ACKNOWLEDGEMENT :

Many people by being what they are, are a great source of inspiration.

We would like to acknowledge some of the people, without whose help and support the
project would not have been successful.

We would like to thank Mr.Souvik Roy, Assistant Professor School of law, for encouraging
us to this highly sensitive topic.

Finally we want to thank the library staff, our hostel inmates and countless other persons,
who are very special in our lives and whose presence motivates us to move ahead.

1
CONTENTS:

 INTRODUCTION ( Presented by : Saptarshi Das )

 HISTORICAL, PHILOSOPHICAL AND RELIGIOUS BACKGROUNDS

( Presented by : Sakaar Nayak )

 LEGAL STATUS OF EUTHANASIA AND ASSISTED SUICIDE IN MODERN

AGE : A COMPARITIVE STUDY ( Presented by : Saptarshi Das )

 RIGHT TO WITHDRAWAL OR WITHOLDING OF LIFE SAVING

TREATMENT ( Presented by : Sanjukta Ghosh )

 SLIPPERY SLOPE ARGUMENT : HOW LOGICAL AND PERSUASIVE?

( Presented by : Sanjukta Ghosh )

 ETHICAL CHALLENGES TO EUTHANASIA AND ASSISTED SUICIDE

( Presented by : Sakshi Kriti )

 CONCLUSION ( Presented by : Sarika Nande )

2
INTRODUCTION
ACTIVE EUTHANASIA and physician assisted suicide, that is the practise of ending an
individual's life in order to relieve pain and suffering, is undoubtedly one of the most
controversial issues of the world today. Active Euthanasia has been at the centre of the moral
debate for long. To inquire whether doctors may kill their conscious/autonomous patients----
if the patient requests it-----is a direct challenge to what is often been seen as the core of
traditional Hippocratic ethic. Granted the fact that a patient asks repeatedly to be killed means
that the families, doctors and judges are not forced to decide whether the quality of life
whether the quality of life of someone who cannot decide for himself/herself is so poor that it
is better that his life not continue. It is after all a patient's life and as long as the patient is
capable of reaching an informed decision, then who better to decide whether life is worth
living? Should the legislators device a law that protects the terminally sick from ill-
considered self-destruction while recognizing their right to decide rationally to live with
dignity.

Dilemmas relating to ending of life have come to the forefront of interest in many parts of the
world in recent decades. The right to live with dignity and the right to euthanasia and assisted
suicide entailed by it are emerging issues of human rights concern. The right to human
dignity requires that the physician gives assistance to his patient to avoid unbearable physical
and spiritual suffering. Although it is unlawful for a doctor to do a positive act to bring about
a patient's death, the discontinuance of life support treatment is lawful when such treatment is
futile and discontinuance is in accordance with responsible medical opinion. As a result of
development of modern medical technology, doctors no longer associate death exclusively
with breathing and heart beat and it has come to be accepted that death occurs when brain
particularly the brain stem, has been destroyed. The debate on the withdrawal of life support
system has also to be seen in the context of healthcare industry which inflicts futile costly
treatments and unnecessary interventions on patients.

The purpose of this project is not to determine whether mercy killing is right or wrong, but to
provide some ethical arguments that are both critical and challenging. The decision to end life
of an irreversibly unconscious patient or those terminally ill who request it not to be simple or
automatic. The considerations of family feeling are both subtle and important, particularly if
the patient is an infant or young person and the loss of consciousness was unexpected. The
project deals with one of the most debated topics in the field of medical practise and law. The
debate is regarding the legalization of euthanasia with the assistance of the physicians. This
debate is regarding the legalization of euthanasia with the assistance of the physicians. This
debate id continuing one as some people say that life belongs to oneself, so each person has
the right to decide what he wants to do with it even if it amounts to dying. This paper offers
only a 'bird's' eye view to the richness of the debate in perspective of law, ethics and
medicine.

3
Historical, philosophical and religious
backgrounds:
The history of the concept of euthanasia is closely associated with human dilemmas involved
in advanced old age and severe illness. In classical Greece, the term meant 'the good death'
and referred primarily to the mode of dying, and easy or painless death associated with
drinking hemlock. In Greeco-Roman antiquity, there was a generally recognised 'freedom to
leave' that permitted the sick and desperate to terminate their lives sometimes with outside
help.

