Major controversies, countries where it is legal, ‘death tourism’ and Indian law

In May, a 28-year-old Dutch woman prepared to voluntarily end her life. Zorya ter Beek does not suffer from any physical illness, but does suffer from mental health problems, including depression and borderline personality disorder, which her doctors have declared cannot be alleviated.

His case has once again brought into focus the concept of euthanasia, which allows people – usually those who are terminally ill or suffering from a disease that threatens to destroy their quality of life and physical autonomy – to Allows a person to end his or her life at a time of his or her choice.

This is a deeply controversial topic, but proponents argue that it offers people the option of having a dignified death and reducing their suffering.

Those who oppose it often question the concept on moral and religious grounds. An overview of anti-euthanasia arguments published in the BBC’s Ethics Guide also lists some practical concerns: Will widespread acceptance of euthanasia compromise the will to find a cure? Will this put pressure on terminally ill people to end their lives? Will this give doctors too much power?

The potential for euthanasia to be abused became more apparent when Nazi Germany under Adolf Hitler continued using it to kill the disabled in order to promote racial purity.

But what has been described as the ethical use of euthanasia – which is approved after thorough review by physicians – is rapidly gaining popularity.

Euthanasia or assisted death is legal in several countries – Australia, Belgium, Canada, Colombia, Luxembourg, the Netherlands, Spain, Switzerland and New Zealand – and 11 of the 50 US states.

Many Swiss organizations such as Dignitas, in fact, actively advocate for it and help people seeking an “assisted” death to travel to the country.

A survey published on BMC Psychiatry to understand the attitudes of Belgian psychiatrists and their readiness to engage in euthanasia assessment processes when dealing with adults with psychiatric conditions (APCs) showed that 74.5 percent agreed that Euthanasia should remain an acceptable option for APC.

However, only 8.4 percent said they would assist in euthanizing their own patients.

In Switzerland, the number of people choosing assisted suicide rose from 187 in 2003 to 965 in 2015, The Guardian reports.

In the Netherlands, in 2017 regional euthanasia review committees (RTEs) recorded 6,585 cases of voluntary euthanasia or assisted suicide, which accounted for about 4.4% of total deaths.

About 96% of these cases involved euthanasia, less than 4% of which were assisted suicide, and the largest number of cases involved people suffering from cancer.

What is euthanasia and is it the same as assisted suicide?

Euthanasia is the practice of intentionally ending a patient’s life to reduce his suffering. However, the patient in question must be terminally ill or experiencing extreme pain and suffering.

The word ‘euthanasia’ comes from the Greek words ‘eu’ (good) and ‘thanatos’ (death).

Although euthanasia and assisted suicide are often used interchangeably, there are some important differences.

Whereas euthanasia involves a third party, usually a medical professional, directly administering a lethal dose of medication to end the patient’s life, assisted suicide involves a person, who may or may not be terminally ill, Including providing the means to end his life, such as a prescription for a lethal drug, which he self-administers.

In art, the concept has been introduced in several films and books, including the 2010 Bollywood film Guzaarish and the 2016 novel Me Before You by British author Jojo Moyes, which has also been adapted for the big screen.

major controversies

Most proponents of euthanasia argue that killing a terminally ill patient is no worse than letting him die. He says patients should have the right to decide what they want to do with their lives.

Although these arguments favor voluntary euthanasia, it is also argued that patients who have no hope of recovery may be euthanized to prevent futile treatment efforts.

Most of the arguments in favor are based on freedom of choice, dignified death, quality of life, using resources for those who can recover and want to live, not for those who want to die because they are terminally ill. People who are ill, and helping the sick and their loved ones end their suffering.

Critics of euthanasia argue that killing is wrong. They argue that non-voluntary euthanasia, where euthanasia is performed on the patient’s behalf based on the consent of someone who cannot do so themselves, violates the patient’s rights.

They also argue that physician-assisted suicide violates doctors’ duty not to harm their patients.

Some arguments are based on ethical and religious grounds, and the patient’s mental capacity when providing consent, and the possibility of the decision being driven by patients’ guilt due to the financial, emotional and mental burden of the disease. Critics also cite the possibility of overcorrection and misdiagnosis and the option of palliative care.

Another argument is that legalizing euthanasia is a slippery slope – widespread acceptance of the concept could lead to involuntary euthanasia or situations where people are forced to take this step due to the cost of treatment.

Particularly in cases involving mental health, it is argued that euthanasia undermines efforts to improve access to mental health care, and that mental illness is often episodic and thus, if patients receive appropriate treatment and support. If so, they can regain the will to live. ,

Death tourism in Switzerland and Belgium

Switzerland has emerged as a destination for individuals seeking euthanasia, allowing foreigners to access these services under certain conditions.

In 2018, Dignitas said that more than 90 percent of its members were foreigners.

Since euthanasia was legalized in Belgium, many patients from neighboring countries, especially France, have been coming there to end their lives.

Belgium’s euthanasia law is quite unique as it allows foreigners to submit a request to end their life in the country.

Euthanasia in India

Both euthanasia and assisted suicide are illegal in India.

The case captured national attention, especially in relation to the case of Aruna Shanbaug, a 20-year-old nurse from Mumbai who was brutally attacked and raped by a ward boy in 1973. The attack caused severe brain damage and left her unconscious.

The Supreme Court rejected the euthanasia petition filed for Shanbaug by writer-activist Pinky Virani, and he eventually died in 2015, having to remain confined to a hospital bed for the better part of his life. However, as part of the Shanbaug decision, the court allowed passive euthanasia subject to certain conditions.

In 2018, the Supreme Court legalized passive euthanasia by allowing ‘living wills’, allowing people to make advance decisions about treatment in a situation where they can no longer express consent.

The court ruled that “a person with mental capacity to make informed decisions has the right to refuse medical treatment, including the withdrawal of life-support equipment”.

In January 2023, the Supreme Court relaxed the norms for passive euthanasia.