In con­trol of life and death

The right to life, guar­an­teed by our Con­sti­tu­tion, is in­com­plete with­out the right to die. In­di­vid­u­als must be al­lowed to choose how to live their lives, or end them, with­out be­ing judged by re­li­gious lead­ers or ham­pered by their coun­try’s laws

Hindustan Times (Lucknow) - - COMMENT - NAMITA BHAN­DARE namita.bhan­dare@gmail.com Twit­ter:@na­mitab­han­dare The views ex­pressed by the au­thor are per­sonal

The woman in the video is talk­ing about joy, life and laugh­ter. She holds her hus­band’s hand as they walk through the woods. She takes a plate of food out­doors for a pic­nic lunch. She packs her bag as if pre­par­ing for a trip.

She does not look like a woman who has cho­sen to die.

But Brittany May­nard is talk­ing about dy­ing. Di­ag­nosed with ter­mi­nal brain can­cer on Jan­uary 1, she was, in April, given six months to live. “If all my dreams came true, I would some­how sur­vive this,” she laughs. But she is get­ting ‘sicker and sicker’. If she waits too long, she fears, she might lose her au­ton­omy. How then will she swal­low the drugs pre­scribed by her doc­tor that will end her life?

The death of May­nard on Novem­ber 3, five weeks short of her 30th birth­day has trig­gered another de­bate on eu­thana­sia. The Vatican has termed her death ‘ab­surd’. For oth­ers, she is a sym­bol of courage; the new­est face of the right-to-die move­ment. She her­self says: “Can­cer is end­ing my life. I am choos­ing to end it a lit­tle sooner and in a lot less pain.”

Pas­sive eu­thana­sia — with­draw­ing life support and with­hold­ing food and sus­te­nance for ter­mi­nally ill peo­ple in a veg­e­ta­tive state — has been le­gal in In­dia since 2011. There is no law yet, but on a pe­ti­tion filed by jour­nal­ist Pinki Vi­rani, the Supreme Court set out guide­lines and this year asked for re­sponses from state gov­ern­ments.

The anti-eu­thana­sia lobby is fear­ful of mis­use. What’s to stop the next-of-kin from has­ten­ing the death of a pa­tient with a view to in­her­i­tance or wrig­gling out of mount­ing med­i­cal ex­penses? Even in cases where some­one makes a ‘liv­ing will’ — sets out in writ­ing that they don’t wish for life support — there is no an­swer to for­mer Chief Jus­tice RM Lodha’s query: “How to make this fool­proof ?”

The is­sue gets some­what more com­pli­cated when you con­sider the as­ton­ish­ing ad­vances in med­i­cal sci­ence — heart-lung ma­chines and ven­ti­la­tors that keep clin­i­cally brain dead peo­ple ‘alive’ for months. When, as a World Health Or­ga­ni­za­tion (WHO) re­port points out, 87% of to­tal health ex­pen­di­ture comes from pri­vate pock­ets and the pub­lic health sys­tem is hope­lessly over-bur­dened, does pro­long­ing the life of some­one in an ir­re­versible veg­e­ta­tive state make any sense at all — par­tic­u­larly when they them­selves do not wish for it?

The thornier is­sue is ac­tive eu­thana­sia, or how May­nard chose to end her life, which is il­le­gal in most coun­tries (just five states in the United States, Switzer­land, Bel­gium, Nether­lands and Lux­em­bourg al­low it in some form). In­dian law crim­i­nalises even sui­cide — a law that re­ally needs to go, but that is another story.

Surely, I have the right to choose whether I wish to en­dure pro­longed suf­fer­ing (and sub­ject my fam­ily and loved ones to it) or not. Surely, the right to refuse treat­ment — should I be di­ag­nosed with a ter­mi­nal ill­ness — vests in me. And surely, I don’t have to, like May­nard did un­til she took the decision to die, be forced to face a slow and tor­tu­ous end.

The right to life, guar­an­teed by our Con­sti­tu­tion, is in­com­plete with­out the right to die. In­di­vid­u­als must be al­lowed to choose how to live their lives, or end them, with­out be­ing judged by re­li­gious lead­ers or ham­pered by their coun­try’s laws.

One in five sui­cides in In­dia is the re­sult of ail­ments like can­cer, AIDS and paral­y­sis, shows data com­piled by the Na­tional Crime Records Bureau. This is not to im­ply that somebody who is dis­abled or suf­fers from AIDS does not have the right to live or the right to treat­ment. Le­gal­is­ing eu­thana­sia is mean­ing­less un­less op­tions for pal­lia­tive care and hos­pices abound. Eu­thana­sia can­not be al­lowed to be­come a ‘no op­tion’ op­tion.

But equally, we need to recog­nise that dig­nity means dif­fer­ent things to dif­fer­ent peo­ple. By choos­ing to end her life, Brittany May­nard be­comes nei­ther heroic nor a mar­tyr. She sim­ply re­mains a per­son in con­trol of her life — and death.

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