EUTHANASIA- SHOULD IT BE LEGALISED IN INDIA?

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283 South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3

EUTHANASIA- SHOULD IT BE LEGALISED IN INDIA?

ASHWINI PRIYA1

ABSTRACT

Human beings are the ultimate creation of God endowed with the best specifications. All human beings are born free and equal in dignity and rights. Everyone has the right to life, liberty and security of person.

Euthanasia is the practice of intentionally ending a life in order to relieve pain and suffering. Each country has a different law regarding euthanasia. The Indian law allows only for passive euthanasia. This paper examines the pros and cons of euthanasia, highlighting the laws in different countries and the implications of euthanasia. The given paper elaborates the concept of euthanasia, the battle of right to life and right to die. Furthermore, the legality of euthanasia is stressed. Legalisation of euthanasia will put an end to many sufferings which in a way will be beneficial for the society.

KEYWORDS-constitutionality, right to life, mercy killing, pain.

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INTRODUCTION

Human beings are the ultimate creation of God endowed with the best specifications. All human beings are born free and equal in dignity and rights. Everyone has the right to life, liberty and security of person.2

The right to life is a moral principle based on the belief that a human being has the right to live and, in particular, should not to be killed by another human being. The concept of a right to life is central to debates on the issues of capital punishment, war, abortion, euthanasia, and justifiable homicide.

Euthanasia is the practice of intentionally ending a life in order to relieve pain and suffering. Each country has a different law for euthanasia. The main problem that arises with this topic is the legalisation of euthanasia. It still remains a debateable topic. Non-voluntary euthanasia is illegal in every country but voluntary euthanasia is legal in few. Euthanasia or “mercykilling” is believed to be the most active area of research in contemporary bioethics.3

Euthanasia is the battle of right to live v. right to die.4

The word “Euthanasia”, is a derivative from the Greek words “eu” and “thanotos” which literally mean “good death”. It is otherwise described as mercy killing. The death of a terminally ill patient is accelerated through active or passive means in order to relieve such patient of pain or suffering. It appears that the word was used in the 17th Century by Francis Bacon to refer to an easy, painless and happy death for which it was the physician’s duty and responsibility to alleviate the physical suffering of the body of the patient. The House of Lords Select Committee on “Medical Ethics” in England defined Euthanasia as “a deliberate intervention undertaken with the express intention of ending a life to relieve intractable suffering”. The European Association of Palliative Care (EPAC) Ethics Task Force, in a discussion on Euthanasia in 2003, clarified that “medicalised killing of a person without the person’s consent, whether non-voluntary (where the person in unable to consent) or

involuntary (against the person’s will) is not euthanasia: it is a murder. Hence, euthanasia can be voluntary only”.

The distinction of passive euthanasia with “active euthanasia” has been highlighted in the decision of the Supreme Court of India in ArunaRamachandraShanbaug vs. Union of India.5

Active euthanasia involves taking specific steps such as injecting the patient with a lethal substance e.g. Sodium Pentothal which causes the person to go in deep sleep in a few seconds and the person dies painlessly in sleep, thus it amounts to killing a person by a positive act in order to end suffering of a person in a state of terminal illness. It is considered to be a crime all over the world (irrespective of the will of the patient) except where

permitted by legislation, as observed earlier by Supreme Court. In India too, active euthanasia is illegal and a crime under Section 302 or 304 of the IPC.

2_{Article 3, Universal Declaration of Human Rights.}

3_{Borry P, Schotsmans P, Dierickx K (April 2006). "Empirical research in bioethical journals.A quantitative} analysis". J Med Ethics 32 (4): 240–5. doi:10.1136/jme.2004.011478.

4_{http://www.hospicepatients.org/euth-experts-speak.html ACCESSED ON 28}TH_{SEPTEMBER, 2015 AT 19.20}

IST.

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Physician assisted suicide is a crime under Section 306 IPC (abetment to suicide). Passive euthanasia, otherwise known as „negative euthanasia‟, however, stands on a different footing. It involves withholding of medical treatment or withholding life support system for continuance of life e.g., withholding of antibiotic where without doing it, the patient is likely to die or removing the heart–lung machine from a patient in coma. Passive euthanasia is legal even without legislation provided certain conditions and safeguards are maintained (vide para 39 of SCC in Aruna’s case). The core point of distinction between active and passive euthanasia as noted by Supreme Court is that in active euthanasia, something is done to end the patient’s life while in passive euthanasia, something is not done that would have

preserved the patient’s life.

To quote the words of learned Judge in Aruna’s case, in passive euthanasia, “the doctors are not actively killing anyone; they are simply not saving him”.

The Court graphically said “while we usually applaud someone who saves another person’s life, we do not normally condemn someone for failing to do so”. The Supreme Court pointed out that according to the proponents of Euthanasia, while we can debate whether active euthanasia should be legal, there cannot be any doubt about passive euthanasia as “you cannot prosecute someone for failing to save a life”. The Supreme Court then repelled the view that the distinction is valid and in doing so, relied on the landmark English decision of House of Lords in Airedale case6_{which held}_{the ‘}_{sanctity of life’ and ‘respect for life’ should}

not be carried “to the point at which it has become almost empty of any real content and when it involves the sacrifice of other important values such as human dignity andfreedom of choice”. Thereby, this case legalised euthanasia.

Hence Euthanasia remains the most heated topic of discussion in recent times. Also, the main scope of this research is to highlight the provisions regarding the legalisation of euthanasia. There are several pros and cons connected to this topic which will be deeply analysed in this research work.

OBJECTIVE AND IMPORTANCE OF THE RESEARCH WORK

Every person has right to live. The researcher mainly tries to find out the legality of euthanasia and the problems attached to it.

The objective of the study is

to- To elaborate the concept of euthanasia.

 To compare the laws on euthanasia of different countries.

 Find out the legal provisions regarding euthanasia.

RESEARCH METHODOLOGY

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phenomena or problems.

The legal research is divided into two parts- Doctrinal or Non-Empirical Research and Empirical or Non-Doctrinal Research.

The researcher has adopted doctrinal method of legal research. Since the work is doctrinal, an emphasis is laid down on referring to relevant literature, judgements, reports and articles on euthanasia.

REVIEW OF LITERATURE

The Indian judiciary plays a very vital role in protection of the rights of every citizen of this country. There are certain books, law reports, judgements, scholarly articles, etc. which have focused on the dimensions of euthanasia. Few of such studies are mentioned

below-A note on euthanasia and the Contemporary Debate by below-ArchanaBarua- deals with the history of euthanasia and refers to its concept in different religions.

