Karnataka Allows Dignified Death for the Terminally ill

Syllabus: GS2/ Governance, GS4/ Ethics

In News

• In a historic move, the Karnataka Health Department issued an order to implement the Supreme Court’s ruling allowing terminally ill patients to die with dignity.
  • Karnataka is the second State after Kerala to implement the directive.
  • Euthanasia is the intentional act of ending a person’s life to relieve suffering caused by a painful, incurable disease or disorder.

Supreme Court’s Directives on Passive Euthanasia

• Legal Recognition (2018 & 2023 Rulings): The Supreme Court legalized passive euthanasia in 2018, recognizing the right to die with dignity under Article 21 of the Constitution.
  • In 2023, the court simplified procedures for withdrawing life support, ensuring a structured and ethical approach.
• Conditions for Passive Euthanasia: Applicable to terminally ill patients with no hope of recovery.
  • Allowed when the patient is in a persistent vegetative state or prolonged suffering from an incurable condition.
• Advance Medical Directive (AMD) or ‘Living Will’: Any competent adult can create an AMD specifying their medical treatment preferences in case they lose decision-making capacity.
  • The AMD can nominate two representatives to make decisions on the patient’s behalf.
• Approval Process for Life Support Withdrawal: Hospitals must set up Primary and Secondary Medical Boards (each with three senior doctors).
  • The District Health Officer must be involved in the decision.
  • Final decision requires Judicial Magistrate of the First Class (JMFC) approval and reporting to the High Court Registrar.

What is Passive Euthanasia?

• It is withholding or withdrawing life-sustaining treatment (LST), allowing a terminally ill patient to die naturally.
• Legal in India (as per Supreme Court rulings in 2018 & 2023) under strict medical and legal procedures.
  • The Ministry of Health and Family Welfare (MoHFW) has released draft guidelines titled “Guidelines for Withdrawal of Life Support in Terminally Ill Patients.” 

Ethical Considerations of Euthanasia

• Autonomy and the Right to Die: 
  • Pro-Euthanasia: Argue that individuals have the right to choose how they live and die. A competent person should be allowed to make decisions regarding their life, including opting for euthanasia.
  • Anti-Euthanasia: Opponents believe that allowing euthanasia undermines the intrinsic value of life and could set a dangerous precedent for determining when life is worth living.
• Beneficence and Compassion:
  • Pro: Physicians take an oath to reduce suffering. For terminally ill patients in unbearable pain, euthanasia can be a compassionate act that provides relief.
  • Anti: Opponents argue that palliative care and pain management should be prioritized rather than ending a patient’s life.
• Slippery Slope Argument:
  • Pro: Some believe euthanasia can be regulated with strict guidelines to prevent misuse.
  • Anti: Others argue that legalizing euthanasia could lead to involuntary euthanasia or pressure on vulnerable individuals (elderly, disabled) to end their lives to reduce the burden on families or society.
• Sanctity of Life vs. Quality of Life:
  • Sanctity of Life: Many religious and moral perspectives argue that life is sacred and should not be taken, regardless of suffering.
  • Quality of Life: Others contend that when a person’s quality of life is irreversibly diminished, euthanasia is a humane option.
• Legal and Social Implications:
  • Legalization Issues: Countries like the Netherlands, Belgium, and Canada allow euthanasia under strict conditions, but legalizing it worldwide remains contentious.
  • Potential Abuse: There are concerns that euthanasia laws could be abused, leading to non-consensual deaths or prioritizing euthanasia over improving healthcare.

Source: TOI