In the seventeenth century, however, euthanasia increasingly came to connote specifically

measures taken by the physician, including the possibility of hastening death. It is with the
later definition that the modern debate has emerged. Based on the idea of active intervention,
the primary meaning is now compassionate murder.

In her study of the traditional Hindu view of euthanasia, Katherine Young observed that, if
one was to take today's emergent definition of euthanasia with its technical insistence on
medically defined cases of terminal illness and its circumscribed meaning of a doctor actively
killing a patient on compassionate grounds, given due process of decision making, then, by
definition, he would be hard pressed to find equivalent situations in the past and in other pre-
modern societies. Her study illumines how self-willed death in certain situations of old age
and disease was found in India throughout much of history until it was eliminated in the early
modern period. In comparison, euthanasia, in the sense of freedom to leave, was rarely found
in the west after the Greeco-Roman period, although today its merits are increasingly
debated, as withdrawal of treatment becomes a common phenomenon in hospitals and the
debate over compassionate murder continues.

Jainism was likely the first religion to accept the practice of a religiously nominated, self-
willed death; it was called 'sallekhana' and involved a fast to death. While suicide was
thoroughly condemned, heroic death in battle, self-imposed death by one who is enlightened
or desires enlightenment, and self-willed death in extreme old age and ill health is
increasingly accepted.

In Hinduism, Brahamanical willingness to ritualise the withdrawal by the king (and his wife)
into the forest as a way of abdicating the throne in old age may have set the stage for
religious self-sacrifice and self-willed death as a way to attain heaven.
Apart from this, when one can no longer perform daily 'dharmic' duties for oneself, such as
bodily purification, euthanasia is then allowed by means such as jumping from a cliff into
water or jumping into fire or walking unto death etc. In Hinduism, therefore, the will power
of the individual to bring about his death was normative for the acceptance of euthanasia. It
may be argued that the western societies today do not share the same religious perspective as
Hinduism.

4
A noted philosopher Joseph Fletcher writes that he has defended euthanasia since the early
1930s, contending that any sane society would want to exercise rational control over ending
human life. In 1954 he published a defence of "voluntary medical euthanasia" and goes on to
ask if the end can sometimes justify the means.

He urges a code of ethics based on quality of life and writes that a day will come when
people will carry cards, notarised and legally executed, that they do not wish to be kept alive
beyond a certain point and authorising the end of their biological processes by any euthanasia
method. Fowler holds that the term 'right to die' is flawed since nothing in medical or nursing
tradition indicates that such a right exists. She urges that pain control become a matter of
priority.1

On both religious and non-religious grounds, and the principles of autonomy, virtue and the
common good, Richard Gula says that individual cases cannot be converted into a public
policy. Kass says that the theories most prominent in medical ethics literature today are those
of autonomy and of general benevolence and compassion (love). He thinks that in euthanasia
insistence on voluntariness cannot be maintained. Legalised killing will damage any doctor-
patient relationship. He indicates that neither autonomy nor the patient's freedoms are ethical
principles restraining physician's power-it is the power of human life itself. If doctors become
technical dispensers of death, Kass writes, they abandon their patients and their duty to care,
He concludes that physicians must offer encouragement and humanity to serve the good of
their patients and the moral health of society.2

1
American Heritage Dictionary
2
Encyclopedia of Bioethics

5
Legal Status of Euthanasia and assisted
suicide in the modern age : A Comparative
Study
The legal status of euthanasia and physician assisted suicide has been hotly debated by
legislators and the judiciary in a number of countries, focussing on either the legalization and
decriminalization of the acts. In spite of the nearly universal rejection of euthanasia and
assisted suicide because they are outside the builds of legitimate medical practice, several
countries and some countries of the United States have or did permit either or both euthanasia
and assisted suicide. An analysis of euthanasia experience in some countries are detailed
below :

India

The law, though active in some countries has been a sleeping giant in India, as euthanasia and
physician assisted suicide are both absolutely illegal in India. A physician who provides
lethal drugs so that another person can end his life will be liable as abettor of helping him
commit suicide. In India, abetment of suicide ( section 306, IPC ) and attempt to commit
suicide ( section 309, IPC ) are both criminal offences. This is in contrast to many countries
such as the US and UK where attempted suicide is not a crime. However a doctor who tries to
kill a patient at his request will fall under exception 5 to Section 300, Indian Penal Code and
the doctor will be held liable under section 304, IPC for culpable homicide not amounting to
murder. Cases of non-voluntary and involuntary euthanasia would be struck by proviso one to
section 92 of the IPC and thus be rendered illegal. The Law Commission of India in its 42nd
report had recommended the repeal of the provisions way back in 19713. The commission
had declared the section harsh and unjustifiable.