EUTHANASIA, ETHICS AND PUBLIC POLICY: AN ARGUMENT AGAINST LEGALISATION BY Keown John – deals with the ethical perspective of euthanasia.

HYPOTHESIS

The hypothesis is a tentative testable statement, which may or may not hold true. It is basically the proposition of the researcher.

The present research is based on the given

hypothesis- Euthanasia, in extreme cases, must be legalised.

 Right to life includes right to die.

 Passive euthanasia has been recently legalised in India.

SOURCES OF DATA

Primary sources include the Constitution of India and the Indian Penal Code.

Secondary sources include books, judgements, reports, articles, magazines, journals,

websites, etc.

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Meaning and Definition

Euthanasia has different meanings in different usages. Here are some of the definitions which are recognised in many nations of the world.

Euthanasia is a Greek term meaning "good death" and refers to the practice of intentionally ending a life in order to relieve pain and suffering.7

The act or practice of painlessly ending the life of an animal or a willing individual who has a terminal illness or incurable condition, as by giving a lethal drug.

Euthanasia is also called mercy killing. the act of putting to death painlessly or allowing to die, as by withholding medical measures from a person or animal suffering from an incurable, esp. a painful, disease or condition.8

Medically, euthanasia refers to the situation when a doctor induces the death with a lethal injection, of a patient who is suffering unrelievably and has persistently requested the doctor to do so.

The word "euthanasia" was first used in a medical context by Francis Bacon in the 17th century, to refer to an easy, painless, happy death, during which it was a physician's responsibility to alleviate the 'physical sufferings' of the body. Bacon referred to an

"outward euthanasia".9_{The term "outward" he used to distinguish from a spiritual concept;}

the euthanasia which regards the preparation of the soul.

In current usage, one approach to defining euthanasia is "painless inducement of a quick death". However, it is argued that this approach fails to properly define euthanasia, as it leaves open a number of possible actions which would meet the requirements of the

definition, but would not be seen as euthanasia. In particular, these include situations where a person kills another, painlessly, but for no reason beyond that of personal gain; or accidental deaths which are quick and painless, but not intentional.

According to the English Oxford Dictionary, suffering is a necessary condition for

euthanasia. Moreover, the death must be intended, rather than being accidental, and the intent of the action must be a "merciful death".

Classification of euthanasia

7_Philosopher_Helga Kuhse_{: "'Euthanasia' is a compound of two Greek words - eu and thanatos meaning,}

literally, 'a good death'. Today, 'euthanasia' is generally understood to mean the bringing about of a good death - 'mercy killing,' where one person, A, ends the life of another person, B, for the sake of

B." http://www.worldrtd.net/euthanasia-fact-sheet.

8_{THE CONCEPT OF EUTHANASIA,} http://etiskraad.dk/upload/publications-en/euthanasia-and-conditions-of-the-dying/end-of-life/kap3_1.htm ACCESSED ON 25TH OCTOBER AT 21.00 IST.

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Euthanasia may be classified according to whether a person gives informed consent into three types: voluntary, non-voluntary and involuntary.10

There is a debate within the medical and bioethics literature about whether or not the non-voluntary (and by extension, innon-voluntary) killing of patients can be regarded as euthanasia, irrespective of intent or the patient's circumstances. In the definitions offered by Beauchamp and Davidson and, later, by Wreen, consent on the part of the patient was not considered as one of their criteria, although it may have been required to justify euthanasia.11_However,

others see consent as essential.

Voluntary euthanasia

Euthanasia conducted with the consent of the patient is termed voluntary euthanasia. Active voluntary euthanasia is legal in Belgium, Luxembourg and the Netherlands. Passive

voluntary euthanasia is legal throughout the U.S. per Cruzan v. Director, Missouri

Department of Health. When the patient brings about his or her own death with the assistance of a physician, the term assisted suicide is often used instead. Assisted suicide is legal in Switzerland and the U.S. states of California, Oregon, Washington, Montana and Vermont.

Non-voluntary euthanasia

Euthanasia conducted where the consent of the patient is unavailable is termed non-voluntary euthanasia. Examples include child euthanasia, which is illegal worldwide but decriminalised under certain specific circumstances in the Netherlands under the Groningen Protocol.

Involuntary euthanasia

Euthanasia conducted against the will of the patient is termed involuntary euthanasia.

Further, there are two categories of euthanasia

basically-ACTIVE EUTHANASIA

Active euthanasia entails the use of lethal substances or forces to kill a person such as with lethal injection given to a person with terminal cancer who is in terrible agony. Active euthanasia is defined as taking an immediate action such as using lethal injection to painlessly put a terminally-ill patient to death.

PASSIVE EUTHANASIA

Passive euthanasia entails withholding of medical treatment for continuance of life, such as withholding of antibiotics where without giving it a patient is likely to die, or removing theheart lung machine, from a patient in coma. Passive euthanasia is withdrawing treatment while the life of the patient is still dependent on it and when it is believed that treatment is more

burdensome than beneficial. Passive euthanasia allows the patient to die naturally and is often

10

LaFollette, Hugh (2002). Ethics in practice: an anthology. Oxford: Blackwell. pp. 25–26. ISBN 0-631-22834-9.

11_{Wreen, Michael (1988). "The Definition of Euthanasia".}_{Philosophy and Phenomenological}

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considered more acceptable.12

Passive euthanasia is further classified as voluntary and non-voluntary.

Voluntary euthanasia is where the consent is taken from the patient. In non-voluntary euthanasia, the consent is unavailable on account of the condition of the patient for example, when he is in coma. The Supreme Court then observed: “while there is no legal difficulty in the case of the former, the latter poses several problems, which we shall address”. The Supreme Court was concerned with a case of non-voluntary passive euthanasia because the patient was in coma.

The general legal position all over the world seems to be that while active euthanasia is illegal unless there is legislation permitting it, passive euthanasia is legal even without legislation provided certain conditions and safeguards are maintained.

