Vasu Pachnanda
The Apex Court in its latest ruling not merely has bestowed legal sanction on passive Euthanasia, ratifying its earlier stand in the Aruna Shanbaug case, but embarked a step ahead, granting a legal affirmation to living wills or what may be called “advanced directives”. Thus, the outcome is a kind of humane verdict that paves way for a reasoned output to the much convoluted discourse vacillating between life and the question of a dignified death, all the while, gauged through the spectrum of subjective morality. In a summation, it won’t be wrong to adduce that the court’s stand solidifies the notion that accelerating the process of death for reducing the suffering of life, is the essence of right to live with dignity. This approach of an “advance directive” offers a reiteration of a person’s sovereignty over oneself, and is an unequivocal sanction to self-determination and autonomy, realized through a person’s active consent endowing him with right to refuse or limit medical treatment in case of future terminal illness reaching a point of no return. This is in corollary to the concept of “do not resuscitate” (DNR) that has been established as a norm when it comes to offering a choice to the elderly, in many of the developed countries. In simple words, living wills offer a reasonable alternative to the person, who deems it unwanted to artificially sustain himself when chances for his revival are reasonably slim or precisely close to none.
The dilemma of the family of the patient, terminally ill and battling such adverse conditions, as well as the doctors that earlier was compounded in the absence of a legal void, finally gets sorted with such a progressive and proactive way worked through by the judiciary.
This will surely, embolden in the patient and the family members in preferring an informed choice, especially in a country like India where social and moral taboos associated with death, and its dreadful connotations, plunges thousands of sufferers into poverty, as the exorbitant contribution towards critical healthcare, takes a toll on their lives, in a society that isn’t ready to accept reason, and still largely governed by opaque beliefs and orthodox taboos.
And on the constitutional front as well, imagining right to life without engulfing in its sphere, individual dignity is a futile discourse. And an extension of the same can be meant to understand that right to live with dignity also can be reasonably inferred to accommodate smoothening of the process of death or easing a person’s suffering for terminally ill patients or ones in vegetative state with all hopes of recovery being extinguished. Thus, this process gaining legal sanction not only facilitates one’s right to dignified existence but also kills many other birds with the same shot.
While the entire spree of events seem like a step in the right direction and for a right cause, its implementation and the architectural guidelines, under which, advanced directive is to be exercised seems heavily guarded, with a lot of filters and regulations imposed by virtue of the SC judgement, what remains a reasonable concern is its impact, short as well as in the long run on the ground. To confront a culture with a progressive norm, takes more than it seems it takes.
A society where the elderly are increasingly counted as burdens, and their neglect is sadly commonplace, with the veneration only limited to certain mandatory drawing room norms, it remains to be seen if living wills are actually processed and executed in the right way, and till then, fears of digression as a tool of exploitation can’t be consciously ruled out. Relatives near and far, who may seem to gain from pulling the plug may wield it as such, much to the frustration of the pious cause for which living wills are meant.
It seems very obvious that such an exercise of making living wills, is simply not a matter of mere right to choice, for it can be maneuvered both ways, and is an extremely sensitive discretion that an author exercises regarding the disposal of his own life. Also linked with it is the inherent departure from the “till now” entrenched norm that families and members have certain traditional rights and duties with respect to their members, and anything that detracts or takes away from such a setting, can be unworkable and may fuel acrimony.
All said and done, what remains the outcome of a situation where medical treatment is theoretically available but practically out of sight for a family, simply by virtue of its exorbitance and in thus in stolid conflict with their financial status, or economical possibilities – will they consider pulling the plug for simply financial reasons? Well, that is something that remains unanswered.
Further there seems no recourse for a condition where a patient might be emotionally, and mentally browbeaten into writing his death, knowing that their family can’t tackle the financial byproducts.
And this whole idea of a will declaring a person’s choice over himself, remains wishful thinking to the extent of implementing it in a society with mammoth rural urban divide and the question as to how many people will actually take to writing wills confronts us with reasonable basis.
And forget India, even a country as advanced as US has merely 67 percent of the populace opting for living wills. So what the chances and the probable paths are in a case such a will is absent. Well, the conditions are there, and so are the challenges.
It remains to be seen how, the Government wrestles through these small yet, significant hurdles in its path of paving a clearway for passive euthanasia to be formulated as a robust legislation, with elaborate ways for its implementation and propagation in a society that still finds itself embroiled in social and moral dilemmas that not only reside but nearly govern all the practicalities that occur in day to day life of a common man. Having said that, it’s a great initiative provided it is administered greatly.
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