Ethics &

Values
Project
Report
Euthanasia

Raima Sen– 17BME090

Pulkit Satapara– 17BME096
Shreesh Shah– 17BME097
Vatsal Shah– 17BME098
Rahil Sharma– 17BME099
Shivam J.– 17BME100
Siddhant Paliwal– 17BME102
Suketu Parekh– 17BME105
Satyajeet S.– 17BME106
Vaibhav Tank– 17BME107
Tanzim Sheikh– 17BME108
Introduction
Euthanasia refers to the practice of intentionally ending a life in order to
relieve pain and suffering. It means “good death”.

There are different euthanasia laws in each country. The British House of Lords Select
Committee on Medical Ethics defines euthanasia as "a deliberate intervention undertaken
with the express intention of ending a life, to relieve intractable suffering". In
the Netherlands, euthanasia is understood as "termination of life by a doctor at the request of
a patient".
Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or
involuntary. Voluntary euthanasia is legal in some countries, U.S. states, and Canadian
Provinces. Non-voluntary euthanasia is illegal in all countries. Involuntary euthanasia is
usually considered murder. As of 2006, euthanasia is the most active area of research in
contemporary bioethics.
In some countries there is a divisive public controversy over the moral, ethical, and legal
issues of euthanasia. Those who are against euthanasia may argue for the sanctity of life,
while supporters of euthanasia rights emphasize alleviating suffering, bodily integrity, self-
determination, and personal autonomy. Jurisdictions where euthanasia or assisted suicide is
legal include the Netherlands, Belgium, Luxembourg, Switzerland, Estonia, Albania, the US
states of Washington, Oregon and Montana, and, starting in 2015, the Canadian Province
of Quebec. Euthanasia can be considered an example of libertarian school of thought.

Definition
Like other terms borrowed from history, "euthanasia" has had different meanings depending
on usage. The first apparent usage of the term "euthanasia" belongs to
the historian Suetonius who described how the Emperor Augustus, "dying quickly and
without suffering in the arms of his wife, Livia, experienced the 'euthanasia' he had wished
for."

In current usage, one approach to defining euthanasia has been to mirror Suetonius,
regarding it as the "painless inducement of a quick death". However, it is argued that this
approach fails to properly define euthanasia, as it leaves open a number of possible actions
which would meet the requirements of the definition, but would not be seen as euthanasia. In
particular, these include situations where a person kills another, painlessly, but for no reason
beyond that of personal gain; or accidental deaths which are quick and painless, but not
intentional.
Thus another approach is to incorporate the notion of suffering into the definition. The
definition offered by the Dictionary incorporates suffering as a necessary condition, with
"the painless killing of a patient suffering from an incurable and painful disease or in an
irreversible coma", and this approach can be seen as a part of other works, such as Marvin
Khol and Paul Kurtz's "a mode or act of inducing or permitting death painlessly as a relief
from incurable suffering".

The third element incorporated into many definitions is that of intentionality – the death must
be intended, rather than being accidental, and the intent of the action must be a "merciful
death".

Classification of Euthanasia
Euthanasia may be classified according to whether a person gives informed consent into
three types: voluntary, non-voluntary and involuntary.
There is a debate within the medical and bioethics literature about whether or not the non-
voluntary (and by extension, involuntary) killing of patients can be regarded as euthanasia,
irrespective of intent or the patient's circumstances. In the definitions offered by Beauchamp
& Davidson and later by Wreen; consent on the part of the patient was not considered to be
one of their criteria, although it may have been required to justify euthanasia. However,
others see consent as essential.
Voluntary euthanasia:
Voluntary euthanasia is the practice of ending a life in a painless manner.
Voluntary euthanasia (VE) and physician-assisted suicide (PAS) have been the focus
of great controversy in recent years.
As of 2009, active voluntary euthanasia are legal in Belgium,
Luxembourg, the Netherlands, Switzerland, and the US states of
Oregon and Washington.
Euthanasia conducted with the consent of the patient is termed voluntary euthanasia.
Passive voluntary euthanasia is legal throughout the U.S. per Cruzan v. Director,
Missouri Department of Health.
When the patient brings about his or her own death with the assistance of a physician,
the term assisted suicide is often used instead. Assisted suicide is legal in Switzerland
and the U.S. states of Oregon, Washington and Montana.