HISTORY OF EUTHANASIA

12_{IBN LIVE,NEW DELHI, 7}TH_{MARCH 2011}

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Euthanasia originated in Greece. According to the historian N. D. A. Kemp, the origin of the contemporary debate on euthanasia started in 1870. Euthanasia was debated and practiced long before it. Euthanasia, in the sense of the deliberate hastening of a person's death, was supported by Socrates, Plato and Seneca the Elder in the ancient world. Hippocrates spoke against this practice, writing "I will not prescribe a deadly drug to please someone, nor give advice that may cause his death".13

Euthanasia was strongly opposed in the Judeo-Christian tradition. Thomas Aquinas opposed both and argued that the practice of euthanasia contradicted our natural human instincts of survival, as did Francois Ranchin (1565–1641), a French physician and professor of medicine, and Michael Boudewijns (1601–1681), a physician and teacher. Nevertheless, there were voices arguing for euthanasia, such as John Donne in 1624, and euthanasia continued to be practised. Thus in 1678, the publication of Caspar Questel'sDe pulvinarimorientibus nonsubtrahend, ("On the pillow of which the dying should not be deprived"), initiated debate onthe topic. Questel described various customs which were employed at the time to hasten the death of the dying, (including the sudden removal of a pillow, which was believed to accelerate death), and argued against their use, as doing so was "against the laws of God and Nature". Despite opposition, euthanasia continued to be practised, involving techniques such as bleeding, suffocation and removing people from their beds to be placed on the cold ground. Suicide and euthanasia were more acceptable under Protestantism and duringthe Age of Enlightenment, and Thomas More wrote of euthanasia in Utopia, although it is not clear if More was intending to endorse this practise.14_{Other cultures have taken different approaches: for example, in Japan suicide has}

not traditionally been viewed as a sin, and accordingly the perceptions of euthanasia are different from those in other parts of the world.

In the mid-1800s, the use of morphine to treat "the pains of death" emerged, with John Warren recommending its use in 1848. A similar use of chloroform was revealed by Joseph Bullar in 1866. However, in neither case was it recommended that the use should be to hasten death. In 1870 Samuel Williams, a school teacher, initiated the contemporary euthanasia debate through a speech given at the Birmingham Speculative Club in England, which was subsequently published in a one-off publication entitled Essays of the

BirminghamSpeculative Club, the collected works of a number of members of an amateur philosophicalsociety. Williams' proposal was to use chloroform to deliberately hasten the death of terminally ill patients.

That in all cases of hopeless and painful illness, it should be the recognized duty of the medical attendant, whenever so desired by the patient, to administer chloroform or such other anaesthetic as may by-and-bye supersede chloroform – so as to destroy consciousness at once, and put the sufferer to a quick and painless death; all needful precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish, beyond the possibility of doubt or question, that the remedy was applied at the express wish of the patient.

DOCTRINE OF DOUBLE EFFECT

DOCTRINE OF DOUBLE

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The doctrine (or principle) of double effect is often invoked to explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end. It is claimed that sometimes it is permissible to cause such harm. As a side effect (or “double effect”) of bringing about a good result even though it would not be permissible to cause such a harm as a means to bringing about the same good end. This reasoning is summarized with the claim that sometimes it is permissible to bring about as a merely foreseen side effect a harmful event that it would be impermissible to bring about intentionally.

Thomas Aquinas is credited with introducing the principle of double effect in his discussion of the permissibility of self-defence in the. Killing one's assailant is justified, he argues, provided one does not intend to kill him. Aquinas observes that “Nothing hinders one act from having two effects, only one of which is intended, while the other is beside the

intention. Accordingly, the act of self-defence may have two effects: one, the saving of one's life and the other, the slaying of the aggressor.” A justification is provided that rests on characterizing the defensive action as a means to a goal that is justified: “Therefore, this act, since one's intention is to save one's own life, is not unlawful, seeing that it is natural to everything to keep itself in being as far as possible.” Aquinas observed that the permissibility of self-defence is not unconditional and yet, though proceeding from a good intention, an act may be rendered unlawful if it be out of proportion to the end.

This principle has certain applications as mentioned

below-*A doctor who intends to hasten the death of a terminally ill patient by injecting a large dose of morphine would act impermissibly because he intends to bring about the patient's death. However, a doctor who intended to relieve the patient's pain with that same dose and merely foresaw the hastening of the patient's death would act permissibly.

*A doctor who believed that abortion was wrong, even in order to save the mother's life, and might nevertheless consistently believe that it would be permissible to perform a

hysterectomy on a pregnant woman with cancer. In carrying out the hysterectomy, the doctor would aim to save the woman's life while merely foreseeing the death of the foetus.

Performing an abortion, by contrast, would involve intending to kill the foetus as a means to saving the mother.

*To kill a person whom you know to be plotting to kill you would be impermissible because it would be a case of intentional killing; however, to strike in self-defence against an

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be fatal.15

The principle of double effect is directed at well-intentioned agents who ask whether they may cause a serious harm in order to bring about a good end of overriding moral importance when it is impossible to bring about the good end without the harm. Therefore, in brief, thedoctrine of double effect is often invoked to explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end.

PRO-LIFE

Pro-life simply means opposing abortion and euthanasia. In the context of euthanasia, abortion also amounts to killing or ending up a life. However abortion is allowed upto a period of 20 weeks. Pro-lifers are always in favour of opposing the ending up of life. Even abortion according to them is an offence. Hence legalising euthanasia will be highly objected by the pro-lifers as it interferes with their beliefs.16

15_{“THE DOCTRINE OF DOUBLE EFFECT”,}_{http://plato.stanford.edu/entries/double-effect/}_{PUBLISHED ON 28}

JULY 2004, ACCESSED ON 21 OCTOBER 2015 AT 15.33 IST.

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₂₉₃

EUTHANASIA IN DIFFERENT COUNTRIES

NETHERLANDS

In April 2002, the Netherlands became the first country to legalise euthanasia and assisted suicide. It imposed a strict set of conditions: the patient must be suffering unbearable pain, their illness must be incurable, and the demand must be made in "full consciousness" by the patient. In 2010,136 people were given a lethal cocktail under medical supervision.

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₂₉₄ is counted as homicide.17

FRANCE

Euthanasia and assisted suicide are against the law. The president, François Hollande, promised to look at the "right to die with dignity" but has always denied any intention of legalising euthanasia or assisted suicide.

In 2005 the Leonetti law introduced the concept of the right to be "left to die". Under strict conditions it allowed doctors to decide to "limit or stop any treatment that is not useful, is disproportionate or has no other object than to artificially prolong life" and to use pain-killing drugs that might "as a side effect, shorten life".

