Need for better understanding and guidelines on euthanasia

Source: The post need for better understanding and guidelines on euthanasia has been created, based on the article “How to ensure dignity for the terminally ill” published in “Indian Express” on 23rd August 2024.

UPSC Syllabus Topic: GS Paper 2 – Issues relating to development and management of Social Sector/Services relating to Health.

Context: The article discusses a Supreme Court judgment on euthanasia in India, specifically about withdrawing a Ryles tube from a terminally ill patient. It questions the ethical and legal clarity of such decisions, highlighting the need for better understanding and guidelines on euthanasia and end-of-life care.

For detailed information on The Debate on Euthanasia read this article here

What is the Case About?

1. Case Background: The Supreme Court of India ruled on a case involving Harish Rana, a 32-year-old man in a vegetative state for 11 years.
2. Parent’s Request: Harish’s parents requested the removal of a Ryles tube, which provides nutrition through the nose, arguing it was not essential for life support.
3. Supreme Court Decision: The court denied the request, stating that a Ryles tube is not considered life support.

Why is the Verdict Controversial?

1. Conflicting Definitions: In 2018, the Supreme Court allowed “passive euthanasia,” meaning natural death can occur by not using life-prolonging measures in terminal cases. However, the Court stated that a Ryles tube is not considered life support, complicating decisions on its removal.
2. Ethical Principles: It challenges ethical principles:

a) Beneficence: Acting for the patient’s benefit is questionable as continuing treatment may prolong suffering.

b) Non-maleficence: The decision may cause harm by prolonging a low-quality life.

c) Autonomy: Harish’s parents are denied the right to choose for their son’s dignity in death.

3. Cultural Impact: The verdict reflects cultural fears around death and dying, viewing the withdrawal of feeding as taboo, despite the patient’s vegetative state and suffering.

What Should be Done?

1. Clarify Legal Definitions: There should be clear legal distinctions between euthanasia and withdrawing futile life-sustaining measures. This confusion is evident in the denial of Ryles tube removal for Harish Rana.
2. Promote Early Palliative Care: Integrate palliative care early in treatment to avoid prolonged suffering, as suggested by the potential benefits it could have offered Harish Rana’s family.
3. Educate on Patient Rights: Increase public awareness about patient rights and available options such as Advance Care Planning and Advance Medical Directives to empower individuals to make informed decisions about their care and end-of-life options.

Question for practice:

Examine how the Supreme Court’s ruling on the withdrawal of a Ryles tube in the Harish Rana case highlights the ethical and legal complexities surrounding euthanasia and end-of-life care in India.