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Euthanasia may be illegal but it’s not unpopular!

February 14, 2008

Euthanasia is illegal in most countries of the world. Here is a list, from this euthanasia site:

Both Euthanasia and Physician-Assisted Suicide are illegal in:

  • Canada
  • India
  • Israel
  • Russia
  • United Kingdom
  • Australia
  • Japan (however, a court had ruled in one case of Physician-Assisted Suicide legal)

Euthanasia may be illegal, but physician assisted suicide isn’t illegal, not in:

  • Germany:
  • Switzerland: Here, even a non-physician can perform it as long as it is proved that his motive is not a selfish one.bbc2.jpg

Both Euthanasia and Physician-Assisted Suicide are legal in:

  • The Netherlands since 2001
  • Belgium since 2002

The difference between Euthanasia and Physician-Assisted Suicide.
It may seem that a fine line separates both, but actually the difference is marked. In both types the patient wants to end his life, but in the second case, the doc is involved, he provides the lethal injection/medication. You can read about the distinction between the two terms here and here. But in neither type does the doctor himself administer the injection/medication as that is considered tantamount to murder.

The law doesn’t allow it but people want it
What I found even more interesting is that even though Euthanasia is illegal in almost all of the world, public attitudes are largely sympathetic to Euthanasia. I got these charts from this blog, and the data is originally from this world survey. I had saved these charts on my pc months ago, and now cannot find them on the original site.

euth1.jpg

Some countries like Japan, New Zealand and France scored more than 6 points out of 10 on the issue of euthanasia, which means that they felt that euthanasia was mostly justifiable. But those in countries like Ireland, Portugal and Hungary had a much lower score and felt otherwise.

Interestingly, in countries where Euthanasia has been de-criminalized, like the Netherlands, Belgium and Switzerland, more people are in favour of it. This makes one wonder whether legalisation tends to swing a certain section of the people who are sitting on the fence to change their view in favour of euthanasia.

There is significant support for euthanasia in the United States and the United Kingdom. More recent surveys show that almost two thirds of the population are in favour of it (wiki). In fact, people are travelling to countries which permit euthanasia so they can end their life! According to the bbc:

…many terminally ill foreigners, including Britons, now travel to Switzerland to commit suicide, taking advantage of the Swiss rules, which are among the world’s most liberal on assisted suicide.

Here is an Asia chart:

euth2.jpg

Overall, those countries which are dead against euthanasia are often so because of religious reasons. In India more people seem to be against it than for it. I am against euthanasia too, but I am ambivalent towards physician assisted suicide, if it is voluntary and the demand is from the terminally ill patient himself, assuming he is of sound mind.

I can’t help thinking of the case of Venkatesh, a young man with a genetic neurological disorder who was on life support. He wanted it turned off “before his organs suffer irreparable damage” as he wanted to donate his organs. But the case in the Supreme court dragged on (the High Court had rejected his request) and Venkatesh died before his last wish could be fulfilled.

Is Mercy Killing a form of assisted suicide?
There is an interesting article, which talks how important it is to distinguish between euthanasia and mercy killing. It is written by Dr. Ram E. Rajagopalan, Consultant & Head, Department of Critical Care Medicine, Sundaram Medical Foundation, Chennai. He writes:

…there is an urgent need to make the public aware of the distinction between `euthanasia’ (also called `mercy killing’) and the limitation or withdrawal of life-prolonging treatments (treatment limitation) in individuals who have a negligible chance of recovery.

Euthanasia is an act that, however well intentioned, aims to end a life. The primary purpose of the act is to use the termination of life as a mode of `providing relief’ from discomfort. In contrast, the act of treatment limitation provides relief by minimising or eliminating treatment options that do not enhance survival.
Recent advances in medical treatment and life-support technology have offered immense benefit to many patients who may not have survived an illness of comparable seriousness even a few decades ago. However, for every life saved by these innovations, there are many others who do not recover and who are left inexorably on treatments and support that only aggravate their pain and suffering.

India stands out as one of the few countries in the world that have no laws on limitation of treatment.

