Need laws that speak for the vulnerable: Pinki Virani on passive euthanasia

Can a terminally-ill person be allowed to execute a ‘living will’ to withdraw life-support system if he or she reaches a vegetative state with no hope of revival? A Supreme Court notice issued on Wednesday seeking responses from all states and union territories on this question has once again started a legal debate over passive euthanasia in India. The notice was issued by the apex court in response to a petition by Common Cause, an NGO, seeking legal recognition of ‘living wills’, which are advance directives by a patient on preferences for medical care when he or she goes in to permanently vegetative or unconscious state. [caption id=“attachment_1623029” align=“alignleft” width=“380”] Pinki Virani. Image courtesy: Penguin India[/caption] In 2011, the Supreme Court in a landmark judgment legalised passive euthanasia, laying down stringent court-monitored guidelines to ensure that the practice was not abused. The judgement was a result of a petition by social activist and award-winning author Pinki Virani to grant euthanasia to her friend Aruna Shanbaug. Firstpost spoke to Pinki Virani about the Supreme Court’s call for a nation-wide debate on the passive euthanasia and whether there were sufficient safeguards in the 2011 Supreme Court judgment to prevent misuse. Your initial thoughts on this latest development. Kudos to the Supreme Court, once again. All legal literacy is absolutely welcome. There is nothing healthier in a democracy than what the Supreme Court 5-judge bench has done. It has called for free, frank and wide-ranging debate on the subject of an existing law which it laid down in the form of a judgement — The Passive Euthanasia — law a few years back. It has also taken this further to include the concept of a “Living Will”. The citizens of India — tax-paying citizens who have since a while begun commenting on the medical-hospitalisation corporatisation and, indeed, in some cases almost a cartelisatoin — are getting more of an understanding about how they need to feel less guilty about a choice (which they are free to either make or not). No matter what the states reply — and it’s best no one lay a wager that most states might opt for the “Bharatiya sabhyata” line — the people of India, especially its below 45s and the middle-class, get a chance to talk among themselves in a free, frank and freewheeling discussion. More knowledge is greater good. The attorney general has argued that it is for the Parliament and not the judiciary to decide on this issue. Your response. Unsurprising. As far the issue of misuse is concerned, do you think it was sufficiently addressed in the 2011 Supreme Court judgement. The Passive Euthanasia Judgement-Law of 2011 allowed a choice to Indians in irreversible medical conditions of brain-dead and persistent vegetative state (PVS), as also their near and dear ones or their “next friend” if they don’t have families. The Law Commission of India report which followed in August 2012 — which recommended to the then law minister that the elected representatives in the Lok Sabha also agree to Passive Euthanasia — further listed the safeguards to be put into place. The attention of the 5-member judge bench has been drawn to this report. I am in further consultation with Senior Advocate Shekhar Naphade and Advocate Shubhangi Tulli — who were instrumental in the 2011 law, especially the concept of “next friend” as me for both, Aruna Shanbaug and other Indians like her in similar conditions in the present and future — on what more we need to submit. I will be addressing the issue of misuse further in it. But I think it’s important for everyone to understand that where there are vulnerable people involved, there needs to be laws for them — which speak in their voice. We, alas, do have the anti-dowry law being sought to be misused. But we need it, don’t we, for our vulnerable brides and women? The reason we have keen legal minds is for precisely this, to ensure no misuse. Is the debate in India on the passive euthanasia different in any way from the debates in Western Europe or the states in the US, where passive euthanasia has been legalised. Let us not get confused over terms. Passive Euthanasia is legal in India. It will stay legal unless the 5-judge bench or Parliament rules otherwise. What is being added to the debate now is “voluntary passive euthanasia”, ergo the Living Will. Where every individual can state how much medicine, drugs and life-support systems their bodies are willing to put up with when, and if, they are in vulnerable positions. The Living Will is exactly like the material will and can be changed as often as the individual wants, as can its contents. I also notice that the media has started a debate on ‘active euthanasia’ which is the delivery of death by a doctor to a person who may not be brain-dead or in PVS. Again not to be confused with Passive Euthanasia where death is already the established and definitive outcome of an irreversibly ill patient.