Two recent high-profile cases have made the headlines i.e. a doctor accused of administering drugs that hastened the deaths of seven elderly patients was acquitted, and France's high court authorised doctors to stop treating and feeding a young man who had been in a vegetative state on life support for six years. In the latter case, the patient's parents have appealed to the European court of human rights and are awaiting a decision.18

UNITED STATES

Doctors are allowed to prescribe lethal doses of medicine to terminally ill patients in five US states. Euthanasia, however, is illegal. In recent years, the "aid in dying" movement has made incremental gains, but the issue remains controversial.

Oregon was the first US state to legalise assisted suicide. The law took effect in 1997, and allows for terminally ill, mentally competent patients with less than six months to live to request a prescription for life-ending medication. More than a decade later, Washington state approved a measure that was modelled on Oregon's law. And last year, the Vermont legislature passed a similar law. Court decisions rendered the practice legal in Montana and, most recently, in New Mexico.19

In 2013, roughly 300 terminally ill Americans were prescribed lethal medications, and around 230 people died as a result of taking them. Some patients choose not to take the medication.

GERMANY AND SWITZERLAND

In German-speaking countries, the term "euthanasia" is generally avoided because of its association with the eugenicist policies of the Nazi era. The law therefore tends to distinguish between assisted suicide and "active assisted suicide".

In Germany and Switzerland, active assisted suicide i.e. a doctor prescribing and handing over a lethal drug is illegal. But German and Swiss law does allow assisted suicide within certain circumstances. In Germany, assisted suicide is legal as long as the lethal drug is taken without any help, such as someone guiding or supporting the patient's hand. In Switzerland, the law is more relaxed: it allows assisted suicide as long as there are no "self-seeking motives" involved. Switzerland has tolerated the creation of organisations such as Dignitas and Exit, which provide assisted dying services for a fee.20

In a recent survey, two-thirds of Germans said they would support a law that enabled active

17_{“Discussion of euthanasia” in The Dutch ministry of Health, Welfare and Sport.} 18_{"France aims to allow euthanasia despite ethics doubts":}_{TVNZ News}_{: 02.07.2013}

http://www.tvnz.co.nz/world-news/france-aims-allow-euthanasia-despite-ethics-doubts-5484055

19_{O'Reilly, Kevin B. (January 18, 2010). "Physician-assisted suicide legal in Montana, court rules".}_American

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₂₉₅ assisted suicide too. But the government has announced it wants to tighten the law around

assisted suicide, with the health minister, Hermann Grohe, stating that he wants to ban organisations like Dignitas in Germany.

BELGIUM

Belgium passed a law in 2002 legalising euthanasia, becoming the second country in the world to do so. The law says doctors can help patients to end their lives when they freely express a wish to die because they are suffering intractable and unbearable pain. Patients can also receive euthanasia if they have clearly stated it before entering a coma or similar vegetative state.

Assisted suicide is not mentioned in the law, which does not specify a method of euthanasia. As Jacqueline Herremans, president of the Association for the Right to Die with Dignity, says: "We don't make a distinction in the semantics." However, the physician has to be present at the bedside of the patient to their last breath, unlike the Oregon model where the doctor gives only the prescription of drugs.

Belgian euthanasia cases rose to 1,807 in 2013, compared with 1,432 in 2012, 708 in 2008 and 235 in 2003. Just over half of cases last year were aged 70 or over, and 80% of the applications were made by Dutch-speakers.

High-profile euthanasia cases have included a 44-year-old transsexual woman whose botched sex-change operation left her with physical deformities that she felt made her look like a "monster"; and 45-year-old identical twins who were deaf and going blind and believed they had nothing left to live for.

This February, Belgium became the first country to legalise euthanasia for children.21

There is no age limit for minors seeking a lethal injection, but they must be conscious of their decision, terminally ill, close to death and suffering beyond any medical help. They also need the assent of their parents to end their lives. So far, no such cases have yet been reported to authorities. 22

20_{Lundin, Leigh (2009-08-02). "YOUthanasia".Criminal Brief.}

21_{"Belgian Senate votes to extend euthanasia to children".}_{BBC News}_{. 13 December 2013.}

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₂₉₆ JAPAN

The Japanese government has no official laws on the status of euthanasia and the Supreme Court of Japan has never ruled on the matter. Rather, to date, Japan's euthanasia policy has been decided by two local court cases, one in Nagoya in 1962, and another after an incident at Tokai University in 1995. The first case involved "passive euthanasia” (i.e., allowing a patient to die by turning off life support) and the latter case involved "active euthanasia" (e.g., through injection). The judgments in these cases set forth a legal framework and a set of conditions within which both passive and active euthanasia could be legal. Nevertheless, in both of these particular cases the doctors were found guilty of violating these conditions when taking the lives of their patients. Further, because the findings of these courts have yet to be upheld at the national level, these precedents are not necessarily binding. Nevertheless, at present, there is a tentative legal framework for implementing euthanasia in Japan.

In the case of passive euthanasia, three conditions must be met:

1. the patient must be suffering from an incurable disease, and in the final stages of the disease from which he/she is unlikely to make a recovery;

2. the patient must give express consent to stopping treatment, and this consent must be obtained and preserved prior to death. If the patient is not able to give clear consent, their consent may be determined from a pre-written document such as a living will or the testimony of the family;

3. the patient may be passively euthanized by stopping medical treatment, chemotherapy, dialysis, artificial respiration, blood transfusion, IV drip, etc.

For active euthanasia, four conditions must be met:

1. the patient must be suffering from unbearable physical pain; 2. death must be inevitable and drawing near;

3. the patient must give consent. (Unlike passive euthanasia, living wills and family consent will not suffice.)

4. the physician must have (ineffectively) exhausted all other measures of pain relief.

