Physician-Assisted Suicide and Euthanasia in Indian Context: Sooner or Later the Need to Ponder!

Article excerpt

Byline: Farooq. Khan, George. Tadros

Physician-assisted suicide (PAS) is a controversial subject which has recently captured the interest of media, public, politicians, and medical profession. Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups to legalize this practice in and around Europe that could possibly affect many parts of the world. The legal status of PAS and euthanasia in India lies in the Indian Penal Code, which deals with the issues of euthanasia, both active and passive, and also PAS. According to Penal Code 1860, active euthanasia is an offence under Section 302 (punishment for murder) or at least under Section 304 (punishment for culpable homicide not amounting to murder). The difference between euthanasia and physician assisted death lies in who administers the lethal dose; in euthanasia, this is done by a doctor or by a third person, whereas in physician-assisted death, this is done by the patient himself. Various religions and their aspects on suicide, PAS, and euthanasia are discussed. People argue that hospitals do not pay attention to patients' wishes, especially when they are suffering from terminally ill, crippling, and non-responding medical conditions. This is bound to change with the new laws, which might be implemented if PAS is legalized. This issue is becoming relevant to psychiatrists as they need to deal with mental capacity issues all the time.

Introduction

Physician-assisted suicide (PAS) is a controversial subject that has recently captured the interest of media, public, politicians, and medical profession. Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups to legalize this practice in and around Europe that could possibly affect many parts of the world. As we live in a multicultural and multireligious society, it is essential to understand the effects of culture and religion in decision-making processes, especially in the area of PAS.

Definition of euthanasia is slightly different in different countries; however, it is generally defined as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering." [sup][1] PAS is the practice of providing a competent patient with a prescription for medication for the patient to use with the primary intention of ending his or her own life; [sup][2] the patient would have to self-administer the medication, directly or through a machine.

Inadequate attention has been given to the cultural, religious, and socioeconomic backgrounds underlying the different views on assisted suicide held by various sections of the society. Current literature shows that cultural differences may account for some inequalities related to assisted suicide. [sup][3]

Although there are very few studies carried out in India on PAS, a survey quotes that 60/100 (28 men, 32 women) Indian doctors answered a questionnaire. Of these doctors, 26 were Hindus, 23 Christians, and 10 Muslims, with a mean age of 35.4 years and a mean experience of 10.2 years. In all, 26.6% of them agreed that euthanasia could be an option for patients with motor neuron disease, whereas 25% agreed with the idea of using euthanasia for patients with cancer. Four Christian and 16 Hindu (8 male and 8 female) doctors supported the concept of euthanasia. [sup][4] To our knowledge, there is no study done to assess the attitude of public in general and professionals in specific who might be involved in caring for some sections of society who might consider discussion around the topic of PAS or euthanasia.

Jain leaders, a powerful group in India, say the constitution protects the fasts and people have the right to decide to die with dignity. …