The constitution bench of the Supreme Court in Gian Kaur v State of Punjab4 held that both
euthanasia and assisted suicide are not lawful in India. The decision overruled the earlier two
judge bench decision of the same court in P. Rathinam v Union of India5. In Gian Kaur's case
the court held that the right to life under article 21 of the Constitution does not include the
right to die. In this case a corollary was drawn between euthanasia and suicide. In this case
the Supreme Court approved the House of Lords judgement in Airedale's case6 and observed
that euthanasia could be made lawful only by legislation. In India, physician assisted suicide
is illegal and it may make the doctors liable for abetment to suicide. Even in the event of
decriminalisation of attempt to suicide by repeal of section 309 of IPC, the abetment to
suicide would remain an offence under IPC.
3
Law Commission of India, 42nd Report 1971
4
(1996)2SCC 648
5
(1994)3SCC 394
6
Airedale N.H.S. Trust v Bland (1993) AC 789

6
Even though active euthanasia is illegal, passive euthanasia is lawful in India. On 7th March
2011 in Aruna Ramchandra Shanbaug v Union of India7, the Supreme Court legalised passive
euthanasia by means of the withdrawal of life support to patients in a permanent vegetative
state. The decision was made a part of the verdict in a case involving Aruna Shanbaugh who
has been in a vegetative state for 37 years at King Edward Memorial Hospital. In an absence
of a law regulating euthanasia in India, the court said that its decision becomes a law of the
land until the Indian Parliament enacts a suitable legislation. While rejecting Pinki Virani's
( friend of Aruna ) plea for Aruna Shanbaug's euthanasia, the court laid out guidelines for
passive euthanasia. The following guidelines were laid down :

1. A decision has to be taken to discontinue life support either by the parents or the spouse or
other close relative, or in absence of any one of them such a decision can be taken even by a
person or a body of persons acting as next friend. It can also be taken by the doctors attending
the patient. However the decision should be taken bona fide in the best interest of the patient.

2. Even if a decision is taken by the near relatives or doctors or next friend to withdraw life
support, such a decision requires the approval of the High Court.

3. When such an application is filed the chief justice of the concerned high Court should
forthwith constitute a bench of at least two judges who should decide to grant approval or
not. A committee of the reputed doctors to be nominated by the bench who will give report
regarding the condition of the patient. Before giving the verdict, a notice regarding the report
should be given to the close relatives and the State. After hearing the parties, the high court
can give verdict.

In Aruna Shanbaug's "right to die" case, the Supreme Court made a significant statement on
attempted suicide. Observing a person who takes his/her own life needs more help than
punishment, it asked the Parliament to consider decriminalizing the attempt to commit
suicide. This would entail the deletion of section 309 of the IPC. The Supreme Court
judgement in Aruna Shanbaug's case seems to have, in a broad sweep, sanctioned passive
euthanasia for terminally ill patients in certain circumstances. Passive euthanasia in reference
to medical practice generally refers to withdrawing life support and treatment, and letting
nature take its course. The active and passive distinction which stipulates that it is morally
wrong to intentionally take a life, but permissible to allow the inevitable to happen by
withdrawing or withholding treatment.8

Other Countries :

In Switzerland, euthanasia is illegal but assisted suicide is not a criminal act if it is motivated
by altruistic considerations. Since assisted suicide is legal, anyone may assist the suicide of a
physically ill person for the purpose of relieving suffering. There are no safeguards and no
necessary requirements and there is not investigation unless someone notifies the police.

7
(2011) 4 SCC 454
8
Stephen Potts, " Looking for the exit door : Killing and caring in Modern medicine.

7
However the practise of assisted suicide is unusual in Switzerland. According to the Swiss
law, whoever from selfish motive, induces another to commit suicide shall be punished if the
suicide was successful or attempted. The key words are from " selfish motives". Thus in
Switzerland, there is no prosecution if the person aiding and abetting suicide successfully
claims that he is acting unselfishly. While this result in de facto legalisation of assisted
suicide but is not legal, only not punishable, unless a selfish motive is proven.