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₂₉₇ the country, has led to the creation of "bioethics SWAT teams".23_{These teams will be made}

available to the families of terminally ill patients in order to help them, along with the

doctors, come to a decision based on the personal facts of the case. Though in its early stages and relying on “subsidies from the Ministry of Health, Labour and Welfare” there are plans to create a non-profit organization to allow the effort to continue.24

23_{McDougall & Gorman 2008, p. 89}

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₂₉₉ Passive euthanasia is legal in India.25_{On 7 March 2011 the Supreme Court of India}

legalised passive euthanasia by means of the withdrawal of life support to patients in a permanent vegetative state.26_{Forms of Active euthanasia, including the administration of}

lethal compounds, are illegal.27

Passive Euthanasia has been advocated by the Law Commission of India in the 196th Report both in the case of competent patients and incompetent patients who are terminally ill. In the case of incompetent patients, the attending medical practitioner should obtain the opinion of three medical experts whose names are on the approved panel and thereafter he shall inform the Patient (if conscious) and other close relatives. Then he shall wait for 15 days before withholding or withdrawing medical treatment including discontinuance of life supporting systems. This 15 days time was contemplated with a view to enable the patient (if conscious) or relatives or guardian to move an original petition in the High Court seeking declaratory relief that the proposed act or omission by the medical practitioner /hospital in respect of withholding medical treatments is lawful or unlawful. High Court will then give a final declaration which shall be binding on all concerned and will have the effect of protecting the doctor or hospital from any civil or criminal liability. The Supreme Court in Aruna’s case has put its seal of approval on (non-voluntary) passive euthanasia subject to the safeguards laid down in the judgment. In the arena of safeguards, the Supreme Court adopted an approach different from that adopted by the Law Commission. The Supreme Court ruled in Aruna’s case that in the case of incompetent patients, specific permission of the High Court has to be obtained by the close relatives or next friend or the doctor / hospital staff attending on the patient. On such application being filed, the High Court should seek the opinion of a Committee of three experts selected from a panel prepared by it after consultation with medical authorities. On the basis of the report and after taking into account the wishes of the relations or next friend, the High Court should give its verdict.28

25_{"India joins select nations in legalising "passive euthanasia""}_{.Chennai, India: The Hindu. 7 March 2011.} 26_{"ArunaShanbaug case: SC allows passive euthanasia in path-breaking judgment"}_{.The Times of India. 7 March} 2011.

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₀

CONSTITUTIONALITY AND JUDICIAL

APPROACH OF EUTHANASIA

Like his right to life, does a man have a right to death also? Is physician-aid-in-dying a crime? The legal aspects of euthanasia are understood only by few people. Some related provisions under the Indian law

are-Article 21, The Constitution of India – Right to live.

Section 309, The Indian Penal Code- Punishment for attempt to commit suicide.

Section 300,Culpable Homicide not amounting to murder, Exception 5, The Indian Penal Code- A person consenting for his own death.

The law, though active in many countries, has been a sleeping giant in India, as euthanasia goes on behind closed doors. The given judicial trends will further lay down the legal perspective of euthanasia in India.



P.Rathinam Case, 1994

The law awoke from its slumber in 1994 by way of a petition filed by P. Rathinam directed against the constitutional validity of Section 309 IPC, which deals with punishment for attempt to commit suicide. The Supreme Court ruled in favour of the petitioner, thereby legalizing suicide and rendering as unconstitutional punishment for abetting of suicide. In this case a corollary was drawn (as a passing reference, or in legal terms an obiter dictum) between euthanasia and suicide. The judgment stated that in cases of passive euthanasia, the consent of the patient (if he be in sound mental condition) is one of the pre-requisites. So, if one could legally commit suicide, he could also give consent for being allowed to die. It went on to say that if suicide was held to be legal, the persons pleading for legal acceptance of passive euthanasia would have a winning point. This judgment came as a shot in the arm for people supporting euthanasia.

IPC rests on the decision in P. Rathinam vs. Union of India and Anr.29_{, by a Bench of two}

learned Judges of this Court wherein Section 309, IPC has been held to be unconstitutional as violation of Article 21 of' the Constitution. It is urged that right to die being included in Article 21 of the Constitution as held in P. Rathinam declaring Section 309, IPC to be unconstitutional, any person alletting the commission of suicide by another is merely assisting in the enforcement of the fundamental right under Article 21; and, therefore, Section 306.



NareshMarotraoSakhre Case,1995

Euthanasia and suicide are different, distinguishing euthanasia from suicide, Lodha

J. in

NareshMarotraoSakhre

v.

Union of India

30

_{, observed:}

“Suicide by its very nature is an act of self-killing or self-destruction, an act of terminating one’s own act and without the aid or assistance of any other human agency.

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₁ Euthanasia or mercy killing on the other hand means and implies the intervention of other human agency to end the life. Mercy killing thus is not suicide and an attempt at mercy killing is not covered by the provisions of Section 309. The two concepts are both factually and legally distinct. Euthanasia or mercy killing is nothing but homicide whatever the circumstances in which it is effected.”



GianKaur Case,1996

In the famous case of GianKaur V. State of Punjab,31_{however, whatever progress was there}

came to a grinding halt in 1996, and the state of confusion returned. The same court now upheld the constitutional validity of Sections 309 and 306 thereby legalizing the same. A judgment totally contradictory to the earlier one, this presented a picture of the confusion that prevails in our apex judiciary as far as euthanasia is concerned. The primary basis for taking such a contention was Article 21, which states that all Indians have a right to life and personal liberty. The judgment accepted the view that in a terminally ill patient (one in a Permanent Vegetative State - PVS), mercy killing does not extinguish life, but accelerates conclusion of the process of natural death that has already commenced. But it goes on to say that the scope of Article 21 cannot be widened enough so as to include euthanasia. In the concluding remarks, assisted suicide and abetting of suicide were made punishable, due to "cogent reasons in the interest of society."32

In 1996 GianKaur Case the Constitution Bench upheld that the right to live with dignity under Article 21 of the Constitution will be inclusive of right to die with dignity. However, the decision did not arrive at a conclusion for validity of euthanasia, be it active or passive.

To give meaning and content to the word 'life' in Article 21, it has been construed as life with human dignity. Any aspect of life which makes it dignified may be read into it but not that which extinguishes it and is, therefore, inconsistent with the continued existence of life resulting in effacing the right itself. The right to die', if any, is inherently inconsistent with the right to life' as is death' with life'.

