 309 of the IPC' to make an attempt to suicide not a crime. This is an indication of a growing legal tolerance towards suicide and assisted suicide. However, abetment of suicide remains an offence punishable under Sections 305and 306 of the Indian Penal Code and euthanasia or mercy killing under whatever circumstances in which is effected is considered as homicide in the country. In this context, the Kerala Law Reforms commission recommendations gain significance as the first expert legal committee to state mendations seriously and make the next move in right earnest,

[N a t i o n a l ] it in clear unambiguous terms. If the government take the recommendations seriously and make the next move in right earnest, which would be a very tough call given the socio-religious equations in the state, Kerala would become the first Indian state to legalise euthanasia. A heart-breaking plea by the mother of a former chess champion K Venkitesh of Andhrapradesh had brought the Indian legal experts to consider mercy killing as a benevolent option to give long suffering patients a right to die with dignity. 25 year old Venkitesh had been on a ventilator for long after suffering a severe attack of muscular dystrophy. His mother, Sujatha moved to the Andhrapradesh HC requesting to allow euthanasia in order to fulfil her son's last wish to donate his organs. After suffering long and fighting an equally painful legal battle, Venkitesh succumbed to his fate in December 2004 with out fulfilling his death-wish.

had not inserted a feeding tube until just a few days before he died, presumably because of his refusal to take the tubes. John Paul himself had opposed pulling the feeding tubes in case of Terry Schiavo. The delay in putting feeding assistance to John Paul II was against the Church's dictum to 'use all modern means possible to prolong life.' In her article titled 'The Sweet Death of

How did Pope John Paul II Die?Karol Wojtyla' appeared in an Italian A heated euthanasia debate raged in the USA after the death of Terry Schiavo in 2005. Her husband wanted to put an end to her hopeless vegetative existence while her parents refused a proposal to remove her feeding tubes. The case was debated in the congress and also reached at the Supreme Court. The pro-life activists and the Vatican condemned the death as 'arbitrarily hastened' and described the removal of her feeding tubes as 'a violation of principles of Christianity and civilization.' But the Vatican was took by surprise when Dr. Lina Pavanelli, head of the anesthesiology and intensive care therapy school at the University of Ferrara, in a highly provocative article, argued that the death of Pope John Paul II was caused by what the Catholic Church itself would consider euthanasia. Dr. Lina, strictly examining the final days of John Paul II, found that the doctors had not addressed his incapacity to swallow and erry Schiavo. The delay in putting feeding assistance to John Paul II was against the Church's

periodical Micromega, she wrote that the Pope had died for reasons that were clearly not mentioned. “Of all the problems of the complicated clinical picture of the patient, the acute respiratory insufficiency was not the principal threat to the life of the patient. The Pope was dying from another consequence of the effects on the [throat] muscles from his Parkinson's Disease... not treated: the incapacity to swallow." In response to the damaging revelations, the Vatican insisted that the ailing Pope's 'treatment was not interrupted' and that he was provided feeding tubes three days before his death. But the Vatican evaded an explanation to the crucial point in Dr. Lina's argument that the Pope needed feeding assistance weeks before his demise. The debates on legalizing euthanasia usually evoke the same responses by the two sides fighting endlessly over God,

a dead end. But a few countries have managed to overcome the ethicsmongers and to formulate a medical and legal frame work to allow long suffering patients to end their trauma by choice. The Northern Territory of Australia was the only place where active euthanasia (administration of drugs by a doctor to end life) had a legal approval. But the Northern Territory Rights of the Terminally Ill Act 1995 was nullified by the Australian senate in 1997. Netherlands legalized euthanasia in 2002, making it the first country on earth to do so. Some US states allow/do not criminalise assisted suicides by law. The state of Oregon had legalised physicianassisted suicides in a 1994 referendum while the states of North Carolina, Utah and Wyoming have no statutes criminalising assisted suicides. An SC verdict in Ohio State in 1996 held that assisted suicide is not a crime.

The history of euthanasia dates back to ancient Greece and Rome where physician assisted suicides were widespread until the advent of Hippocratic School of medicine who pledged "never (to) give a deadly drug to anybody if asked for it, nor make a suggestion to this effect." The spread of Christianity and the acceptance of the 'supreme values of suffering' that would be rewarded later in heaven, made suicide and assisted suicide a grave sin. The Nazi euthanasia drive to eliminate terminally ill patients and children with A Global Dilemma antiusually evoke the same responses by the genetic disorders brought euthanasia brigade to silence voices in two sides fighting endlessly over God, ethics and morality and finally reaching favour.

is based on ethical grounds. Only a few countries and territories have legalised mercy killing and the rest of the world is resisting it on ethical grounds,” Dr.Paul said. “The commission argues that the mercy killing should be subjected to the consent and request of the patient. But the contentious issue is how can we define and determine the consent in a given case.

out 'the danger lurking behind mercy' and provided a powerful argument for anti-euthanasia brigade to silence voices in favour. Apart from a conservative ethical point of view, the legal and medical experts also points to some valid points to check the slope side of legalising euthanasia. The major fear is that allowing active euthanasia can degrade the whole medical profession and it might be difficult to check the criminal use of euthanasia in organ trade. Legalising euthanasia is likely to put a mental pressure on terminally ill patients to 'volunteer' for death instead of being a burden to their close relatives. The major argument against euthanasia is that it is a product of social Darwinism and that it would gradually undermine the very dignity of human life. Apart from all these things, it is pointed out that in the absence of a strong and credible legal, medical and social mechanism to decide on each case of euthanasia applications, things can turn extremely wrong.

An academic exercise The Law Reforms Commission Recommendations are not made with out strong resentments with in. Dr. Sebastian Paul MP, a member of the commission, has registered his note of difference in the draft. “My difference

problematic.Legal experts also points out that the recommendations can not be implemented even if the state government decides to take the plunge. Legalising euthanasia can only be made possible by affecting fundamental amendments in the Indian Penal Code which criminalises homicide and suicide and a state government can only pass the recommendations to the centre There can be incidents where the patient for consideration. is forced to give consent/request. I believe that the society is responsible to H e n c e t h e c o m m i s s i o n ' s save and retain life until death.”But with recommendations can only generate the remarkable technological advances academic interest at the best and cause in the medical sciences, life has become political stunts at the worst. Similarly, more of a technical term which can be the proposals to end polygamy, to extended/retained for long with the help appoint lower caste priests in temples of mechanical support devices. and to bring the assets of Catholic Church under a trust can send So the exhortation to 'use all modern conservative hot heads to the streets and means possible to prolong life' becomes allow them to hold the society to by affecting fundamental amendments ransom. in the Indian Penal Code which criminalises homicide and suicide and a state government can only pass the recommendations to the centre for consideration.

P.J. Mehta & Associates

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