It’s a persuasive argument, but the truth is even in countries where the rule of law is strong, like Holland and Switzerland, there are some cases where these “end-of-life decisions (took place) for morally unacceptable reasons.”

There will always be someone who takes this critical decision, the decision that survival will not be enhanced, and well, that is the pitfall.

Related Reading: Suicide rates of the world and why people kill themselves
Some reasons for the high suicide rate in India
Some tips on how you can help people manage their depression and grief
Rejecting others and isolating them seems to be a human trait (about the suicide of a young student)
Humans like forming ghettos

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28 Comments leave one →
  1. Raj permalink
    February 14, 2008 4:29 pm

    Nita,

    Thanks for this balanced article on a subject that interests me a lot.

    Personally,I am totally against any form of killing a person (except for self-defence or defence of a helpless person)-and that INCLUDES the uncivilised punishment called the death penalty,but that is a different topic altogether.

    But euthanasia is a different matter.If a person feels that his life is too miserable to bear and no medical treatment can help him,he should be allowed to end his life painlessly.Efforts must be made to give the person the best treatment possible and he/she should be talked out of it if it can be done,but if the person still feels that it is too much to bear,then it must be that person’s own choice.

    Physician assisted suicide is a different issue.Under no circumstances should a physician be allowed to kill a person,it is against medical ethics and the Hippocratic Oath apart from being inhuman.And I think that no one should be allowed to do the job of a hangman either.I really do not know how to deal with a case where the person undergoing treatment is in no condition to state his/her wish and did not declare it previously.

    On the subject of suicides,I think the obsolete and shocking law of treating attempted suicide as any other “-cide” should be SCRAPPED IMMEDIATELY.A person who has attempted suicide should be treated a victim who needs psychological or other forms of help and not as a criminal.It is like punishing a woman who is a victim of sexual assault rather than punishing the culprit(s).The REAL CULPRIT(S),the person(s) who drove the victim to suicide,must be punished and not the victim.Every completed suicide (I don’t know if successful suicide is the right word) must be treated a homicide or even a murder and the culprits must be found out and brought to book and punished severely.

    On the subject of treatment limitation or withdrawal of treatment,again it should be that person’s wish alone (if there is really no chance of long term survival) and not that of anyone else.

    I think J.K.Rowling has beautifully explained almost all aspects of death (and,indeed,of life itself) in her best selling Harry Potter series (especially the last book ‘Harry Potter and the Deathly Hallows’).I am tempted to quote Dumbledore who chose to end his own life in a manner of assisted suicide that was used for his own advantage (and that of others as well).The wise old headmaster of Hogwarts tells Harry after his death (I really do not know what to call Harry’s state-may be out-of-the-body-experience would do) “Do not pity the dead,Harry,do not pity the dead.Pity the living,especially those who live without hope”(I think he used love instead of hope).By the way,I am no death-eater !

    • beth permalink
      May 19, 2009 8:09 pm

      i think this was a well done argument and enjoyed reading it and i love harry potter too

  2. February 14, 2008 5:01 pm

    Thanks Raj, for your views. I certainly believe that those who attempt suicide should be treated as victims and not criminals. Indeed, the law in our country is too harsh regarding this.
    About physician assisted suicide, the physician himself is not allowed to do the job. If a terminally ill patient wants to die, he might require a painless method to do so and this is where a physician comes in. Docs often know the best and most painless method and where to procure the tools for it. A person who is very sick and say bed ridden has no way to do the job himself.
    In any case, the problem with all these issues lies in implementation, and we know that in a country like India, where there is so much corruption, legalizing euthanasia in any form will not work.

  3. February 14, 2008 6:08 pm

    Both (Euthanasia and Physician-Assisted Suicide) are very sad and horrific way for a person to die. I know a case where the person committed suicide because he was suffering from cancer and he could no longer withstand the pain. He was my neighbor.
    For us we can debate whtether that both or one of these practice(s) can be justified or not, but then for a patient on the death bed there is no right or wrong.
    But ofcourse its a very difficult decision for the loved ones even if the patient insist on dying.