Protagonist of euthanasia on the view that existence in persistent vegetative state (PVS) is not 31_{1996 AIR 946}

32_{http://www.questia.com/library/controversial-topics/euthanasia-and-assisted-suicide}_{ACCESSEDON 21STOCTOBER,}

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₂ a benefit to the patient of a terminal illness being unrelated to the principle of 'sanctity of life' or the right to live with dignity' is of no assistance to determine the scope of Article 21 for deciding whether the guarantee of right to life' therein includes the right to die'. The right to life' including the right to live with human dignity would mean the existence of such a right upto the end of natural life. This also includes the right to a dignified life upto the point of death including a dignified procedure of death. In other words, this may include the right of a dying man to also die with dignity when his life is ebbing out. But the 'right to die' with dignity at the end of life is not to be confused or equated with the right to die' an unnatural death curtailing the natural span of life.33

A question may arise, in the context of a dying man, who is, terminally ill or in a persistent vegetative state that he may be permitted to terminate it by a premature extinction of his life in those circumstances. This category of cases may fall within the ambit of the 'right to die' with dignity as a part of right to live with dignity, when death due to termination of natural life is certain and imminent and the process of natural death has commenced. These are not cases of extinguishing life but only of accelerating conclusion of the process of natural death which has already commenced. The debate even in such cases to permit physician assisted termination of life is inconclusive. It is sufficient to reiterate that the argument to support the view of permitting termination of life in such cases to reduce the period of suffering during the process of certain natural death is not available to interpret Article 21 to include therein the right to curtail the natural span of life.34

We are, therefore, unable to concur with the interpretation of Article 21 made in P. Rathinam. The only reason for which Section 309 is held to be violative of Article 21 in P. Rathinam does not withstand legal scrutiny. We are unable to hold that Section 309 I.P.C. is violative of Article 21.

The only surviving question for consideration now is whether Section 309 IPC is violative of Article 14, to support the conclusion reached in P.Rathinam.

The question

Whether, the scope of Article 21 also includes the 'right to die' ? Article 21 is as under:

Article 21- Protection of life and personal liberty. “No person shall be deprived of his life or personal liberty except according to procedure established by law."

A significant part of the judgment in P. Rathinam on this aspect, is as under:

33_{http://www.newhealthguide.org/Where-Is-Euthanasia-Legal.html}_{ACCESSED ON 20TH OCTOBER 2015}

AT 18.00 IST.

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₃ "If a person has a right to live, question is whether he has right not to live.” The Bombay High Court stated in paragraph 10 of its judgment that as all the fundamental rights are to be read together, as held in R.C. Cooper v. Union of India35_{what is true of one fundamental}

right is also true of another fundamental right. It was then stated that is not, and cannot be, seriously disputed that fundamental rights have their positive as well as negative aspects. For example, freedom of speech and expression includes freedom not to speak. Similarly, the freedom of association and movement includes freedom not to join any association or move anywhere. So too, freedom of business includes freedom not to do business. It was, therefore, stated that logically it must follow that the right to live will include right not to live, i.e., right to die or to terminate one's life.36

Two of the above named and critics of the Bombay judgment have stated that the aforesaid analogy is "misplaced", which could have arisen on account of superficial comparison between the freedoms, ignoring the inherent difference between one fundamental right and ,the other. It has been argued that the negative aspect of the right to live would mean the end or extinction of the positive aspect, and so, it is not the suspension as such of the right as is in the case of 'silence' or 'non- association' and 'no movement'. It has also been stated that the right to life stands on different footing from other rights as all other rights are derivable from the right to live.37



ArunaRamachandraShanbaug Case:

Shanbaug, now 60, a former nurse, was beaten and sexually assaulted in 1973 by a co-worker, a hospital janitor at Mumbai's King Edward Memorial Hospital, where she remains today. She suffered severe brain damage and paralysis after her attacker, SohanlalBharthaValmiki, reportedly choked her with a chain. Valmiki was convicted of robbery and assault in 1974 and imprisoned for seven years. After his release, he reportedly moved, changed his name and found another hospital job.

The petition asking that Shanbaug be allowed to die was brought by PinkiVirani, an author and right-to-die activist, after Shanbaug's family abandoned her. Virani argued that with the patient unable to see or speak properly, keeping her alive violated her basic dignity. Virani expressed regret that the court didn't put an end to Shanbaug's force-feeding. "She still does not, after more than three and a half decades, receive justice, the bizarre postscript to Aruna's story is that those who claim to 'love' her and 'look after her' are the ones who want her not to rest in peace.38

Refusing mercy killing of ArunaShanbaug, a two-judge bench of Supreme Court comprising of

35_{1970 AIR 564}

36_{https://www.avma.org/Advocacy/StateAndLocal/Pages/euthanasia-laws.aspx}_{ACCESSED ON 21ST}

OCTOBER 2015 AT 19.33 IST.

37_{“EUTHANASIA: A LEGAL PERSPECTIVE”, IBN LIVE SPECIALS, 27}_TH_{FEBRUARY 2014}

http://ibnlive.in.com/news/euthanasia-an-indian-perspective/454714-3.html ACCESSED ON 3RD OCTOBER

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₄ justices MarkandeyKatju and GyanSudha Mishra, in a landmark judgement on 7th March 2011, allowed "passive euthanasia" of withdrawing life support to patients in (PVS) but rejected outright active euthanasia of ending life through administration of lethal substances. 39

The recommendations made by the Law Commission of India in this case are stated

below- Passive euthanasia, which is allowed in many countries, shall have legal recognition in our country too subject to certain safeguards, as suggested by the 17th Law Commission of India and as held by the Supreme Court in ArunaRamachandra‟s case. It is not objectionable from legal and constitutional point of view.

 A competent adult patient has the right to insist that there should be no invasive medical treatment by way of artificial life sustaining measures / treatment and such decision is binding on the doctors / hospital attending on such patient provided that the doctor is satisfied that the patient has taken an “informed decision” based on free exercise of his or her will. The same rule will apply to a minor above 16 years of age who has

expressed his or her wish not to have such treatment provided the consent has been given by the major spouse and one of the parents of such minor patient.

 As regards an incompetent patient such as a person in irreversible coma or in Persistent Vegetative State and a competent patient who has not taken an “informed decision”, the doctor’s or relatives’ decision to withhold or withdraw the medical treatment is not final. The relatives, next friend, or the doctors concerned / hospital management shall get the clearance from the High Court for withdrawing or withholding the life sustaining treatment. In this respect, the recommendations of Law Commission in 196th report is somewhat different. The Law Commission proposed an enabling provision to move the High Court.

 The High Court shall take a decision after obtaining the opinion of a panel of three medical experts and after ascertaining the wishes of the relatives of the patient. The High Court, as parenspatriae will take an appropriate decision having regard to the best interests of the patient.

 Provisions are introduced for protection of medical practitioners and others who act according to the wishes of the competent patient or the order of the High Court from criminal or civil action. Further, a competent patient (who is terminally ill) refusing medical treatment shall not be deemed to be guilty of any offence under any law.