Non-voluntary euthanasia:
Non-voluntary euthanasia (sometimes known as mercy killing) is
euthanasia conducted where the explicit consent of the individual concerned is
unavailable, such as when the person is in a persistent vegetative state, or in the case
of young children. It contrasts with involuntary euthanasia, where euthanasia is
performed against the will of the patient.
 The decision can be made based on what the incapacitated individual would have
wanted, or it could be made on substituted judgment of what the decision maker would
want were he or she in the incapacitated
person's place, or finally, the decision could be made by the doctor by their own
decision.

Involuntary euthanasia:
Involuntary euthanasia occurs when euthanasia is performed on a person who is able
to provide informed consent, but does not, either because they do not choose to die, or
because they were not asked. It is currently under debate as to whether it corresponds
to murder.
Involuntary euthanasia is contrasted with voluntary euthanasia (euthanasia performed
with the patient's consent) and non-voluntary euthanasia (where the patient is unable
to give their informed consent, for example when a patient is in comma or a child).
Involuntary euthanasia is widely opposed and is regarded as a crime in legal
jurisdictions, and is sometimes used as a reason for not changing laws relating to other
forms of euthanasia.

Passive and active euthanasia

Voluntary, non-voluntary and involuntary euthanasia can all be further divided into
passive or active variants. Passive euthanasia entails the withholding of common
treatments, such as antibiotics, necessary for the continuance of life. Active euthanasia
entails the use of lethal substances or forces, such as administering a lethal injection, to
kill and is the most controversial means. A number of authors consider these terms to
be misleading and unhelpful. Passive euthanasia has been legalized in India by the
Supreme Court since 7 March 2011

History
The first recorded use of the word euthanasia was by Suetonius, a Roman historian, in his De
Vita Caesarum--Divus Augustus (The Lives of the Caesars--The Deified Augustus) to
describe the death of Augustus Caesar:

"...while he was asking some newcomers from the city about the daughter of Drusus, who
was ill, he suddenly passed away as he was kissing Livia, uttering these last words: "Live
mindful of our wedlock, Livia, and farewell," thus blessed with an easy death and such a one
as he had always longed for. For almost always, on hearing that anyone had died swiftly and
painlessly, he prayed that he and his might have a like euthanasia, for that was the term he
was wont to use. "
Augustus' death while termed "a euthanasia" was not hastened by the actions of any other
person.

Withdrawal or with-holding treatment was practiced in history; the correct term for this
is orthothanasia, which means 'passive death.' In this method, the actions of curing the
patient are never applied and his death is made easy in a passive form. In orthothanasia, the
action of killing is not applied, but, passive actions are present in order to provide death.

The actions of easy death have been applied for hopeless patients who have been suffering
extreme pain since ancient ages.

These actions were forbidden from time to time. In Mesopotamia, Assyrian physicians
forbade euthanasia. Again in the old times incurable patients were drowned in the River
Ganges in India. In ancient Israel, some books wrote that frankincense was given to kill
incurable patients.
Jewish society, following the teaching of the Bible and the sixth command "thou shall not
kill", had rejected centuries ago every theory on shortening the life of handicapped or
disadvantaged people. Judaism considered life to be sacred and equated suicide and
euthanasia with murder. Dr Immanuel Jakobovits, former Chief Rabbi of England explained,
"Cripples and idiots, however incapacitated, enjoy the same human rights (though not
necessarily legal competence) as normal persons... One human life is as precious as a million
lives, for each is infinite in value..."

In Sparta, it was the common practice for each newborn male child to be examined for signs
of disability or sickliness which, if found, led to his death. This practice was regarded as a
way to protect the society from unnecessary burden, or as a way to 'save' the person from the
burden of existence.

In ancient Greece, suicide of the patient who was suffering extreme pain and had an
incurable terminal illness was made easy and for this reason, the physician gave medicine (a
poisoned drink) to him. Plato wrote: "Mentally and physically ill persons should be left to
death; they do not have the right to live."

Pythagoras and his pupils were completely against suicide due to their religious beliefs that
the Gods place the man as the protector of the earthly life and he is not allowed to escape
with his own will.

The first objection to euthanasia came from the Hippocratic Oath which says "I will not
administer poison to anyone when asked to do so, nor suggest such a course."

In ancient Rome, euthanasia was a crime and this action was regarded as murder. However,
history notes that sickly newborn babies were left outside, overnight, exposed to the
elements.

In the middle Ages in Europe, Christian teaching opposed euthanasia for the same reason as
Judaism. Christianity brought more respect to human beings. Accordingly, every individual
has the right to live since God creates human beings and they belong to Him and not
themselves. Death is for God to decree, not man.

