Friday, 9 March 2018

Right to die: Supreme Court upholds passive euthanasia

The Supreme Court on Friday upheld the right of a person to die with dignity and made it possible for all adults to make an advance directive specifying to their near and dear ones whether they would like to refuse treatment or have their life extended artificially if they are terminally ill. Right to live with dignity includes the right to die with dignity a five-judge bench led by Chief Justice Dipak Misra said recognising the legality of passive euthanasia. Right to live with human dignity would mean existence of such a right up to the end of natural life. That would include a dignified death the court said. A person who is terminally ill or in a persistent vegetative state can make a choice to prematurely extinguish his life the bench said. While Friday s order by the constitution bench will allow for the withdrawal of life-support systems for the terminally ill active euthanasia https://kkd4int.dreamwidth.org/profile usually by administering a lethal injection is still banned. Active euthanasia involves an overt act whereas passive euthanasia comes within the sphere of informed consent and authorised omission the court said. Such omission will not invite any criminal liability if guided by certain safeguards it added. The bench said the directive by a person on his wish against using life support systems has to be made in clear unambiguous terms. Such a directive has to be signed by two witnesses and counter-signed by a judicial officer. It should also specify the person who will take the call. The directive kicks in when the person s physician declares him terminally ill or in a persistent vegetative state. Such directives can also be revoked any time. If there are more than one such directives the last one will be given effect to. The judgement was hailed by many lawyers including Prashant Bhushan who had actively espoused its cause and additional solicitor general PS Narasimha as a progressive piece of jurisprudence. But some hinted at the possibility of the provision being misused. The court also acknowledged the possibility that this could be misused to grab property given the low ethical levels prevailing in our society and rampant commercialisation and corruption . Accordingly the court provided a two-step vetting process by medical experts and a final vetting by a judicial magistrate before an advance directive could be given effect to. In such a case the hospital treating the person would first set up a medical board (comprising the head of the department treating him plus three other medical experts) which has to rule in its favour. This opinion will be conveyed to the district collector who will have this decision vetted by another medical board consisting the chief medical officer and three medical experts of 20 years standing. Should this board too clears it the magistrate will ensure that it is carried out and the records kept with the high court for three years. In case the person hasn t registered such an advance care directive his family and friends could still set into motion the process to ensure that his treatment is not prolonged through artificial means. If the collector s board refuses permission the family or friends can move the high court which will examine the case with the help of an independent medical board before taking a call.
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Ahmedabad: When the SC on Friday upheld passive euthanasia as a fundamental right it rekindled a sense of stoic hope in Dinesh Maisurya who four months ago had sought permission for euthanasia for his 12-year-old son Parth. It has been excruciating to see our son die every minute. He gets 10-odd seizures a minute keeping him in pain for every living second. It is tough for a father to seek death for his child but his suffering prompted me to seek death for him. I learned about the SC order I am not familiar about the legalities but will write an application to the apex court the PM as well as the CM seeking euthanasia for Parth Dinesh told TOI. Parth a resident of Savarkundla in Amreli district suffers from subacute sclerosing panencephalitis (SSPE) a rare neurological disorder which causes spasms or jerks and the patient loses control over movement. This viral disease often represents itself in dementia or personality alterations and the patient s behaviour turns abnormal and erratic. Parth contracted this illness after a spell of high fever in July 2016. While the fever broke after a few days the seizures continue unabated. In fact five months ago he used to suffer a seizure once every 10 minutes the frequency has now risen to 10 seizures a minute his parents said. In November 2017 Dinesh wrote to the PM and President seeking death for his bedridden son who cannot eat speak and even move. The letter led to the PMO arranging free medical treatment for Parth at AIIMS Delhi. Parth was given interferon injections but they did not really help. He was then brought to Civil Hospital for treatment but no treatment really worked. Finally we brought him home said Dinesh who left his job as a diamond polisher and currently sells packets of dal and rice to industrial workers so he can work from home and look after his son. Either my wife of I have to be with Parth 24x7 as there is always fear of him falling due to the constant seizures said Dinesh who also has an older daughter. May God not curse anybody with debilitating diseases but when such aberrations happen the right to die will help end misery for which medical science has no answer Dinesh said. SSPE is a disease where the patient neither live nor dies. The SC verdict allowing passive euthanasia will give relief to such patients and their relative from mental psychological and financial distress said Dr Jaimin Shah head of neurosurgery department at Civil Hospital.
