New passive euthanasia bill is not in best interests of patients

The Centre has proposed to introduce a law on passive euthanasia for terminally-ill patients.

While withdrawal of life-sustaining treatment in certain cases is already permitted in terms of the guidelines laid down by the Supreme Court in the 2011 Aruna Shanbaug case, the draft law circulated by the government proposes to expand the scope of passive euthanasia in India.

The proposed law, apart from by and large adopting the Supreme Court guidelines on withdrawal of life support on directions of a court in case of incompetent patients, allows a terminally-ill patient who is capable of taking an informed decision to order withdrawal of life-sustaining treatment.

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While there may be nothing wrong in respecting the wishes of a terminally-ill patient on withdrawing treatment, the Medical Treatment of Terminally-ill Patients (Protection of Patients and Medical Practitioners) Bill, as it stands, may put at risk the lives of the sick, elderly, depressed and handicapped.

Section 3 of the draft law makes it binding on the doctor to withdraw treatment as per the wish of the patient if he is satisfied that the patient is competent and has taken an informed decision.

While "best interests" of the patient is to be taken into consideration by courts while allowing passive euthanasia in case of incompetent patients, Section 3 does not give the discretion to the doctor to refuse the command to withdraw treatment in case of competent patients on the ground that it was not in the best interests of the patient.

Any other interpretation is difficult as Section 2(b) defines "best interests" as interests of a patient who is incompetent or who is competent but has not taken an informed decision.

In these two cases, treatment can be withdrawn only on orders by any high court in terms of Section 9.

Since suicide is still a crime in India, it would be logical to respect the wish of a patient on withdrawal of life support only if it was in his best interests.

Such a safeguard would also protect the vulnerable that may have been forced to take a decision under pressure.

Since court is not involved in case of passive euthanasia to competent patients, the law should specifically provide for additional safeguards to check against misuse.

The Supreme Court observed in the Shanbaug case that "we cannot rule out the possibility that unscrupulous persons with the help of some unscrupulous doctors may fabricate material to show that it is a terminal case with no chance of recovery".

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While there have been demands for recognising Advance Medical Directives (also known as living will) whereby a person declares in advance whether or not treatment should be given if he is terminally-ill and incompetent to take decisions in future, the government has rightly shot down the proposal.

Apart from scope for misuse and the fact that it may not be an informed choice in so far as the specific nature of the illness may not be known, the law already provides for a better procedure for decision on withdrawal of life support and treatment in case of incompetent patients.

True, too many safeguards will make passive euthanasia an exception rather than the rule.

But to begin with, that's the way it should be. It cannot be forgotten that the Supreme Court refused euthanasia for Aruna Shanbaug, who has been the face behind the movement to legalise passive euthanasia.

The court framed guidelines for passive euthanasia but did not allow euthanasia for Shanbaug who lived in a vegetative state for decades until her death in 2015.

(Courtesy of Mail Today.)