Thinking Allowed
Do you have the right to die with dignity? To decide in advance when to switch off machines that keep you alive, that prolong your suffering and financially ruin your loved ones, in case you are terminally ill or ever in a vegetative state? The Supreme Court is thinking about it.
The debate on euthanasia gave us a passive euthanasia law. Now we are debating the “living will” — where a person could leave instructions refusing life support in case of an irreversible terminal illness or a vegetative state. Arguing for the legalisation of a living will, Prashant Bhushan, on behalf of Common Cause, noted that the right to reject treatment flows from our right to life. The government, however, believes such a will “may be misused in the case of elderly people who are treated like a burden by many”. Both positions have their merits, and the court has reserved its verdict for now.
But the court has said the living will is “not postulated on the right to die but on the right to live, as the person is actually saying he wants to live only till he can without outside support”. And the court could frame guidelines for it, which should be executed only when a medical board affirms a person’s medical condition was incurable and irreversible. It mentioned a twopronged test for the living will to take effect: “when the medical condition of the patient has become irreversible” and “when the prolongation of his life can be done only at the cost of pain and suffering...”
A proper debate on the “living will” can’t be limited to just medical treatment and our right to live. It needs to look at how we live, and why we fear the law can be abused — that elders may be hastened to an early death by their families, or that we may wish to choose death rather than a lingering half-life of abuse and neglect. It needs to explore what we as a society and as a nation can do about it.
First, the fear of abuse shouldn’t prevent us from making laws. We just need to guard against misuse. Every law can be abused. Laws prohibiting dowry are routinely misused — that doesn’t justify scrapping the law itself. And if we fear people would be wrongfully put to death by the misuse of a living will, we should scrap the death penalty (and I seriously hope we will), which often kills innocents who have been wrongly convicted.
Second, we do need to respect the right to live with dignity. A living will would certainly help. But we need much more. Abuse of the elderly is rampant in India, even as we tout our traditional respect for old people. India is home to over 100 million elders. Even though elder abuse is largely unreported in India, according to various surveys (by HelpAge India and others), half this population is abused. Which makes India the most gigantic bloc of elder abuse worldwide. This abuse can be physical, mental, emotional, sexual and financial. And the most widespread is one we don’t even acknowledge as abuse — neglect.
The vulnerability of the elderly is not only due to failing health, but due to social attitudes