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Report No. 196

(2) Euthanasia and Assisted Suicide are and continue to be criminal offences in India but not withdrawal of life support systems, under certain circumstances.:

This aspect has been referred to in some measure in the Introductory Chapter (Chapter I). We propose to go into some more detail.

(A) 'Euthanasia' is defined generally as an act of killing somebody painlessly, especially for relieving the suffering of a person from incurable illness. This is also called 'mercy killing'. The acts constituting Euthanasia may be attributed to any person, including doctors. Euthanasia is an offence in almost all countries. We shall here once again repeat what we stated in Chapter I.

'Euthanasia' which is illegal in India and in several countries, is divided into four categories. (1) passive voluntary euthanasia; (2) Active voluntary Euthanasia, (3) passive involuntary euthanasia; (4) active involuntary euthanasia and (5) Active non-voluntary euthanasia. The word 'voluntary' denotes a voluntary action of the patient himself. The word 301'active' means the positive act of another person. The word 'passive' means an omission of another person which results in a patient's death.

We shall refer in some detail about these five categories of Euthanasia..

(1) Passive Voluntary Euthanasia: Here the medical treatment is withdrawn or withheld from a patient, at the patient's request, in order to end the patient's life. The word 'passive' denotes that there will be 'omission' by another person to take measures to prolong a patient's life. 'Voluntary' means it is the patient's express wish based on his informed consent, to refuse life prolong treatment.

(2) Active Voluntary Euthanasia: Here, it is 'active' in the sense that another person takes action. It may be the patient's desire for a lethal injection be given to him by another person and that decision is a conscious and rational decision. It is not a case of omission to get the treatment but a positive act. It is 'voluntary' because it is done with the patient's express and informed consent.

(3) Passive involuntary Euthanasia: It is a situation where medical treatment is withdrawn or withheld or is refused by another person in order to end the life of the patient but it is not voluntary as in the categories (1) and (2) above. It is 'involuntary' as it is done not at the instance of the patient but at the instance of the doctor or others. It is cessation of life-prolonging treatment to a conscious and rational person but not against his will. (This is based on intention of the said third party and is different from 'withdrawal of life support', where there is no such intention to kill).

(5) Active involuntary Euthanasia: Here there is a positive or active medical intervention to end the patient's life by a doctor or other persons. It is not at the patient's request. Lethal injection is administered to a conscious and rational patient. This is pure 'Euthanasia' in the absolute sense.

(6) Active Non-voluntary Euthanasia: Euthanasia performed on a person who is incompetent and therefore not capable of giving consent.

(B) 'Assisted Suicide' is different from Euthanasia. It is basically 'suicide' because it is an act of the patient himself who puts an end to his life, while Euthanasia is always the act or omission of a third party. The patient here, however, seeks the assistance of a doctor to suggest and give him drugs which he can administer to himself in order to commit suicide. In a way, it may amount to 'abetment' of suicide. In 'assisted suicide' the doctor actively assists the patient and gives him the medicines which enable the patient to use it to commit suicide. The patient wants to commit suicide because he is unable to bear the pain and suffering.

In Euthanasia, in particular, in active involuntary euthanasia, the doctor injects the patient with a lethal dosage of medicine but in assisted suicide, the doctor prescribes the lethal dose to the patient and the patient takes it or administers it to himself. In both, the 'intention' element is important.

Passive Involuntary Euthanasia may appear to be close to 'withdrawal of life support system' but, as pointed by Sopinke J in Rodriguez vs. British Columbia Attorney General 1993(3) SCR 519, the difference is one of intention. In the former, the person (who may also be a doctor) removes the life support system of a patient, without the latter's consent, but with an intention to kill him. But in the case of 'withdrawal of life support system' by a doctor in respect of an incompetent person, the withdrawal is made as being in the best interests of the patient, as accepted by a body of medical experts, and not with an intention to kill the patient. Hence it is not 'Passive Involuntary Euthanasia', and not an offence.

In India, Euthanasia and Assisted Suicide are and will continue to be unlawful.

Medical Treatment to Terminally Ill Patients (Protection of Patients and Medical Practitioners) Back

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