The term euthanasia may have been derived from a Greek word which means "good death" but in 21st century it is well known as "mercy killing". Euthanasia is defined as administration of a lethal dose of sedative or drugs to a patient by the physician or any other person for the purpose of relieving the patient's intolerable and incurable suffering.1 There are two types of euthanasia - passive euthanasia and active euthanasia. Active euthanasia is defined as taking an immediate action such as using lethal injection to painlessly put a terminally-ill patient to death.
Death is inevitable and whoever has taken birth will die ultimately. If a person is suffering from a disease which is incurable, painful and chronic then the patient must have the option to choose a pain free dignified way to death. However, Article 21, which guarantees right to life to all its citizens cannot be interpreted as having the right to die. But the people who know that their life is nearly over and whatever time they have left will befull of pain and distress and they cannot enjoy their right to life in the truest sense, under such exceptional circumstances, patient should be allowed to choose his/her own fate.
HISTORICALBACKGROUND OF EUTHANASIA AND PHYSICIAN ASSISTED SUICIDE.
In ancient Greece and Rome (5th Century B.C.-1st Century B.C.), before the coming of Christianity, attitudes toward infanticide, active euthanasia, and suicide tended to be tolerant. Many ancient Greeks and Romans had no cogently defined belief in the inherent value of individual human life, and pagan physicians likely performed frequent abortions as well as both voluntary and involuntary mercy killings. Although the Hippocratic Oath prohibited doctors from giving 'a deadly drug to anybody, not even if asked for,' or from suggesting such a course of action, only a few ancient Greek or Roman physicians followed the oath faithfully. Throughout classical antiquity, there was widespread support for voluntary death as opposed to prolonged agony, and physicians complied by often giving their patients the poisons they requested.
Since ancient times, Jewish and Christian thinkers have opposed suicide as inconsistent with the human good and with responsibilities to God. In the 13th century, Thomas Aquinas supported Catholic teaching about suicide in arguments that would shape Christian thought about suicide for centuries. Aquinas condemned suicide as wrong because it contravenes one's duty to oneself and the natural inclination of selfperpetuation and since it injures other people and the community of which the individual is a part and because it violates God's authority over life, which is God's gift. This position exemplified attitudes about suicide that prevailed from the Middle Ages through the Renaissance and Reformation.
BEGINNINGS OF RECOGNITION OF EUTHANASIA AS AN OPTION.
In the mid-1800s, the use of morphine to treat "the pains of death" emerged, with John Warren recommending its use in 1848. A similar use of chloroform was revealed by Joseph Bullar in 1866. However, in neither case was it recommended that the use should be to hasten death.
"That in all cases of hopeless and painful illness, it should be the recognized duty of the medical attendant, whenever so desired by the patient, to administer chloroform or such other anesthetic as may by-and-bye supersede chloroform – so as to destroy consciousness at once, and put the sufferer to a quick and painless death; all needful precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish, beyond the possibility of doubt or question, that the remedy was applied at the express wish of the patient." —Samuel Williams (1872), Euthanasia Williams and Northgate: London2
PERSPECTIVES IN DIFFERENT COUNTRIES
The Netherlands - In the Netherlands, euthanasia and physician-assisted suicide have been practiced with increasing openness, although technically they remain illegal. In 1995–1996 a new procedure for reporting cases of euthanasia and physician-assisted suicide was introduced. Probably as a result, the number of reported cases of euthanasia increased, from 486 in 1990 to 1466 in 1995. The purpose of the 1995 study was to make reliable estimates of the incidences of euthanasia and other medical practices pertaining to the end of life to describe the patients, physicians, and circumstances involved; and to evaluate changes in these practices between 1990 and 1995.The study attracted a great deal of attention, partly because it gave the first complete overview of medical decisions concerning the end of life in a single country.
Belgium - In 2002, Belgium became the second country in the world after Netherlands, to legalize euthanasia. Over the next decade the country became a living laboratory for radical social change.3 Belgium's euthanasia doctors even believe they are being humane because they are liberating people from their misery. Fundamentalist humanists go further and describe euthanasia as the ultimate act of selfdetermination. The opinion of the patient's family has no weight whatsoever. A doctor is entitled to give the mother of a family a lethal injection without offering any explanation to her children. Euthanasia is being promoted as a "beautiful" and positive way to die. Doctors are transplanting organs from patients who die in the operation.
