After years of debate and legal battles, India will soon decide whether or not to pass a law to legalize “passive euthanasia”. The Union government has released a draft Bill on it and has invited public suggestions before the formation of the law.
According to the draft Bill, a terminally ill patient above the age of 16 years can decide on whether to continue further treatment or allow nature to take its own course.
"Every competent patient, including minors aged above 16 years, has a right to take a decision and express the desire to the medical practitioner attending on her or him," says the draft Bill uploaded on the Union Health Ministry website.
Every competent patient, including minors aged above 16 years, has a right to take a decision and express the desire to the medical practitioner…
The Bill provides protection to patients and doctors from any liability for withholding or withdrawing medical treatment and states that palliative care (pain management) can continue.
Here are some of the suggestions from the draft Bill:
1. "When a patient communicates her or his decision to the medical practitioner, such decision is binding on the medical practitioner," the draft Bill says. However, it also notes that the medical practitioner must be “satisfied” that the patient is “competent” and that the decision has been taken on free will.
2. There will be a panel of medical experts to decide on case by case basis.
3. The medical practitioner has to maintain all details of the patient and ensure he/she takes an informed decision. He is also required to inform the patient whether it would be best to withdraw or continue treatment. If the patient is not in a conscious state, he/she needs to inform family members. In the absence of family members, the medical practitioner needs to inform a person who is a regular visitor.
4. The draft also lays down the process for seeking euthanasia, right from the composition of the medical team to moving the high court for permission.
The Bill only portends to legalise what is called “passive euthanasia”, as discussed in the judgement pertaining to nurse Aruna Shanbaug.
Shanbaug, a nurse at KEM Hospital in Mumbai, was raped and strangulated, leaving her in a vegetative state for decades till her “next friend”, author Pinki Virani (who wrote a book on her) filed a case to allow her to be euthanized.
Active euthanasia is not being considered "as it is likely to be used by unscrupulous individuals to attain their ulterior motives.”
The Ministry said that active euthanasia (which involves taking specific steps such as injecting a terminally ill patient with a lethal substance to end suffering) is not being considered "as it is likely to be used by unscrupulous individuals to attain their ulterior motives.”
Some said it's a “good start”, but others didn't quite agree.
The draft has disappointed experts who wanted complete clarity on the concept of a living will. A living will is defined as "a document in which a person states his/her desire to have or not to have extraordinary life-prolonging measures used when recovery is not possible from his/her terminal condition''.
Paragraph 11 of the draft Bill said that any "advance medical directive (living will) or medical power of attorney executed by the person shall be void and of no effect and shall not be binding on any medical practitioner''.
"It deals with legal details, but doesn't guide the doctor about how to handle a 90-year-plus patient with terminal complications from cancer or a patient suffering a third stroke. Should the doctor concerned take a chance by starting treatment or not offer any treatment at all?'' asked a doctor.
Child rights activists are also not too happy about it.
Enakshi Ganguly of the Haq Centre for Child Rights in Delhi called it “ridiculous.”
"We cannot sign a contract or marry before the age of 18, but you can decide to die? How can we allow a child to decide something as important as life and death?” she was quoted in Scroll.in.
Paediatrician Dr Vandana Prasad, a former member of the National Commission for Protection of Child Rights, feels that a young person is too “impressionable”.
"I am too scared for vulnerabilities of young children. The child may feel that he is too much of a burden and take a decision," she said.
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