Belgium legalized euthanasia and assisted suicide in 2002. However, it limits euthanasia to
competent adults and emancipated minors. A permanent committee has been set up to
monitor such deaths and the committee must approve an official form for physicians to fill
out every time they assist a suicide. Under the law, a patient must request euthanasia for at
least one month before killing is carried out, and a second opinion must be sought if the
patient is not in the final stages of terminal illness. The Northern territory of Australia
became the first country in the world to legalize euthanasia by passing the Rights to the
terminally Ill Act 1996. It was held to be legal in the case of Wake v Northern territory of
Australia,9 by the Supreme Court of Northern territory of Australia. After a brief period
wherein the practise as considered legal in Australia, the Australian administration introduced
legislation declaring voluntary euthanasia and assisted suicide illegal in all its States and
territories.

Patients in Canada have right to refuse life sustaining treatments but they can't ask for
assisted suicide or active euthanasia. In Canada, physician assisted suicide is illegal vide
section 241 (b) of the Criminal Code of Canada. The leading decision of the Canadian
Supreme Court in this connection in Sue Rodriguez v British Columbia10 ( Attorney General )
in which a woman of 43 was diagnosed with Amyotrophic Lateral Sclerosis ( ALS),
requested the Canadian Supreme Court to allow someone to aid her in ending her life.
Sopinka J observed :

"Sanctity of life has been understood historically as excluding freedom of choice in self-
infliction of death and certainly in the involvement of others in carrying out that choice. At
the very least, no new consensus has emerged in society opposing the right of the State to
regulate the involvement of others in exercising power over individuals ending their lives."

9
(1993) 124 FLR 298
10
(1993) 3 SCR 519

8
Right to withdrawal or withholding of life –
saving treatment
In 1976, in the case of Karen Ann Quinlan11, the New Jersey Supreme court held that
Quinlan’s father could make the decision to turn off the respirator that was keeping his
daughter alive . In that case, the patient’s constitutional right of privacy , as asserted by her
guardian ,outweighed the state’s interest in preserving the sanctity of human life and
defending the best judgement of medical professionals .The court recognised that the state’s
interest diminished as the potential for life diminished .This was the first of several cases
concerning the withdrawal of life support from persons in a persistent vegetative state .

The issue was again addressed in the case of Cruzan V Director, Missouri Department
of Health12. In that case , Nancy Cruzan sustained brain injuries resulting in a persistent
vegetative state, and when it became apparent that she had virtually no chance of regaining
her mental faculties , her parents asked the hospital to remove the artificial nutrition and
hydration which sustained her .The hospital refused to act absent a court order. In Cruzan ,the
court specifically found that the right of an individual to refuse life –sustaining medical
treatment derived from the common law doctrine of informed consent and has constitutional
basis : “ Every human being of adult years and sound mind has a right to determine what
shall be done with his own body; and a surgeon who performs an operation without his
patient’s consent commits an assault for which he is liable in damages”.13 Thus , under
common law, a patient can consent to , or conversely , refuse medical treatment . Since the
patient can refuse the treatment any time , the patient can have treatment withdrawn even
after it has been initiated. The court held that under the duo-process clause of the fourteenth
amendment, a competent person has a constitutionally protected liberty in the right to refuse
treatment; however a state can restrict the ability of others to exercise that right on behalf of
an incompetent person. Specifically , a state may require that an incompetent person’s wish
to have life support withdrawn be proved by clear and convincing evidence. Absent such
evidence, a state has a legitimate interest in the protection and preservation of human life .
One notable consequence of Cruzon’s decision was a rise in the use of advance directives as
a means of meeting the required clear and convincing standard.