PHYSICIAN ASSISTED SUICIDE AND BEHAVIORAL SCIENCE
Proponents of legalizing of physician assisted suicide argue that the practice is ethically justifiable because it can alleviate prolonged physical and emotional sufferings associated with debilitating terminal illness. Opponents claim that legally sanctioned lethal prescriptions might destroy any remaining desire to continue living - a sign of society having given upon the patients. Ultimately arguments rest on differing opinions regarding the effect of this policy on the patients' wellbeing. The challenge, then, is to determine how legalization of physician assisted suicide would affect the wellbeing of terminally ill patients and their medical decision making.
Looking at the question from an expected utility perspective suggests that given the option to terminate their own life, terminal patients will decide how long they want to live by comparing the value they expect to gain from rest of their lives to the expected intensity of their suffering. At the point where future utility is expected to be negative and so intolerable that living any longer is not worth the cost - the patient would choose to end life if the option was so available.
The critical point from this perspective is that patients choose the amount of time they are willing to continue living with their illness, which will depend on how quickly they deteriorate. If the rate of deterioration is slower than expected, then patients should delay terminating their lives; if the rate of deterioration is faster than expected, patients desire to end their lives quicker. But now let us say that patients have been prescribed lethal medication and have the option of ending their lives at any point of their choosing. Being given the option to determine the time of our own death can transform patients from powerless victims of their illness to willing survivors of it. Together, the importance of feeling in control and the ability to reduce (but not eliminate) uncertainty about rate of deterioration adds an interesting new dimension to the underlying ethical debate and seems to provide credence to the benefits of legalized physician-assisted suicide.
Some form of euthanasia is legal in Belgium, Luxembourg, The Netherland, Switzerland and the US's state of Oregon and Washington. It seems that the legislators started responding to the needs of terminally ill patients. Importantly, the legalized use of voluntary euthanasia in this jurisdiction is not out of control as has been claimed by those opposing voluntary euthanasia. Interestingly, but not surprisingly, the rate of euthanasia in the Netherlands has decreased rather than increased because inter alia, people are aware that a voluntary euthanasia, and suicide by premature access of more drastic and less dignified options, is not required.
The reading speech for the euthanasia laws act by Kevin Andrews (MP) referred to economic pressure on terminally ill patients, but not in a way that reflects a tight monetary situation. Is it preferable to pay $5000 to $6000 on average for a person in the terminal stages of their life even if they want to die, rather than spending this on, say a younger person who is badly injured and wants to live.
In India, 87% of the health sector expenditure comes from the private sector funding and private healthcare facilities are expensive and not everyone can afford it. This definitely puts financial pressure on the family of the patient.4
THE HUMAN FACTOR T
hese people must be treated in a humane and compassionate way. But for some people drugs do not provide a good quality of life, and they may suffer from continuous pain, discomfort or loss of dignity. Therefore, some people would like to choose the option of euthanasia rather than taking medicines for lifetime.
To deny terminally ill patients the right to euthanasia is to condemn them to a miserable existence, against their wishes and best interests. It is difficult to establish any difference in moral character between someone, who denies a legitimate request for voluntary euthanasia, and who subsequently watches that person die a slow and a painful death like someone watching a cancer –ridden pet writhe in agony without putting it down. Most people - around 80 per cent - would argue that if you are terminally ill, are of sound, mind not clinically depressed, and choose euthanasia, then it is morally right.
For acts like voluntary euthanasia that affect directly on an individual, and only an individual, the moral and humane thing to do is what is right for that individual. Voluntary euthanasia is moral and humane because it is what the individual wants, and the gist of above analogies is that not providing the option of voluntary euthanasia in the above situations is inhumane and callous. In our society the prevention of suffering and dignity of the individual should be the uppermost on the minds of those caring for the terminally ill. When quality of life is more important than quantity, voluntary euthanasia is good option.
1 Future of assisted suicide and euthanasia, Neil. M Goursuch, Oxford University Press,2003
2 Emanuel, Ezekiel; The history of euthanasia debates in the United States and Britain
3 Euthanasia: A reference handbook; Jennifer FecioMcdougal, Martha Gorman.
4 WHO report,2008
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