Scenario in the last century

The efforts of legalization of euthanasia began in the USA in the first years of the 20th
century. The New York State Medical Association recommended gentle and easy death.
Even more active euthanasia proposals came to Ohio and Iowa state legislatures in 1906 and
1907 but these proposals were rejected.

In 1920, two German professors published a small book with the title 'Releasing the
destruction of worthless animals' which advocated the killing of people whose lives were
"devoid of value." This book was the base of involuntary euthanasia in the Third Reich.

In this book, authors Alfred Hoche, M.D., a professor of psychiatry at the University of
Freiburg, and Karl Binding, a professor of law from the University of Leipzig, also argued
that patients who ask for "death assistance" should, under very carefully controlled
conditions, be able to obtain it from a physician.

Alfred Hoche also wrote an essay, which he published as "Permitting the Destruction of Life
Not Worthy of Life." It embraced euthanasia as a proper and legal medical procedure to kill
the weak and vulnerable so as not to taint the human gene.

The reduction of punishment in mercy killing was accepted in Criminal Law in 1922 in
Russia. But this law was abolished after a short while.

A French physician, called Dr.E.Forgue. published an article, named "Easy death of

incurable patients" in La Revue de Paris, in 1925, and pointed out that killing an incurable
patient wasn't a legal condition. But, Liege Bar said that killing an incurable patient with his
free consent had to be forgiven.

The laws that accept euthanasia as a legal condition are present in two countries of South
America. According to Uruguay Penal Code, a Judge must not punish a person for mercy
killing. A person must also be forgiven for this kind of killing in Colombia.
Adolf Hitler admired Hoche's writing and popularized and propagandized the idea. In 1935,
the German Nazi Party accepted euthanasia for crippled children and "useless and non-
rehabilitatable" patients.

Before 1933, every German doctor took the Hippocratic Oath, with its famous "do no harm"
clause. The Oath required that a doctor's first duty is to his patient. The Nazis replaced the
Hippocratic Oath with the Gesundheit, an oath to the health of the Nazi state. Thus a German
doctor's first duty was now to promote the interests of the Reich.

Anyone in a state institution could be sent to the gas chambers if it was considered that he
could not be rehabilitated for useful work. The mentally retarded, psychotics, epileptics, old
people with chronic brain syndromes, people with Parkinson's disease, infantile paralysis,
multiple sclerosis, brain tumors etc. were among those killed. The consent of the patient was
absent in this type of euthanasia. This kind was applied by order.

Many people don't realize that, prior to the extermination of Jews by Nazi Germany, in the
so-called "final solution," as many as 350,000 Germans were sterilized because their gene
pool was deemed to be unsuitable to the Aryan race, many because of physical disability,
mental deficiency or homosexuality.

In 1936 the Voluntary Euthanasia Society was founded in England. The next year the
English Parliament (the House of Lords) rejected a proposal to legalize euthanasia. In
opinion polls of those years, euthanasia supporters had around 60% of the votes.

According to a questionnaire in 1937, 53% of American physicians defended euthanasia.

Approximately 2000 physicians and more than 50 religious ministers were among the
members of the American Euthanasia Society. At that time, a majority of physicians in some
American cites defended this subject.
In 1938, the Euthanasia Society of America was established in New York.

Aruna Shanbaugh Case:

Aruna Shanbaug was a nurse working at the KEM Hospital in Mumbai on 27 November
1973 when she was strangled and sodomized by Sohanlal Walmiki, a sweeper. During the
attack she was strangled with a chain, and the deprivation of oxygen has left her in a
vegetative state ever since. She has been treated at KEM since the incident and is kept alive
by feeding tube. On behalf of Aruna, her friend Pinki Virani, a social activist, filed a petition
in the Supreme Court arguing that the "continued existence of Aruna is in violation of her
right to live in dignity".
Following the attack, nurses in Mumbai went on strike demanding improved conditions for
Shanbaug and better working conditions for themselves. In the 1980s the BMC made two
attempts to move Shanbaug outside the KEM Hospital to free the bed she has been
occupying for seven years. KEM nurses launched a protest and the BMC abandoned the
plan.

Sohanlal was caught and convicted, and served two concurrent seven-year sentences for
assault and robbery, neither for rape or molestation.

On 24 January 2011, after she had been in this status for 37 years, the Supreme Court of
India responded to the plea for euthanasia filed by Aruna's friend journalist Pinki Virani, by
setting up a medical panel to examine her. The court turned down the mercy killing petition
on 7 March 2011. However in its landmark judgment, it allowed passive euthanasia in India.