Any treatment against the wishes of the patient is against the basic principle of self-
determination .The principle of self-determination requires that respect must be given to the
wishes of the patient ,so that if an adult patient of sound mind refuses ,however unreasonably,
to consent to treatment or care by which his life would or might be prolonged ,the doctors
responsible for his care must give effect to his wishes ,even though they do not consider it to
be in his best interests to do so.14 In case of comatose patients and those who are in persistent
vegetative state the courts often used the substitute judgement test to make decisions about

11
355 A.2d 467(NJ1976)
12
497 U.S. 261( 1990)
13
ibid
14
ibid

9
the withdrawal of treatment. The right of a patient on determine his or her mode of medical
treatment or to reject it is a sine qua non of modern medical ethics . Indeed many of the most
fundamental and universally accepted medical practices rooted in patient autonomy are
actually other aspects of individual autonomy, a doctrine central to the Indian constitutional
tradition. Important to the concept of autonomy is that the patient be capable of
understanding the various choices he or she may have and the consequences of those choices.

Decisions about medical treatment should focus on the benefits and burdens to be
experienced by the patient , and should not be intended to hasten death or delay it . As far as
possible , decision –making around end of life concerns should remain in the hands of the
dying person in collaboration with the competent health care professionals ,assisted by loved
ones whom the patient wants to be involved .If the dying person is no longer capable of being
in decision-making ,others who know him or her well should be empowered to act as
substantive decision-makers. Good management of pain and other symptoms is not
euthanasia; and it is not euthanasia to withdraw, withhold or forego treatment that would only
prolong the dying process. In the majority of cases where the Americans courts have
sanctioned the withdrawal of life –supporting medical care they have done so by developing
the rule that informed consent can release the doctor from his duty to treat. For this purpose
they have founded upon the constitutional rights of the patient, either the express right of due
process or the still implied right of privacy.

The refusal of any modality of treatment including life support is not an act of suicide or an
attempt at suicide .Acknowledgement of this right of refusal on the part of the physician
cannot be interpreted as euthanasia. Jurisprudentially , a possible path for persons with
terminal debilitating illness is to try to expand the right to life to include the right to die with
dignity along with an assertion of a constitutional right to discontinue unwanted medical
treatment .The Law Commission of India examined the issue of withholding of life support
measures to terminally ill patients . The Commission submitted a comprehensive report on
“Medical Treatment of Terminally Ill Patient.” It makes a sharp distinction between
“euthanasia “ and “assisted suicide” and withholding of life support systems” to terminally ill
patients . The report defines euthanasia as an act of any person including a doctor of
intentionally killing an individual who is terminally ill by giving drugs and assisted suicide
are treated as unlawful in the report while withholding of life support system to terminally ill
patients is looked upon as lawful.15

Although the Supreme Court in Aruna Shanbaug case quoted with approval the view of the
House of Lords in Airedale’s that a life support system can be withdrawn , it has not clarified
who can decide whether life support should be discontinued in the case of an incompetent
person e.g a person in coma or PVS .This vexed question has been arising often in India
because there are a large number of cases where persons go into coma and are unable to give
consent , and then the question arises as to who should give consent for withdrawal of life
support system. This is extremely important question in India that need, to be settled legally
and humanly.
15
Law Commission of India 196th Report on Medical Treatment of Terminally Ill Patients( protection of patients
and Medical practitioners),2006

10
SLIPPERY SLOPE ARGUMENT:HOW
LOGICAL AND PERSUASIVE ?
The most powerful objection to the legislation of either voluntary or physician-assisted
suicide is that ,once one begins to allow some people to kill others, one finds himself sliding
down a slope that leads to killing of a kind that no one wants. one begins with strict controls
designed to ensure that euthanasia is only carried out after a patient in an unbearable
condition has repeatedly requested it but ,so the argument runs ,one will gradually slide to
euthanasia for people who are not capable of requesting it ,or for people who are not
suffering unbearable ,but whose continued life puts a burden on their families ,and then,
perhaps, one shall move to euthanasia for those who have not asked for it, but whose
treatment consumes scarce health-care resources that could be more effectively used
elsewhere. In the end ,say some opponents will end up with the state that ,like Nazi Germany,
kills all those whom it considers to be unworthy of life .The practice was well established by
1936,when extermination of so-called “physically and specially unfit” was accepted as Nazi
policy.16 One estimate has indicated that 275,000 “undesirables” were killed by the time
world war II started.

