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What are the different types of euthanasia?

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Dr KK Aggarwal    20 January 2021

The landmark judgment titled as “Common Cause versus Union of India, 2018 (5) SCC 1 passed by the Hon’ble Constitution Bench of 4 Judges of the Supreme Court of India, has discussed about various types of euthanasia which are:

In common parlance, euthanasia can be of three types, namely, ‘voluntary euthanasia’ which means killing at the request of a person killed which is to be distinguished from ‘non-voluntary euthanasia’, where the person killed is not capable of either making or refusing to make such a request. Second type of euthanasia would be involuntary euthanasia where the person killed is capable of making such a request but has not done so. These terms can be described as under:

  1. Voluntary euthanasia: People concerned to legalize the termination of life on medical grounds have always concentrated on Voluntary Euthanasia (this implies that the patient specifically requests that his life be ended.) It is generally agreed that the request must come from someone who is either; (a) in intolerable pain or (b) who is suffering from an illness which is agreed as being terminal. It may be prior to the development of the illness in question or during its course. In either case it must not result from any pressure from relatives or those who have the patients in their care. Both active and passive euthanasia can be termed as forms of voluntary euthanasia.
  2. Non-Voluntary Euthanasia: Seen by some as sub-variety of voluntary euthanasia. This involves the death, ostensibly for his own good, of someone who cannot express any views on the matter and who must, therefore, use some sort of proxy request. These definitions of voluntary, non-voluntary and involuntary euthanasia correspond to those employed by the House of Lords Select Committee on Medical Ethics (Walton Committee) that his/her life be ended. This form of Euthanasia is that which most intimately concerns the medical profession. Selective non-treatment of the new-born or the doctor may be presented with demented and otherwise senilely incompetent patients. In practice, non-voluntary euthanasia presents only as an arguable alternative to non-treatment.
  3. Involuntary Euthanasia: It involves ending the patient’s life in the absence of either a personal or proxy invitation to do so. The motive ‘The relief of suffering’ may be the same as voluntary euthanasia -but its only justification - “a paternalistic decision as to what is best for the victim of the disease.” In extreme cases it could be against the patient’s wishes or could be just for social convenience. It is examples of the latter which serve as warnings as to those who would invest the medical professional with more or unfettered powers over life and death.

Contrary to the above, in legal parlance, euthanasia has since come to be recognised as of two distinct types: the first is active euthanasia, where death is caused by the administration of a lethal injection or drugs. Active euthanasia also includes physician-assisted suicide, where the injection or drugs are supplied by the physician, but the act of administration is undertaken by the patient himself. Active euthanasia is not permissible in most countries. The jurisdictions in which it is permissible are Canada, the Netherlands, Switzerland and the States of Colorado, Vermont, Montana, California, Oregon and Washington DC in the United States of America.

Passive euthanasia occurs when medical practitioners do not provide life-sustaining treatment (i.e. treatment necessary to keep a patient alive) or remove patients from life-sustaining treatment. This could include disconnecting life support machines or feeding tubes or not carrying out life-saving operations or providing life extending drugs. In such cases, the omission by the medical practitioner is not treated as the cause of death; instead, the patient is understood to have died because of his underlying condition.

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