Dying has become an obligation upon human beings, who seek to avoid it as they encounter the unavoidably fatal aging process. But death has not always been thought of in this manner. Euthanasia is one of the issues that have been the subject of extreme debate over time. It has been a relevant issue in human rights discourse as it also affects ethical and legal issues pertaining to patients and health care providers. Euthanasia is a concept used in the medical field which means easy death or gentle death, and is defined as the intended speeding up of the death of an individual based on terminal medical conditions. Euthanasia reflects one of the current debatable issues and raises many questions that need to be answered. Life is full of blessings, challenges and opportunities. Even dying brings its own unique blessings, challenges and opportunities. ‘Dying well’ is as important as getting our potential at school and at work, or finding happiness and fulfillment within our families, relatives and with our friends. The work of dying well often involves the healing and/or deepening of relationships. Health care professionals, including oncology nurses, frequently encounter ethical issues when caring for end of life patients and have to make a choice and choose between difficult or objectionable options and are frequently required to use their own moral reasoning to solve these ethical and moral issues. In today’s world, in spite of technological and scientific progress, especially in the field of laws and policy related to human health care, there are still ambiguity and controversy over the concept of peaceful death (euthanasia). Thus, this ethical or moral dilemma may inflict health care providers to legal and ethical risk. Arguments about euthanasia frequently hinge on the “right to life” and the “right to die”. The first is a widely accepted basic human right and moral and ethical value, based on the fact that people generally want to live. But what should we do when seriously ill people no longer want to live? Do they have a right to die? Sufferers sometimes wish to commit suicide but do not have the physical strength or the means to do it painlessly. Like many problems of medical ethics, this has become more critical in recent times. A century ago most people died quite quickly (and probably painfully) if they had serious injuries or illnesses. These days they can be treated, sometimes cured, and often kept alive almost indefinitely. Codes of conduct formulated centuries ago, for example those found in sacred texts, or the Hippocratic Oath, cannot necessarily help us with twentieth century problems of medical ethics. This understanding of euthanasia emphasizes two important features of acts of euthanasia. First, that euthanasia involves the deliberate or intentional taking of a person’s life; and, second, that life is taken for the sake of the person whose life it is – usually because she or he is suffering from an incurable or terminal disease. This distinguishes euthanasia from most other forms of taking life. Debate on Euthanasia has been raging for more than half century around the world and it continues to raise important questions in medical ethics, civil rights, moral theology and liberty. For the first time in India, there was a serious in-depth discussion about it in Supreme Court which finally endorsed Passive Euthanasia with its landmark judgment in Aruna Shanbaug case. Aruna Shanbaug was an Indian nurse who was at the centre of attention in a court case on euthanasia after spending 42 years in a vegetative state as a result of sexual assault. On 18th May 2015 Aruna Ramchandra Shanbaug died a natural death. Her funeral was performed by the hospital nurses and other staff members. Aruna Shanbaug was one of the longest living comatose patients, who were on ventilator support in the ICU of King Edward Memorial hospital. It gave straight forward guidelines that are to be followed whenever such a scenario arises in India which will be law until parliament passes legislation in this regard. In the last several decades, we have seen a swift devaluing of human life in the world. It is important to understand what is meant by the word “value.” There are two different types of value: intrinsic, and instrumental. Intrinsic value is something that has value in itself. The value or worth that it has is inherent in its very existence.
For example, most people would say that love is something that has intrinsic value. Something that has instrumental value is only valuable in that it leads to something else that has intrinsic value. A classic example of something that has instrumental value is money. Money in itself is not valuable, but its valuable is that it can get something that has intrinsic value. This is very important to take hold of that the problem in our culture today lies in that human life once was considered to have intrinsic value. Now we are being reduced to having instrumental value. You hear this every time someone argues for assisted suicide to preserve the “quality of life” of a person. Instead of human beings, being valuable in them, the only truly valuable things are experiences or states of living that human beings can have. For example, making a contribution to society, having a meaningful life and being happy are the states of existence that our culture views as inherently valuable. This is the type of thinking that naturally leads to the idea of euthanasia or physician assisted suicide (PAS). Life in itself has no specific value to us, other than as the way we can have experiences, and these experiences are what we find to be valuable. Humans do not put the worth of life into the physical state of mere aliveness, but give it worth through its ability to allow for experiences. Life, as a set of experiences that are good, is what has value, and our ability to have them is the intrinsic value of life. Most supporters of euthanasia uphold that they believe in the basic sanctity and dignity of life, but argue that ending the suffering of terminally ill patients at their request is actually a move which respects sanctity of life. For them death with dignity, as opposed to a life of pain and suffering, is more compassionate. Though, such contentions seem to be concerned more with the quality of life than its sanctity. In effect their case is that if we need to decide between the two, quality of life is more important than the sanctity of life. Thus the extremely low quality of life of a terminally ill patient out-weights the very sanctity of that life and justifies his/her mercy killing. The problem with such reasoning is that admitting that quality is more important that sanctity is tantamount to saying that individuals who have a lesser quality of life than us have a life which is less sanctified. As for those who fly the banner of the rights and wishes of the patient, we must keep in mind that certain individual freedoms, such as the right to sell oneself into slavery, must be restricted because of their broader societal implications. And the societal implications of physician-assisted suicide are grave, as it has the potential for use wrongly. The right to die could become a duty to die, with patients feeling pressurized into requesting euthanasia. Patients might choose to die not because they cannot bear physical pain anymore, or because they don’t want to live, but because they decide that the financial and emotional burden that they are placing on their families and loved ones is not worth it. The “right to die” and “death with dignity” brigade do not occupy the moral high ground on this issue. And those who support euthanasia are certainly not the only ones with compassion for those who suffer. All of us feel the pain and anguish of those we love and who are terminally ill; like many others, I have personally experienced the anguish and pain of people experiencing a slow, painful death. But my response to such suffering differs fundamentally from those who would legalize euthanasia. As a society we should show compassion for those who suffer, not by saying “we can help you get rid of your pain or by getting rid of you” but by making such individuals feel wanted. We should provide them with companionship, affection, love and care, and send out the message that every life is sacred to us and life matters. We should cherish every extra second that the sick and suffering have amongst us.
(The author is a Research Scholar Ph.D Department of Philosophy Punjabi University Patiala Punjab. Views are his own)