Indications for voluntary mercy killing started with terminal cancer patients in controllable
pain, have opened to include anorexia nervosa and psychological problem e.g, depression
.Increasing numbers of cases are involuntary. So far the “safeguards” that the proponents of
mercy killing believed would stop excess and the slippery slope to indiscriminate killing have
not been proved .There are, of course, several precautions that would need to be
implemented .The most obvious problem with the proposal for a physician-assisted suicide
law is that many people would abuse it .However, with the proper restrictions and safeguards
abuse would be near impossible. Many such safeguards are already in place in Oregon and
the Netherlands and are working well. Under the Oregon Death and Dignity Act, the patient
must undergo a rigorous qualifying test. If at any point the patient is not qualified then his
request will not be granted. This law provides several safeguards to prevent abuse by either
the patient or physician. The most important restriction would be that the patient must be
resident of the state or country . This is present in both Oregon’s Act and Netherlands law.
This will prevent suicide tourism or tourists taking trips just so they can be euthanized . The
requirement of two-doctor agreement would prevent doctors from euthanizing people who do
not qualify for suicide.

There is widespread belief among philosophers and ethicists that the slippery slope argument
is illogical which does not stand up to close scrutiny . Pabst Battin has identified four
common errors of slippery slope thinking which all have the same features in common .The
first error is that this line of reasoning fails to identify clearly what the bottom point of the

16
In Oct 1939 amid and outbreak of war Hitler ordered widespread “mercy killing” of the sick and disabled.
They first focused on newborns and very young children who showed symptoms of mental retardation and
physical deformity ,the Nazi euthanasia programme quickly expanded to include older disabled children and
adults.

11
slippery slope is or what it is that people fear most about the outcome of legalised euthanasia.
Secondly, the cause of the slide down the slippery slope from the current situation to the
predicted bad outcome as the bad outcome is never made clear .Pabst Battin states that, if the
bad outcome is simply that any individual is recognised to have the right to die while the
integrity of the decision to live or die were safeguarded, it is by no means clear that this
would be a bad thing .Fourthly, for those opposed to the practice of euthanasia ,the Nazi
practices during the second world war inevitably enter into the discussion as an example of
how the slippery slope has existed in the past.17

Ethical challenges to euthanasia and

assisted-suicide:

17
Pabst Bartin. The Least Worth Death ( Oxford: Oxford University Press,1994)

12
The standard view, of the law, and of the traditional ethics is that every human life has equal
value. The notion of a worthless life is alien to the Hippocratic tradition as is to criminal law,
both of which subscribe to the principle of the sanctity of human life which holds that, all
lives are intrinsically valuable . It is always wrong intrinsically to kill an innocent human
being. As Sanford Kadish describing the view of human life taken by Anglo-American law,
puts it: "all human lives must be regarded as having equal claim to preservation simply
because life is an irreducible value. Therefore, the value of a particular life, over and above
the value of life itself, may be taken into account" . 18

The world medical community considers both euthanasia and assisted suicide to be in conflict
with basic ethical principles of medical practice. The world medical Association, with
members representing medical associations, from more than eighty countries, has adopted
strong resolutions condemning both practices and urging all national medical associations
and physicians to refrain from participating in them even if national law allows or
decriminalises the practices.19 'Euthanasia' , i.e., the act of deliberately ending the life of a
patient, even at the patient's own request or at the request of close relatives, is unethical. This
does not prevent the physicians from respecting the desire of a patient to allow the natural
process of death to follow its course in the terminal phase of sickness. As regards the
"physician-assisted suicide, like euthanasia is unethical and must be condemned by the
medical profession". Where the assistance of the physicians is intentionally and deliberately
directed at enabling an individual to end his or her own life, the physicians acts unethically.
However, the right to decline medical treatment is a basic right of the patient and the
physicians does not act unethically even if respecting such a wise results in the death of the
patient. 20

American medical association in its report on euthanasia in 1989 states: "The intentional
termination of the life of one human being by another-mercy killing-is contrary to public
policy, medical tradition, and the most fundamental measures of human value and worth".
What is termed "active euthanasia" is a euphemism for the intentional killing of a person; this
is not part of the practice of medicine, with or without the consent of the patient. Legally, a
person who kills another person under these circumstances is guilty of homicide. A motive of
mercy is not a defence.21 The public policy committee of American Geriattics Society took
two positions, each with a brief rational: (1) A physician should not provide intervention that
will actively, directly, and intentionally cause the death of patient; (2) The current legal
prohibition of physician assistance in active voluntary euthanasia and suicide should not be
changed. 22

