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THE EMERGENCY EXIT Suicide and Assisted Suicide

Literature on suicide says that “not all persons who commit suicide want to die and not all persons who want to die commit suicide”.

Through the ages, suicide has been gloated upon, romanticized, bemoaned, and even condemned. The time when Lord Sri Ram died, there was the deadly spread of suicide in his kingdom, Ayodhya. The sage Dadhichi sacrificed his life in order that the Gods could use his bones during the war against the demons. The religious text of Bhagavad Gita condemns suicide for self-serving reasons and posits that such a death cannot have “shraddha’, the all-important last rites. Brahmanical view through the years held that those who attempt suicide ought to fast for a stipulated period. Upanishads, the Holy Scriptures, condemn suicide and state that ‘he who takes his own life will enter the sunless areas covered by impenetrable darkness after death’.

However, the Vedas approve of suicide for religious reasons and consider the sacrifice of one’s own life as the best sacrifice.

According to the WHO, every year, almost one million people die from suicide and 20 times more people attempt suicide; a global mortality rate of 16 per 100,000, or one death every 40 seconds and one attempt every 3 seconds, on average. The main reason for suicide attempt is ‘psych ache’ which translates to immense psychological pain. This psychological pain comes from sources varying from trauma, violence, stress, domestic violence, family problems, unemployment, drug addiction, failure in examination, poverty, and dowry dispute to name a few. Basically, emotional pain triggers suicide. Bolger defined emotional pain as a state of ‘feeling broken’ that involved the experience of being wounded, loss of self, disconnection, and critical awareness of one’s more negative attributes.

A number of people experience emotional pain and attempt suicide. An unsuccessful attempt however is punishable under the Indian penal code 1986 An attempt under section 309 of Indian Penal Code implies a voluntary action towards suicide. An attempt should be intentional and voluntary. Under Section 309 of IPC, the main ingredient for suicide is that it should be a voluntary attempt of self-destruction. However, the new mental health bill decriminalizes suicide. In 2013, Healthcare bill was introduced which through its provisions seeks to decriminalize suicide. This of course is not a means to promote suicide, it is to help the people who are suffering from depression or mental disorder. 

Article 21 of the Constitution of India states “No person shall be deprived of his life or personal liberty except according to procedure established by law.” Article 21 of the Constitution of India states “No person shall be deprived of his life or personal liberty except according to procedure established by law.” In the case of Gian Kaur v State of Punjab[1], the supreme court overruled the decision of P. Rathinam case[2] and held that Right to life does not include Right to die in Article 21 and hence Section 309 of IPC is constitutionally valid. In Aruna Ramchandra Shanbaug v. Union of India & Ors[3], Supreme Court stated that although 309 of IPC has been held constitutionally valid in Gian Kaur’s case. After the Aruna Shanbaug’s case, Parliament introduced the healthcare bill as previously mentioned. But in the year 2016 section 309 was deleted by the parliament.

This simmered the age long conflict of right to live and right to die, which includes both suicide and assisted suicide.

Assisted suicide, more commonly known as euthanasia is in plain words pulling the plug. Euthanasia is a highly debated concept. Passive euthanasia that allows the granting of painless death to the patient upon the request of the patient or in the lack of the competence of the patient then by the legal guardian is closely related to the emotions of the people. Euthanasia has over the years seen a lot of positive and negative feedback. There are several cases where the suffering of the patient is so high that the only solution is euthanasia. Allowing the willful death of a person by external interference is still highly debated in our society. Euthanasia however is the way to give a person a dignified death while at the same time fulfilling a dying man’s wish to die a painless and easy death. Euthanasia has been legalized in several countries, the Netherlands being the first and passive euthanasia has been legalized in India too.

The landmark decision in the case of Aruna Shanbaug led to the Supreme Court laying down the guidelines for euthanasia to be followed in India. As per the laws passed by the Supreme Court of India in 2011 as a means to legally withdraw life support in patients in vegetative state. These guidelines included:

  1. A decision to be taken by the parents or the spouse or other close relatives; close friend or doctors attending the patient.
  2.  Decision requires approval from the high court concerned.
  3.  When such an application is filled the Chief Justice of the High Court should forthwith constitute a Bench of at least two judges who should decide whether to grant approval or not.
  4.  A committee of three reputed doctors must examine the patient. After hearing the parties (relative, doctors, judges), the High Court can give its verdict.

Patients suffering from terminal illness already know that their disease is incurable and their days are numbered, in this case if they want to minimize their suffering and that of the people around them euthanasia seems like the only cure. There are several cases in which the person is in a vegetative state, i.e. he has no control over his body but their brain is still active. The life of such patients can only be prolonged by machines and surgeries. A life where every organ is hooked onto a machine and the body is being forced to function; a painless death seems like a better option. Euthanasia provides the patients the freedom of choice to make their own decisions, since only the patient himself knows how they feel and the physical and emotional pain of illness and prolonged death impacts their life. Every individual should be given the chance to die with dignity. It is more humane to allow a person with unfathomable suffering to be allowed to choose an end to that suffering. It has been seen that the people who have witnessed the slow death of others support this mercy killing as it can shorten the grief and suffering if loved ones

Therefore, in my opinion if anyone feels that death is easier than living in excruciating pain everyday them the medical personnel who perform euthanasia are doing no wrong. Yes, the Hippocratic Oath says that a doctor shall not harm the patient in anyway, yet it is also the doctor’s responsibility to let the patients be content, if a patient wants to die a dignified end knowing that his days are numbered the doctors must comply with their request. The people who are against the concept of euthanasia must imagine themselves in the shoes of the patient, being in a vegetative state, not being in control of your body but still having an active mind is pure torture. Being in a vegetative state is like being in an endless dream, one that you cannot wake up from no matter how hard you try. Patients with diseases such as Cancer, dementia, AIDS, Alzheimer’s know that they cannot be treated and thus wish to exit the world before they become a liability to themselves and their family. When a person is sick, he does not suffer alone, his whole family feels the wrenching pain of watching a piece of your heart slowly withering away. Euthanasia gives the patients the chance to say goodbye in the image they want their family to remember. In cases where the patient is in a vegetative state, he becomes the anchor that prevents the family from moving on. No one wishes for a life where they are in a state of oblivion or in constant nerve wrecking pain, for them pulling the plug is the help they need. Therefore, before dismissing the idea of euthanasia please first understand what it means to the people assenting to it. Similarly, though I do not encourage suicide but I also do not wish for people to live while hating themselves. Try to put a hand out so that a warm hand may comfort it.

SUICIDE PREVENTION HELPLINE-022 2754 6669

REFERENCE-

  1. www.manupatra.com
  2. Shneidman, E. S. (1993). Commentary: Suicide as psychache. Journal of Nervous and Mental Disease, 181(3), 145–147.
  3. Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97(1), 90–113.
  4. Anton J. L. Van Hooff, From autothanasia to suicide: Self-killing in classical antiquity (Routledge, 2002).
  5. www.bbc.co.uk/ethics/euthanasia
  6. Gevers S. Euthanasia;law and practice in the Netherlands. Br MedBull1996 Apr:22(2):326-333
  7. Gandhi KR. Euthanasia: A Brief History and Perspectives in India. Int J Educ Res Health Sci 2017;3(2):105-108
  8. www.medicalnewstoday.com

[1] AIR 946, 1996 SCC (2) 648

[2] P.Rathinam vs Union Of India on 26 April 1994, AIR 1844, 1994 SCC (3) 394

[3] [(2011) 4 SCC 454]

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