Recently I had a colleague describe the time his father was diagnosed with advanced liver cancer. The set-up where he was diagnosed declined to admit him because there were no treatment options available. Unable to take care of him at home because of numerous nursing challenges, they moved from place to place, without any succour till he succumbed in unbearable agony in the absence of suitable end of life remedies. Some of these concerns may have been addressed by today’s Supreme Court verdict.
Euthanasia has been in vogue for long in varying degrees in the developed countries. There it is an informed decision made in consultation with family, clinicians and attorneys. But in India these mechanisms are lacking. Key decisions are largely made by doctors and health-care institutions with robotic responses from the patient and family who are often shell-shocked. They only determine what is active life support and what is a passive one. Friday’s apex court judgment, too, puts the onus of determining the “right time” to pull the plug on medical professionals.
The concept of a “living will” is a progressive one and needs to be lauded so that such end-of-life decisions are made in advance. At the same time, in India only a handful of people have even a traditional will. A “living will” will need hard sell. Because the concept is so alien for most Indians, the scope of misuse is huge. Many health-care institutions are under the scanner for their poor ethics as are many high-profile individuals. It does not require much imagination to foresee how a nexus can quickly form to “hasten” the death of a person who has supposedly outgrown his utility to society but has huge assets to his name or simply because looking after him is an economic and social burden.
The writer is with the Centre for Bioethics, New Delhi; he is involved with issues of medical ethics