 The procedure for preparation of panels has been set out broadly in conformity with the recommendations of 17th Law Commission. Advance medical directive given by the patient before his illness is not valid.

 Notwithstanding that medical treatment has been withheld or withdrawn in

accordance with the provisions referred to above, palliative care can be extended to the competent and incompetent patients. The Governments have to devise schemes for palliative care at affordable cost to terminally ill patients undergoing intractable suffering.

 The Medical Council of India is required issue guidelines in the matter of

38_{BALBIR KAUR, “EUTHANASIA REVISITED”}_{http://medind.nic.in/jal/t12/i2/jalt12i2p165.pdf}_{ACCESSED ON 21ST}

OCTOBER, 2015

39_{ARUNA SHANBAUG CASE, NDTV, NEW DELHI, 7}TH_{MARCH, 2011}

http://www.ndtv.com/article/india/aruna-shanbaug-case-supreme-court-rejects-euthanasia-plea-8989 4

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₅ withholding or withdrawing of medical treatment to competent or incompetent

patients suffering from terminal illness.

 Accordingly, the Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill, 2006, drafted by the 17th Law Commission in the 196th Report has been modified and the revised Bill is practically an amalgam of the

earlier recommendations of the Law Commission and the views / directions of the Supreme Court in ArunaRamachandra case. 40

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₆

CONCLUSION

To force a person to be kept alive in a vegetative state when medical opinion is as certain as can be, that there is no chance of recovery, is cruel both on the person and on his or her family and friends. The law must, therefore, clearly allow for euthanasia, both active and passive, in such situations. While passive euthanasia is limited to withdrawing life support, active euthanasia goes a step further by assisting in a terminally ill patient's death. There must, however, be very strict safeguards to ensure that the provision is not misused by people, who may benefit from the death of the patient.41

Euthanasia should be legalised in extreme cases if the patient so desires. Though life is a gift from God, if a patient is incapacitated and miserable, it should be allowed. After all, there is no pleasure in just existing. The quality of life is also to be considered. If a patient is in pain, unable to move, totally dependent on his caretaker, and if his condition is in all probability unlikely to improve, maybe he cries in his heart to be dead. In life, we are constantly making choices. Every moment, we have the freedom to choose what we want to do next and so why not to make the decision of death.

As per the decision of The Supreme Court on 16th July, 2014 a notice was issued to all states and Union territories on a plea for legalizing passive euthanasia. An apex court constitution bench headed by Chief Justice RM Lodha, Justice Jagdish Singh Khehar, Justice J. Chelameswar, Justice AK Sikri and Justice RohintonFaliNariman issued the notice on a plea filed with it, saying the question of passive euthanasia (mercy killing) needs a comprehensive examination as there was no authoritative judicial pronouncement on the issue. The SC has appointed former solicitor general TR Andhyarujina as amicus curiae to assist it in the case relating to legalizing euthanasia.The Centre, however, strongly opposed the plea saying it cannot be legalized as it is a form of suicide which is an offence in the country. It said that if euthanasia is legalized, then it will be misused. "We do not accept passive euthanasia. It is one form of suicide and suicide is an offence, It is a matter for legislature to decide”, this was what was quoted.

It asked the petitioner on what is least painful way to bring life to an end as there has been discussion going on across the world on the matter and there is no unanimous finding. The court has also issued notice as attorney general MukulRohatgi told it that the issue entirely concerns the legislature and the judiciary should not take it up. The matter came on a plea by an NGO Common Cause that a person, who is afflicted with a terminal disease, should be given relief from agony by withdrawing artificial medical support provided to him.42

41_{PRIYA GUPTA “ACTIVE EUTHANASIA WITH STRICT SAFEGUARDS”, THE TIMES OF INDIA, 20}TH

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₇ SC finally issued notice to all states and Union Territories on a plea for legalising

passive euthanasia.

Passive euthanasia has been legalised in India as of now. Further, the researcher through the research work would like to conclude that the hypothesis holds true and euthanasia must be legalised in extreme cases. Relating it with death penalty, as it is given in the rare of the rarest case, the same should be done with euthanasia. The court should make a wise decision as to who should be given the permission of euthanasia and who not else it would be misused in our society. As far as the consent of the patient is concerned, when the patient is not in a position to decide as to what should happen with his life, i.e. if the patient is in a permanent vegetative state, the legal guardians of the patient should be asked for the consent. The main object should be “death with dignity”. Legalising euthanasia in every case would be a very vague decision and so it must be restricted to the extreme cases where the scope of revival of the person would be almost nil. Medical practitioners should not be given the chance to decide the fate of the person as no human being can replace God. And, it has also been seen in many cases that the prediction and experience of renowned doctors fail when it comes to saving of life. Moreover, the duty of a doctor is to save life, grant a new life and not to take life and so it is against the ethics.

So far there has been no reported case of euthanasia per se, but if it does come up, the prosecution will have a definite advantage. The law as of now is still pretty ambiguous on the topic of euthanasia, but we can hope that some concrete steps shall be taken to resolve this burning problem.

The legalisation of euthanasia to end suffering painlessly has been one of the heated discussions in many countries around the world. Many terminally-ill patients do not have a possibility to recover, but the laws do not allow doctors to end their lives. In my opinion, the government should legalise euthanasia in extreme cases.

The primary reason in legalising euthanasia helps the patients alleviate the pain, suffering and depression. Individuals have the liberty right, which includes the right of owing their death. The individual’s decision should be carried out because they have the right to their own personal decisions, which is one reason why euthanasia should be legalised. Another reason is mercy killing which can reduce inconveniences, emotional and physical burdens, and drawbacks imposed on family members, relatives and friends of the patient. The family members may not be bear the burden to keep the patient alive or in vegetative state for a longer duration. Apart from the pain that the patient suffers, the pain and trauma that the family members has to go through is also immense. Moreover, the family members in many cases cannot accumulate enough money for the patient. So, in such cases euthanasia should be permitted.

42_{DHANANJAY MAHAPATRA, “SC WANTS COUNTRYWIDE DEBATE ON LEGALIZING}

EUTHANASIA”, THE TIMES OF INDIA, 16TH JULY, 2014, ACCESSED ON 21ST OCTOBER 2015 AT

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₈

CRITICISM

Those in favour of euthanasia argue that a civilised society should allow people to die in dignity and without pain, and should allow others to help them do so if they cannot manage it on their own. They say that our bodies are our own, and we should be allowed to do what we want with them. So it's wrong to make anyone live longer than they want. In fact

making people go on living when they don't want to violates their personal freedom and human rights. It is immoral, they say to force people to continue living in suffering and pain.

