The health ministry's draft Bill permitting passive euthanasia, or withholding medical treatment or a life support system required to keep a terminally ill patient alive, should be broadly welcomed. It has been framed on guidelines set out by the Supreme Court in 2011, drawn up following an emotive case involving an appeal by a human rights activist to withdraw food and treatment to Aruna Shanbaug - a nurse who had been in a vegetative state for three decades after being assaulted by a hospital assistant in 1973. Though the Supreme Court turned down that appeal, it allowed passive euthanasia in a landmark judgement. The apex court argued that stopping treatment did not amount to a "positive step to terminate life", as is the case with active euthanasia involving, say, the administration of a lethal injection or poison.
Debates for and against euthanasia, also known as assisted suicide, have convulsed the global medical and human rights fraternities for decades. So far, two countries and five American states have legalised passive euthanasia, with Switzerland controversially allowing both kinds of assisted suicide. In recent decades, arguments for the right to life - the basis on which Shanbaug's colleagues who had nursed her for decades opposed the appeal - have been increasingly leavened by the case for the right of a human being to die. The possibility of the misuse of the guidelines remains high, especially in the context of rising medical costs or the nefarious intent of relatives. The Supreme Court's guidelines and the Bill, however, have been cognisant of the ramifications of the issue by building in safeguards. They stipulate that the doctor and the patient will be protected from criminal liability - the concomitant move to decriminalise attempted suicide under the Indian Penal Code was made in 2014 - and have set out distinct procedures for "competent" (conscious) and "incompetent" (comatose) patients, for whom the decision rests with relatives. The latter involves reference to a high court panel in each state which will refer to a committee of three reputed doctors who will examine the patient and submit its report. The wishes of the patients' close relatives - spouse, child, parents - will also be considered.
The Bill stipulates a month for the high court to give a verdict, a time-frame that may be excessive in the context of a patient's suffering. The process for "competent" patients may also need to be made more robust to ensure that they are not being subjected to coercion from relatives or hospital staff. In its broad intent, however, the Bill not only provides a reasonably rigorous due process but is also in alignment with a humane reality often followed by doctors and hospitals in terminal cases. To be sure, the issue will remain controversial but as a move towards affording Indians some measure of dignity the Bill is an important step forward.
