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Report No. 196

The Supreme Court stated, after the above quotation from Airdale as follows: (p 665)

"The desirability of bringing about such a change was considered to be function of the legislature by enacting a suitable law providing therein adequate safeguards to prevent any possible abuse."

In effect, the Supreme Court, while making the distinction between euthanasia, which can be legalized only by legislation, and 'withdrawal of life-support', appears to agree with the House of Lords that 'withdrawal of life support' is permissible in respect of a patient in a persistent vegetative state as it is no longer beneficial to the patient that 'artificial measures' be started or continued merely for 'continuance of life'. The Court also observed that the principle of 'sanctity of life, which is the concern of the State', was 'not an absolute one'.

(B) We may also refer to certain observations in Gian Kaur as to whether a 'right to die' with dignity was part of a 'right to live' with dignity in the context of Article 21 where death due to termination of natural life is certain and imminent and the process of natural death has commenced. The Court observed: (p 661)

"A question may arise, in the context of a dying man who is terminally ill or in a persistent vegetative state that he may be permitted to terminate it by a premature extinction of his life in those circumstances. This category of cases may fall within the ambit of the 'right to die' with dignity as a part of 'right to live' with dignity, when death due to termination of natural life is certain and imminent and the process of natural death has commenced."

From the above passages, it is clear that the Supreme Court accepted the statement of law by the House of Lords in Airedale that 'euthanasia' is unlawful and can be permitted only by the legislature i.e. act of killing a patient painlessly for relieving his suffering from incurable illness. (and be subject to appropriate supervision and control). Otherwise, it is not legal. 'Assisted suicide' is where a doctor is requested by a patient suffering from pain and he helps the patient by medicine to put an end to his life. This is also not permissible in law. Again, at p 661, the Supreme Court stated:

"These are not cases of extinguishing life but only of accelerating conclusion of the process of natural death which has already commenced. The debate even in such cases to permit physicianassisted termination of life is inconclusive. It is sufficient to reiterate that the argument to support the view of permitting termination of life in such cases to reduce the period of suffering during the process of certain-natural death is not available to interpret Article 21 to include therein the right to curtail the normal span of life." (emphasis supplied).

The last sentence must be understood in the context of 'assisted suicide' and not in the context of withholding or withdrawing life support. But where a patient is terminally ill or is in a persistent vegetative state, a premature extinction of his life in those circumstances, by withholding or withdrawal of life support, is part of the right to live with dignity and, is permissible, when death due to natural termination of life is certain and imminent and the process of natural death has commenced.

The case of 'withdrawal of artificial measures for continuance of life by a physician', decided by Airedale N.H.S. Trust v. Bland (1993 (1) All ER. 821 (HL) deals with something different from euthanasia or physician assisted suicide. It relates to the withdrawal of artificial measures used by a physician for continuance of life. In the context of a patient in a persistent vegetative state with no benefit to himself, the principle of sanctity of life,which is the concern of the State, has been stated to be not an absolute one.

In such cases also, there is a crucial distinction between cases in which (a) a physician decides not to provide or continue to provide treatment or care which can or may prolong his life and (b) where the physician decides, for example, to administer a lethal drug, actively to bring an end to the patient's life. The former is permissible but the latter is not. Taking care of a living patient is different from crossing the Rubicon to resort to euthanasia. (para 40 of SCC)

If these are the guidelines that can be culled out from the judgment of the Supreme Court in Gian Kaur's case, which expressly referred to Airedale N.H.S. Trust v. Bland, there is no difficulty in accepting the principles laid down in UK and other countries as to when it would be lawful for a patient or a doctor to direct stoppage of ventilation or artificial nutrition or other life sustaining treatment. We shall, therefore, deal elaborately with the principles of law laid down in UK and other countries. After referring to the case law in other countries, we shall come back to the provisions of the Indian Penal Code and to the tort law.



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




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