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

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.