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I never knew anyone who would soon die. Never saw the specter of death lingering ominously over someone slowly and methodically subtracting life in small but highly visible amounts until all that was left was an unfamiliar rendering of someone once so familiar. When my stepfather Fred died a once barrel-chested black soldier with a proud gait he did so in solemn increments. Each day for weeks he wilted and withered falling inward like a flower deprived of light and water until eventually he was closed off to us forever. I flew home to Colorado on what I thought would be the eve of his death. He d been in the hospital for three painfully elongated years tirelessly working to preserve kidneys that had gone mad. When I first saw him he laid in somber repose lingering in that liminal space between life and death where he seemed to be drifting in a backward slow motion receding from a life that had long been expiring. When I brought my lips to his forehead I felt the warmth of a fever that refused to abate and skin so taut from malnutrition it appeared as thin as the pages in a Bible. The feeding tube had long since been removed a direct result of his decision to plot his own demise. There had been hushed spirited debates for weeks regarding his decision to discontinue dialysis. At a sickly 83-years-old he didn t consider refusing treatment and food surrendering to the drama of it all. Admittedly he was battle-weary but his controversial choice to discontinue life-saving measures was a pronouncement made from a place of strength. Terminally ill man can appeal against right-to-die ruling say judges Read more He could have taken a more dramatic stance had he chosen to. Colorado is one of seven states with a Death and Dignity statute which in effect gives terminally ill patients a right to end their incurable suffering. Montana affords physician assisted suicide but the courts must mandate it. In all cases patients must be terminally ill and have less than six months to live before an accredited doctor would administer a cocktail of drugs hastening the patient s death. In a 2013 Pew Research Poll 66% of Americans say there are at least some situations in which a patient should be allowed to die. 57% percent say they would tell their doctors to stop treatment if they had an incurable disease and were totally dependent on someone else for their care. Ultimately the right to die to exercise complete control over one s physical self is as fundamental a right as free speech and worshipping whatever God you choose. Just like a woman s womb is hers alone a terminally ill patients should have complete autonomy over their bodies. Facing the reality of one s own mortality isn t a task for the weakest among us. Nearly everything about America s culture is based on our ability and desire to live as long as possible to drive the hands of time in reverse. Death even in the abstract is a subject to be avoided feared. There is no glory in it. As such deciding to engineer one s death to in effect call upon it is seen as a permanent moral and spiritual failure. Terminally ill UK man launches legal challenge for right to die Read more Conversely among African Americans a spiritual group that prides itself on its resiliency its ability to weather the most extreme suffering with minimal intervention and care the issue of one s right to die is markedly different than other groups. The general consensus remains the same: if we could survive 300 years of slavery and another 100 years of Jim Crow there is no force of evil no stage of cancer or degree of institutional racism that we cannot withstand with aplomb. So it s not surprising that according to the Health Research Fund 60% of blacks would prefer their doctors to do everything possible to save their lives if they knew they were suffering from an incurable illness. The right to choreograph the end of one s life is a topic I ve long considered. Having undergone two liver transplants and intestinal surgery before turning 28-years-old I know well that there s a degree of misery that you simply cannot outrun when the pain feels an ocean wide and a soul deep when every second is to be battled through. Life isn t always a welcomed choice. I know what it means to look in on your life from the outside with unfamiliarity. Later after the small gravesite funeral after the American flag was draped over his lacquered coffin and later folded and deferentially presented to my mother she began to mourn in earnest. She d stood sentry for years. She bathed him. She fed him. She changed his diapers. She cradled him like she had once cradled my sisters and I. All the things she d done to usher in life as a young mother she was now as a dutiful wife doing in death. Assisted dying: what can the UK learn from places where it is legal? Read more We didn t stay long enough to watch as they lowered Fred into the cold ground. I suppose we still lamented our inability to throw death off course hoping that if we bore down and willed it away it would afford us additional birthdays and family holidays. And while my feelings vacillated between grief anger and acceptance I knew that I needed to honor his wishes even if they were achingly finite. There is perhaps no greater gift than respecting someone s wishes in honoring their most heartbreaking choices even when it hurts. Kim Lute is a freelance journalist Sign up for the Guardian US opinion newsletter here: Topics Death and dying Opinion Family comment Share on Facebook Share on Twitter Share via Email Share on LinkedIn Share on Pinterest Share on Google Share on WhatsApp Share on Messenger Reuse this content
MUMBAI: The city has held a special spot in the four-decades-long battle to demand a dignified exit for very ill persons who are beyond treatment and unlikely to live a quality life. On Friday the SC judgment legalising passive euthanasia and living will was welcomed by those championing the cause but they called it just the beginning of a long journey ahead. One of the earliest demands for dignified death originated from Mumbai in 1981 when social activist Minoo Masani formed The Society for the Right to Die with Dignity (SRDD). This group that started with a handful of persons now has over 600 members including several non-medical persons. SRDD had a roller coaster ride making small attempts to discuss end-of-life through medical conference and gatherings. http://celebrate.mywedding.com/kkd4int After the death of urologist Dr B N Colabawalla one of the society s founder members in 2002 it again slipped into inertia but was revived by some doctors and relatives. It had filed an intervening petition in the NGO Common Cause plea that won a favourable verdict on Friday. A senior doctor from KEM Hospital Parel added Aruna Shanbaug s case was majorly responsible for pushing the passive euthanasia debate. Dr Surendra Dhelia SRDD secretary called Friday s order a great beginning. The SC has granted autonomy to a citizen to decide what he wants and doesn t at the end of life. Doctors patients and caretakers go through a lot of stress which is physical emotional and financial but there is little understanding or empathy for that he said. Neurologist Dr Roop Gursahani a member of the steering committee of End-of-life-care in India Task Force (ELICIT) said the judgement is the foundation of a process for both doctors and legal professionals to understand duties and responsibilities towards patients. Importantly he said it was the beginning for patients to take charge of their last days. Now experts said it s time to look into the details. The SC said a medical board would take a final call once a petition is in. Dr Gursahani said information about who would constitute the board whether the state would have one or every hospital would have their own bodies is awaited.

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