They add that as suicide is not a crime; in many nations like U.S., euthanasia should not be a crime either.

Euthanasia should be forbidden as religious opponents of euthanasia believe that life is given by God, and only God should decide when to end it. Other opponents fear that if euthanasia was made legal, the laws regulating it would be abused, and people would be killed who didn't really want to die.28

Legalising euthanasia in India totally will lead to many ethical disasters as India is a sacred nation and here people believe in the nature and extent of God and interfering with their religious beliefs and ending up someone’s life will amount to cruelness and a devilish act. Further, many may misuse it in a negative aspect. People may mis-utilise the power of legal euthanasia and will tend to end up the life of those who are a burden to them. Moreover suicide and assisted suicide will also be considered as euthanasia in many cases. People will commit offences and defend themselves on basis of euthanasia if it is legalised. So there must be a bar to the legalisation of euthanasia and its pros and cons must be critically analysed.

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₀₉

SUGGESTIONS

After the research work on the above topic, there are a few suggestions that the

researcher would like to put up in the limelight for the purpose of legalising euthanasia in India.

 Consent of the victim/ patient in any form must be mandatory.

-if the victim/ patient himself wants to end his suffering, he should be allowed to do so.

-if the victim/ patient is in PVS i.e. Permanent Vegetative State, the consent of his legal guardians should be considered valid.

-consent by words, actions, written form or gestures, all should be valid.

 Doctors must not be the prime people to decide the validity of life of any patient as it has been seen in many cases that the prediction of the doctors fail substantially.

 It should be the ultimate decision of the competent court (only the HCs or the SC) must have the authority to grant euthanasia.

 There should be a time frame that should be given to the patient to recover, if the patient suffers from severe pain and suffering, then after a limited time,

euthanasia should be granted.

 The patient should die with dignity and Article 21 should not be violated. This means that the patient should not be starved to death or made to wait for his death, rather the death should be peaceful and practical.

 Not only the doctors should be made entitled to end up life but also the relatives of the patient, with the permission of the Court should be allowed to do so.

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₁₀

BIBLIOGRAPHY

1. PRIMARY SOURCES

THE CONSTITUTION OF INDIA, 1950, UNIVERSAL PUBLICATION.

THE INDIAN PENAL CODE, 1860, UNIVERSAL PUBLICATION.

2. SECONDARY SOURCES

 LAVI SHAI J.THE MODERN ART OF DYING: A HISTORY OF EUTHANASIA IN THE UNITED STATES, PRINCETON UNIVERSITY PRESS, 2007.

 GORSUCH NEIL M.THE FUTURE OF ASSISTED SUICIDE AND EUTHANASIA, PRINCETON UNIVERSITY PRESS, 2006.

 KEOWN JOHN,EUTHANASIA, ETHICS AND PUBLIC POLICY: AN

ARGUMENT AGAINST LEGALISATION, CAMBRIDGE UNIVERSITY PRESS, 2002.

 BAIRD ROBERT M. AND ROSENBAUM STUART E., EUTHANASIA: THE MORAL ISSUES, PROMETHEUS BOOKS, 1989.

ONLINE SOURCES-

 http://www.hospicepatients.org/euth-experts-speak.htmlACCESSEDON 25THOCTOBER, 2015 AT 19.20 IST.

 “Discussion of euthanasia” in The Dutch ministry of Health, Welfare and Sport.

 "France aims to allow euthanasia despite ethics doubts": TVNZ News: 02.07.2013

http://www.tvnz.co.nz/world-news/france-aims-allow-euthanasia-despite-ethics - doubts-548405 5

 O'Reilly, Kevin B. (January 18, 2010). "Physician-assisted suicide legal in Montana , court rules".American Medical New s

 https://www.avma.org/Advocacy/StateAndLocal/Pages/euthanasia-laws.asp x ACCESSED ON 16TH OCTOBER, 2015 AT 16.40 IST.

 “EUTHANASIA: A LEGAL PERSPECTIVE”, IBN LIVE SPECIALS, 27TH FEBRUARY 2014

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South -Asian Journal of Multidisciplinary Studies (SAJMS) ISSN:2349-7858:SJIF:2.246:Volume 3 Issue 3₃₁₁

 http://www.bbc.co.uk/ethics/euthanasia/overview/problems.shtmlACCESSEDON20TH OCTOBER, 2015 AT 23.00 IST.

 http://www.life.org.nz/euthanasia/euthanasialegalkeyissues/ACCESSEDON 21STOCTOBER. 2015 AT 21.00 IST.

 BALBIR KAUR, “EUTHANASIA REVISITED”

http://medind.nic.in/jal/t12/i2/jalt12i2p165.pdfACCESSEDON 21ST OCTOBER,2015 AT 21.00 IST.

 ARUNA SHANBAUG CASE, NDTV, NEW DELHI, 7TH MARCH, 2011 http://www.ndtv.com/article/india/aruna-shanbaug-case-supreme-court-rejects - 5 ACCESSED AT 21ST_{OCTOBER 2015}_AT_{19.00 IST.}

 The Guardian, Thursday 17 July 2014 17.04 BST

 "India joins select nations in legalising "passive euthanasia"".Chennai, India: TheHindu. 7 March 2011.

 "ArunaShanbaug case: SC allows passive euthanasia in path-breaking judgment".The Times of India. 7 March 2011.

 Magnier, Mark (8 March 2011). "India's Supreme Court lays out euthanasia guidelines".LA Times.

 “PASSIVE EUTHANASIA- A RELOOK”, THE LAW COMMISSION OF India, REPORT NO. 241, AUGUST 2012.

http://lawcommissionofindia.nic.in/reports/report241.pdfACCESSEDON 23RDOCTOBER 2015AT 20.30 IST.

 PRIYA GUPTA “ACTIVE EUTHANASIA WITH STRICT SAFEGUARDS”, THE TIMES OF INDIA, 20TH_{JULY, 2014, ACCESSED ON 21}ST_{OCTOBER 2015 AT 20.03}

IST.

 DHANANJAY MAHAPATRA, “SC WANTS COUNTRYWIDE DEBATE ON