Dilemma of Assisted Dying

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JULY 2021

The voice for assisted dying is rising. It is a matter of hot debate whether it is morally correct. Assisted dying or assisted suicide is unlawful in most countries, as it is considered detrimental to the well-being of society; hence their laws don't permit this practice.

There are few countries still, most advanced economies that have already legalized assisted dying. Yet, paradoxically, countries that have the most resources to support and comfort the vulnerable are the ones who favour euthanasia.

इच्छामृत्यु की ‘दुविधा’

What makes people choose assisted dying?

People have understood that end of the road is reached, and there is no way left to continue living comfortably. Condition in which crucial parts of the body are not functioning and performing daily routine is complex, propel people to choose this critical decision.

The situation arises when medical science has consumed all its options of medications and surgery and therefore given up. They have declared the patient as incurable or terminally ill.

Those who can live longer, their life is solely dependent on micro-management and assistance of carers. They are either wheelchair-bound or bedridden and unable to undertake any task for self or others.

The consciousness of the patient feels burdened by seeing one's life as a favour from others. Losing self-control is highly likely. Over a period, the patient does lose the mental strength and motivation to live, as nothing is motivating enough to look forward to in life.

Though, they were still capable of deciding the all-important assisted dying.

The moral question?

The moral question that arises is that of taking the human life of another human.

The main argument against assisted dying is based upon the religious belief that life is a gift of God. There is a natural process of life and death, governed by the almighty.

Therefore, any intervention by humans, like changing the duration of the life cycle, is against God. Assisted dying is shortening the natural process of life and, therefore, against God.

The counterargument is equally valid. Assisted birth, using IVF, and other fertility treatments are equally assisted interventions in the cycle of life. In this case, too, another human is changing the life cycle against the will of God.

However artificial the method may be, artificial insemination and fertility treatments are allowed in all religions. Births using synthetic methods is altering the life cycle, too, like assisted death. Therefore, religions seem to be biased towards assisted deaths by that account.

Who decides it is the end of life?

The declaration by the medical professionals that there is no cure makes a strong case for giving up. The declaration lies in the assumption of absoluteness in western medical science.

There are numerous cases where the patients were declared terminally ill but recovered when they opted for traditional medicines and remedies.

Hence the basis of assisted death is flawed. The procedure and the regulation to govern assisted dying is not the core issue. In fact, in the moral debate, deciding to allow or disallow is a question of utmost importance.

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Deciding to end life – is also about poor mental health

Suicide is a decision by someone in distress. No one, in happiest times, would like to end their life. Therefore, it can be reasoned that the primary condition to decide about ending life is the absence of happiness, Hence, external methods can be applied to make people happier.

Positive energy can be pursued even with disabilities and pain, though a tall order, yet not impossible. It would entail pain management, assisted living and spiritual support. There are umpteen tools available in medical science that can elevate the patient's mental health-seeking death.

इच्छामृत्यु की ‘दुविधा’

The risk is the misapplication of the law allowing assisted dying.

There can be more than one intention in the administration of assisted death. It can be to release the burden on the medical system or release the bed in a hospital. The financial burden due to medical and assisted living can be a factor too.

Over the period, what trends build up in society is unknown. Patients might automatically be assumed as a case of euthanasia. There could also be unsaid societal pressure to explore the option – just because it is available.

There are many examples where society, however liberal, exerts unsaid pressure, for example, having a life partner, family, own home, a kind of pleasure, lifestyle etc. Euthanasia could add to the list.

इच्छामृत्यु की ‘दुविधा’

When given a choice, and practised widely, the new normal will tune the society in categorizing a set of people suitable for assisted dying.

Allied Services, financial models and support groups will spring into the market with the commercialization of this human situation. Once it starts, it will then be challenging to reverse the practice.

For now, most of the arguments are being made assuming that only a few manageable cases may exist. At the same time, the fact remains that as the volume of applicants increases, there will be inefficiency and mistakes.

Negligence is a common symptom found whenever the numbers are significant — considering the scenario in countries like India and China, owing to the size of the population.

Statistically, the number of requests for assisted dying will be much higher than in any other developed country. The medical system in developing countries is struggling; topping it with consequential medico-legal decision making will be a definitive recipe for miscarriage of justice.

Like suicide, assisted death is little about the patient but has more to do with society's failure and medical science. No community should be so liberal that people are let loose to take their own lives, nor should society be so intellectually poor that people cannot care for their fellow beings' happiness.

इच्छामृत्यु की ‘दुविधा’

Those family members who support assisted dying do it for the reason of not being cruel, but for their love towards one who is suffering. They cannot bear to see the unbearable pain their loved one is undergoing. It is a tough collective decision they all have to take.