Ongoing Debate
Historically, the euthanasia debate has tended to focus on a number of key concerns.
According to euthanasia opponent Ezekiel Emanuel, proponents of euthanasia have
presented four main arguments: a) that people have a right to self-determination, and thus
should be allowed to choose their own fate; b) assisting a subject to die might be a better
choice than requiring that they continue to suffer; c) the distinction between passive
euthanasia, which is often permitted, and active euthanasia, which is not substantive (or that
the underlying principle–the doctrine of double effect–is unreasonable or unsound); and d)
permitting euthanasia will not necessarily lead to unacceptable consequences. Pro-euthanasia
activists often point to countries like the Netherlands and Belgium, and states like Oregon,
where euthanasia has been legalized, to argue that it is mostly unproblematic.
Similarly, Emanuel argues that there are four major arguments presented by opponents of
euthanasia: a) not all deaths are painful; b) alternatives, such as cessation of active treatment,
combined with the use of effective pain relief, are available; c) the distinction between active
and passive euthanasia is morally significant; and d) legalizing euthanasia will place society
on a slippery slope, which will lead to unacceptable consequences.

Doctors’ sentiment
A survey in the United States of more than 10,000 physicians came to the result that
approximately 16% of physicians would ever consider halting life-sustaining therapy
because the family demands it, even if they believed that it was premature. Approximately
55% would not, and for the remaining 29%, it would depend on circumstances.
This study also stated that approximately 46% of physicians agree that physician-assisted
suicide should be allowed in some cases; 41% do not, and the remaining 14% think it
depends.
In the United Kingdom, the pro-assisted dying group Dignity in Dying cite conflicting
research on attitudes by doctors to assisted dying: with a 2009 Palliative Medicine-published
survey showing 64% support (to 34% oppose) for assisted dying in cases where a patient has
an incurable and painful disease, while 49% of doctors in a study published in BMC Medical
Ethics oppose changing the law on assisted dying to 39% in favour.

Our View
It remains for a fact that we come into this world chosen among millions of other
possibilities. The fact that each of us is alive is in itself a miracle. Life is definitely a divine
gift. But what becomes of this “gift” when a person is forced to live a life which is just more
painful than death itself? The idea of euthanasia definitely has a big taboo to it as it does
doctors too much power as:

 Doctors do this all the time. (put people to permanent rest)

 Any medical action that extends life changes the time when a person dies and we
don't worry about that
 This is a different sort of decision, because it involves shortening life
 Doctors take this sort of decision all the time when they make choices about
treatment
 As long as doctors recognize the seriousness of euthanasia and take decisions about
it within a properly regulated structure and with proper safeguards, such decisions
should be acceptable.
 In most of these cases the decision will not be taken by the doctor, but by the
patient. The doctor will provide information to the patient to help them make their
decision
 Since doctors give patients the information on which they will base their decisions
about euthanasia, any legalization of euthanasia, no matter how strictly regulated,
puts doctors in an unacceptable position of power.
 Doctors have been shown to take these decisions improperly, defying the
guidelines of the British Medical Association, the Resuscitation Council (UK), and
the Royal College of Nursing:
 An Age Concern dossier in 2000 showed that doctors put Do Not Resuscitate
orders in place on elderly patients without consulting them or their families
 Do Not Resuscitate orders are more commonly used for older people and, in the
United States, for black people, alcohol misusers, non-English speakers, and people
infected with Human Immunodeficiency Virus. This suggests that doctors have
stereotypes of who is not worth saving.

Also given the case of exceptional emotional vulnerability, a person is likely to opt for
euthanasia in a hustle. Vulnerable people will be put under pressure to end their lives. It
would be difficult, and possibly impossible, to stop people using persuasion or coercion to
get people to request euthanasia when they don't really want it.
A script from the Canadian Committee on Euthanasia & assisted suicide reveals this
disturbing fact:

I have seen . . . AIDS patients who have been totally abandoned by their parents, brothers
and sisters and by their lovers.

In a state of total isolation, cut off from every source of life and affection, they would see
death as the only liberation open to them.

In those circumstances, subtle pressure could bring people to request immediate, rapid,
painless death, when what they want is close and powerful support and love.

A stark contrast to this would be the Aruna Shanbaug, who like several others has been
living a life so devoid of nearly everything that is human & no better than that of a parasite.
Aruna Shanbaug has been living a life who’s course was had NOTHING to do with her
willful actions. The brutality that she faced nearly 4 decades ago is something she will be
forced remember & live with as long as her wretched life comes to an end. This is one of
many critical case where human beings have been forced to live under a vegetative state for
decades, a case where the difference between life & death are nothing more than the fact that
the latter would be more convenient. A life that pleads for death.

