Verdict on living wills does not take into account socioeconomic realities.
A five-judge bench of the Supreme Court of India has legalised passive euthanasia and permitted the “living will”. A person making such a will can state that medical support be withdrawn when he or she becomes terminally ill. The verdict has been hailed for its far-reaching impact on Indian society. Though the five judges differed on the matter, they were unanimous in allowing “living will”.
As a surgeon who has been treating bone cancers for the last 15 years, I have seen innumerable patients die and survive. I, therefore, have a different perspective on the judgment. I believe that death has an immorality of its own. It is inevitable. The Supreme Court judgment has, in a sense, added morality to death. Paul Kalanithi in his bestseller, When Breath Becomes Air, has written “But knowing that even if I’m dying, until I actually die, I am still living.” For physicians who see the dying from a close quarter, nothing could be truer. The process of life is not over till it ends. Whether this judgment is bound to change that perception is something we will have to wait and see.
A living will which allows one to choose death is a privilege which only the educated can avail. In a country which is riddled with ignorance and illiteracy, who can make such a living will is no secret. Thus, in a sense, the provision of passive euthanasia in India becomes exclusive to the educated, if not the elite. The judgment draws blood from similar judgments and cases in the US and Australia. To believe that we can emulate the legal provisions of these nations on a contentious issue like euthanasia is not only difficult but outrageous. For many of us who treat terminally-sick patients, the judgment appears blemished as it bestows death (through passive euthanasia) upon some while “actively” denies it to others. A law that does not take into account the poverty and ignorance in society requires a serious re-think.
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