18
Saford H. Kadish, "Respect for life and regard for right in criminal law" in Stephen F. Barker (ed). Respect
for life in medicine, philosophy and the law 72 (Balcimore : John Hopkins University Pess, 1977).
19
World medical association policy, The world medical association resolution on Euthanasia, World medical
association general assembly, Washington, 2002.
20
Ibid
21
American medical association, Euthanasia, report 12 (June 1988), Report of the council on ethical and
judicial Affairs (Chicago: American medical association, 1989).
22
American Geriatrics Society, Public policy committee, Voluntary active euthanasia , "Position statement"
39(8) journal of the American Geriatrics society 826(1991)

13
The British medical Association also considered active euthanasia and assisted suicide to be
in conflict with medical practice. In 1988, the association submitted its report on euthanasia.
The report includes discussions on the end of life, causes for requests to die, autonomy, and
the rights and responsibilities of physicians under British law. The working party of the
association concludes that active euthanasia is different from non-treatment and should
remain illegal; current law should not be changed. They say that neither doctors nor any
occupational groups should be placed in a category that lessens responsibility for their
actions, and that any physicians who intervenes to end a person's life should face closest
scrutiny under the law. Patients should not be able to require doctors to collaborate in their
deaths. 23

What the sanctity of life doctrine proscribes is the deliberate destruction of the human life; it
does not demand that life should always be prolonged for as long as possible. It is morally
wrong to intentionally take a life but permissible to allow the inevitable to happen by
withdrawing or withholding treatment.24 One fundamental principle is the principle of the
sanctity of human life-a principle long recognised throughout the world by all civilised
societies, as is indeed evidenced by its recognition in the European conventions on Human
Rights25 and the International convent on civil and Political Rights.26 Furthermore, as was
held in osman v. United kingdom27, by Denman J:

In respecting a person's death, we are also respecting their life-giving sanctity. A view that
life must be preserved at all costs does not sanctify life...To care for the dying, to love and
cherish them and to free them from suffering rather than simply to postpone death is to have
fundamental respect for the sanctity of life and its end.

In Airedale N.H.S. Trust v. bland,28 the house of lords made it clear that it did not value life
that is human only in a biological sense. Since this is fundamental point, it is worth looking.
Lord Keith of Kinkel discussed the difficulties of making a value judgement about the life of
a 'permanently insensate' being, and concluded cautiously that, 'it is, however, perhaps
permissible to say that to an individual with no cognitive capacity whatever, and no prospect
of ever recovering any such capacity in this world, it must be a matter of complete
indifference whether he lives or dies'. In Airedale, Lord Keith noted that it was unlawful to
administer treatment to an adult who is conscious and of sound mind, without his consent.
Such a person is completely at liberty to decline to undergo treatment, even if the result of his
doing will be that he will die. This extends to the situation where the person in anticipation of
his entering into a condition such as PVS, gives cleat instructions that in such an event he is
not to be given medical care, including artificial feeding, designed to keep him alive. It was
23
British medical association, euthanasia report of the working party on euthanasia
24
supra note 45
25
European convention on human right and fundamental freedoms (1950) art. 2
26
ICCPR, art 6.
27
(1998)29 EHRR 245
(1998)29 EHRR 245

28
Supra note 43

14
held by Lord Keith that a medical practitioner is under no duty to continue to treat such a
patient where a large body is informed and responsible medical opinion is to the effect that no
benefit at all would be conferred by continuance of the treatment. Existence in a vegetative
state with no prospect of recovery is by that opinion regarded as not being of benefit to that
patient. 29

Lord Goff described medical treatment 'simply to prolong a patient's life' as futile if the
patient is unconscious and there is no prospect of an improvement in his condition.30 Lord
Lowey in his brief judgement agreed with Lord Goff and said that 'it is not in the interests of
an insentient patient to continue the life-supporting care and treatment'. Lord Browne-
Wilkinson thought that the decision whether continued treatment was a benefit to the patient
was not one for the court to make, but for the doctor; all that the court had to decide whether
the responsible doctor has reached a reasonable and bona fide belief that continued treatment
is not a benefit to the patient. In Bland he had no doubt that it was 'perfectly reasonable' for
the responsible doctor to conclude the sustaining bland's life brought him 'no affirmative
benefit' .31 Finally Lord Mustill concluded that to withdraw life support was not legally, but
ethically justified, since the continued treatment of Anthony Bland can go longer to serve to
maintain that combination of manifold characteristics which we call a personality and Tony
Bland had no interest at all in being kept alive.32 thus, with the decision in the Bland's case,
British law abandoned the traditional idea that life itself is a benefit to the patient living it,
irrespective of its quality.