A very important reality that we all possibly choose to ignore is that the right to live is a veil
which not only covers but also includes the right to die.

The right to life includes the right to die

 The right to life is not a right simply to exist
 The right to life is a right to life with a minimum quality and value
 Death is the opposite of life, but the process of dying is part of life
 Dying is one of the most important events in human life
 People have the right to try and make the events in their lives as good as possible
 So they have the right to try to make their dying as good as possible
 If the dying process is unpleasant, people should have the right to shorten it, and thus
reduce the unpleasantness.
 People also have obligations - to their friends and family, to their doctors and nurses,
to society in general
 These obligations limit their rights
 These obligations do not outweigh a person's right to refuse medical treatment that
they do not want.

Also it is possible that by allowing euthanasia in critical & necessary case, we can free up
medical resources & also relive a financial burden that the person’s concerned have to bear.
In most countries there is a shortage of health resources.
As a result, some people who are ill and could be cured & have a better chance of survival,
are not able to get speedy access to the facilities they need for treatment.
At the same time health resources are being used on people who cannot be cured, and who,
for their own reasons, would prefer not to continue living.
Allowing such people to commit euthanasia would not only let them have what they want, it
would free valuable resources to treat people who could recover & live.
Abuse of this would be prevented by only allowing the person who wanted to die to initiate
the process, and by regulations that rigorously prevented abuse.

From a utilitarian viewpoint, justifying euthanasia is a question of showing that allowing

people to have a good death, at a time of their own choosing, will make them happier than
the pain from their illness, the loss of dignity and the distress of anticipating a slow, painful
death. Someone who wants euthanasia will have already made this comparison for
themselves.

On the bottom line, The idea is that death hurts people because it stops them having more of
the things that they want, and could have if they continued to live.
Someone who makes a request for euthanasia is likely to have a bad quality of life (or a bad
prognosis, even if they are not yet suffering much) and the knowledge that this will only get
worse. If that is the case, death will not deprive them of an otherwise pleasant existence. The
Aruna Shanbaug Case is an example of this.
Of course, most patients will still be leaving behind some things that are good: for example,
loved ones and things they enjoy. Asking for death does not necessarily mean that they have
nothing to live for: only that the patient has decided that after a certain point, the pain
outweighs the good things.
The idea of death is considered bad because the idea of life is considered divine. But we
must ponder on the question “is death really a bad thing?” Don’t we often say “it’s good
his/her suffering came to an end” when a near & dear one departs? Wouldn’t it be more
peaceful to have ended the pain & suffering earlier (with the consent of the departed)?

Conclusion
Voluntary Euthanasia should be made legal with strict regulations permitting it under only the
most severe circumstances. Circumstances which clearly state that the person has reached a
vegetative state & shows a non-probable chance of recovery.
A person should be allowed to choose to have at least a pleasant death after having lived a life
which was deliberately massacred by the evil that exists in society.
Involuntary Euthanasia must under NO circumstances be permitted due to a great possibility
& grim opportunity of misuse by putrid elements of society as seen in the case of Nazi
Germany where once genocide was hidden under the veil of involuntary euthanasia. Also due
to the fact that often the will to live has proved to be a cure more effective than any procedure
or anti-biotic.
Non- Voluntary Euthanasia can be made legal but in the case that it be enforced, the person
who makes the call should be without a doubt & due to complete obviousness, a person
elected by the person commissioning euthanasia. Non- voluntary Euthanasia can be
considered as the safer form of euthanasia due to a presence of a third opinion. This third
person can act as a fail-safe against the possibility of the decision being made under purely
sentimental reasons.
Passive euthanasia has already been adapted by the supreme court of India & hence needs no
more discussion.
We are descendents of generations that have found the courage to live in the darkest &
dimmest points of their lives. But, in the glory of such few there lies the buried horror of
those who suffered throughout their lives finding peace only in death.

References
 www.life.org.nz/euthanasia/abouteuthanasia/history-
euthanasia1/Default.htm
 https://debatewise.org/debates/861-do-you-agree-or-disagree-with-
euthanasia-or-mercy-killing/
 http://www.bbc.com/ethics/euthanasia/overview/introduction.shtml
 www.euthanasiaprocon.org
 https://www.thehindu.com/opinion/op-ed/should-euthanasia-be
allowed/article22524514.ece
 https://www.thehindu.com/opinion/editorial/death-with-
dignity/article23009854.ece