EUTHANASIA - An ethical dilemma

On February 5, 2024 a former Dutch Prime Minister, Van Agt, and his wife Eugenie opted for duo euthanasia and it is making news all over the world. Married for 70 years, they were both 93 years old and reportedly held hands through the doctor assisted death. They belonged to Netherlands that was the first country in the world to legalize euthanasia in 2002.

So what is euthanasia? The word is derived from Greek in which ‘Eu’ means good and ‘Thanatos’ .  means death. Put together it means good death which has been a topic of controversy since its inception. The attending physician administers a suitable drug to the patient on his or her request or by assisted suicide in which the lethal drug is supplied by the doctor but the patient takes it on their own.

Switzerland can be called the pioneer of assisted suicide where people have been helping others end their lives since 1940s. In the last 20 years several countries in Europe have legalized euthanasia like Spain, Belgium and Luxembourg. Among the Latin American countries Columbia was the first to decriminalize euthanasia followed by Ecuador. Even then many religious, moral and ethical principles remain after Vatican categorically denied acceptance of euthanasia as a recognized form of death. The controversy has been raging for a long time in India too. It started in the form of PIL for Aruna Shanbaug who had lead a vegetative life for 42 years in the hospital. In March 2018 the supreme court legalized passive euthanasia which means withdrawal of life support in cases where it only delays the process of suffering  causing pain, anguish and suffering. Dignity in life and dignity in death was the guiding principle behind this legalization along with the legal sanction  given to writing a ‘living will’ or ‘ advanced medical directive’.

Thus euthanasia is defined as the hastening of death of a patient to prevent further suffering and is of two types.

(1).Active euthanasia is the deliberate physician act whereas passive euthanasia refers to withdrawal of support necessary for maintenance of life. The ethical implications arise because active euthanasia may be voluntary with patient consent, non voluntary without patient consent and involuntary where the patient is not in a position to give consent. Keeping in view a terminal illness or  prolonged suffering with no hope of remission, countries like Belgium has lifted ban on all age restrictions on euthanasia.

With increasing acceptance of right to exercise one’s free will in life termination, terms like ‘Euthanasia tourism’ or ‘death tourism’ are becoming popular. People from Britain, Germany and France are travelling to countries like Switzerland where such services are  legally available.(5)

How does euthanasia work : The most popular drug used in these cases is barbiturates though a combination of drugs may also be used in succession. Firstly, a general anaesthetic is given to induce unconsciousness followed by neuromuscular blocking agents to paralyse the muscles and  stop all movements including respiratory efforts and muscle spasms. This is the accepted  treatment norm as , opposed to the machine ‘Mercitron’ or ‘Thanatron’ which was used by ‘ Dr. Death’  Jack Kevorkian who installed it in the back of his van and is said to have assisted in 130 suicides.

Dissent against euthanasia is based on the ‘slippery slope’ phenomenon which highlights the greater number of non voluntary cases as compared to voluntary euthanasia. To prevent misuse of this law governments should come up with stringent rules and regulations and all cases of euthanasia should be mandatorily reported failing which strict punishment should be meted out to all parties involved.

Sources:

1. Chao DV.Chan NY. Chan WY. Euthanasia Revisited, Fam Pract.2002;19:128-34.( Pub Med) (GoogleScholar)

        2. BBC,The Guardian, NYT, The