CONCLUSION
Although the concept of euthanasia is fertile, making it legal seems illusionary for a number
of countries. strong campaigns against legalization have been mounted by the religious
bodies, medical societies, politicians, and legislators. there is no indication that the views of
religious groups and fundamentalists will change in the near future. they rest on the principle
of "the sanctity of life". the religious and medical groups in general find that there is no need
to legislate for euthanasia, since adequate pain control and passive euthanasia can be used
instead, and are already morally accepted. here it may be noted that India is secular country,
so one needs to think rationally and humanly rather than religiously and morally. While
religions and morality do have an influence, euthanasia and assisted suicide are wanting in
29
(1993) All ERat 860
30
(1993) AC 789 at 867
31
(1993) All ER at 879-80
32
(1993) AC at 898

15
the context of commercialization of medical treatment. The apex court's ruling in Aruna
Shanbaug ignores the important factor of India's costly and unavailable medical treatment.
The present trend is toward privatization of healthcare centres including government
hospitals that charge heavy amount from their patients in the name of treatment and rests. The
extreme commercialization of healthcare completely ignores the basic ethics of medical
treatment.

The view of euthanasia as voluntary and aqs a good death was solidified by the resistance of
it's abuse. However the argument of the possibility of misuse cannot be grounds to oppose
legalizing euthanasia. Perhaps the greatest fear of abuse is presented as the "slippery slope"
argument: gradually voluntary euthanasia will slip over into involuntary killing of the
demented and the mentally handicapped. This fear is based on the abuse of abuse of power
that virtually defined the Nazi experience after 30 year of experience in the Netherlands there
is no indication of a slippery slope occurring. The appropriate criteria may be created for
eligibility for euthanasia and assisted suicide. Opponents of doctor-assisted suicide law often
cite the potential for doctors and family abuse. However, the experiences of Oregon and
Dutch laws shows that the governments can draft a reasonable law that can prevent abuse and
protect the value of human life.

The Dutch model may not be helpful for India. The Netherlands is a welfare state that
provides a high standard of health care and social security to its citizens. No patient needs to
ask for euthanasia because they are unable to good afford good health care. In addition,
everyone in Netherlands has his or her own family doctor, and usually stays with that doctor
for many years. These doctors and patients get to know each other well, own a long
relationship very different from modern medical practices in some other countries. so the
Dutch system will not be a suitable model for all countries to follow. However, Euthanasia
and assisted suicide merits special consideration. In India where there is less emphasis on
individual rights and religious fundamentalists have more clout, change seems likely to come.
more thought and discussion are needed to develop a well balanced broad proposal that can
take the place of traditional ethics.

Though attempted suicide is a crime in India, euthanasia merits serious

considerations. the following statistics cannot be ignored-about 10 per cent of its people are
disabled and more than 10 per cent are suffering from the problem of ageing, as advances in
medicine and health care have served to prolong life so that the percentage of the aged in the
total population is constantly increasing. serious physical and mental problems are common
among elderly, what is more important, more than 90 percent of the medical attention a
person requires is during the last few years of his/her life. why can't we allow those disabled,
terminally ill and all those who suffer from the problem of ageing with no productive life to
die honourable death if that is what they wish and ask for? In addition to this category there
are many more who are not only too old but suffer from innumerable diseases like asthma,
diabetes, cancer, arthritis and brain tumour. such people are quite aware that their quality of
life will get increasingly worse day by day. many of them often do not have family members
to look after them. thus, for those who do not wish to be a burden on the younger generation
or those who do not have caretakers to look after them sympathetically, legal and official

16
death may be more than a welcome solution. Apart from this there is a long waiting lists for
hearts, kidneys, livers, and other organs that they are necessary to save the life of people who
can be saved. doctor-assisted suicide allows physicians to preserve vital organs that can be
donated to others ( assuming the patients are organ donors ). However if certain diseases are
allowed to run their full course, the organs may weaken or cease to function altogether. In the
context of all these, euthanasia and assisted suicide merit special considerations.

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