  4. Rajesh permalink
    February 14, 2008 6:39 pm

    Hi Nita

    Nice Article..I have come across many old people wanting to do the same. There are lot of old age homes and the concept of nuclear families is prevailing now.Firstly these old people feel that they are burden to their sons and daughters , as they have to take care of them. When these people are physically and financially dependent, they lose hope in their lives. They feel that there is no point to stay alive . At this stage they dont get the respect , love from thier dear ones.So most people end up in suicide.

    It also makes me to think in other way…

    A person who is suffering from renel failure undergoes dialysis daily.Its just he is dying out of pain daily and getting back his life. If the doctor says there is no hope of survival without this brutal painful process of dialysis , why should he be alive till he gets a natural death.
    I think if the affected person and his dear ones agree to this ethunasia, then it has to be carried out for the good. It is emotionally hard at this stage…but it is better than suicide which is an onesided act.

    I agree that there are lot of issues or difficulties in leagalising or implementing this in India, but if this is not in place then the number of suicides could grow larger in comming days..

    Thanks
    Rajesh

  5. February 14, 2008 6:48 pm

    Thanks for the article Nita. I firmly believe that the individual, in the case of illness, should be able to decide before death, how and what treatment should be given. Many States allow a DNR (Do Not Resuscitate) but many hospitals and doctors will not abide by that request. A Living Will as well does not have the force of law.

  6. February 14, 2008 9:23 pm

    As per hindu mythology Bhisma chose when he gets to die, now does this constitute euthanasia? Its really interesting topic, will need to think a lot more, will be back later for sure..

  7. February 14, 2008 9:45 pm

    I didn’t really know that Euthanasia and PAS are two different terms because generally, people only use the term euthanasia. Also, I blame it on my general medical ignorance.

    Getting back to the point, I think the second link your provided (that explains the difference) is by a guy at MySpace and shouldn’t really be taken as an authoritative source. I found this at Medicinenet.com:

    Euthanasia is the intentional termination of life by somebody other than the person concerned at his or her request. Assisted suicide means intentionally helping a patient to terminate his or her life at his or her request.

    So, it doesn’t mention anywhere that the doctor “indirectly” causes the death, as far as Euthanasia is concerned. I found the definition given at the MySpace page a little confusing for some reason, because the guy says:

    Physician-Assisted Suicide, or PAS, is when a competent, terminally ill patient makes a decision to commit suicide by requesting a lethal dose of medication prescribed by a physician. The act is committed by the patient, not the doctor. The doctor is merely prescribing medication at the patient’s request. What the patient does with said medication is up to the patient. Physician-Assisted Suicide is most often confused with Euthanasia. Euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient’s life (Braddock).

    I think what he’s saying is quite restricted, because he’s focusing only on the “direct” or “indirect” act of the doctor.

    How does it matter whether the patient really wants to die and requests it or if the doctor decides to end the patient’s life? Sometimes a patient might be too ill to even speak or make known that he would prefer dying. In such a case, wouldn’t euthanasia be justifiable? As long as the bottomline is to relieve the patient of his or her pain and there has been no mistake in thinking that this – ending the life- is what the patient would really want, euthanasia is fine, according to me.

  8. Guqin permalink
    February 14, 2008 11:27 pm

    Is giving birth to someone into this vulnerable world and go through life and eventually death course without asking him/her first more moral than helping him/her to leave this same world with asking him/her first?

    It is an ethical but legal issue. Law simply doesn’t have the reach to decide. If it does, then giving birth should be illegal too (Who gives you the right to create death by creating life?). This is a classic example of the paradox of rationality. Life is a blind force. The only thing law can say should be that, ANY LEGALIZATION OR ILLEGALIZATION OF SUICIDE IS ILLEGAL. Rationalizing death in itself is barbaric. This is also a classic example of the fallacy of western culture: the tynany of reason. If at the very end of life, we still can not give up the delusion of reason, and should die “legally”, what is the point of creating “civilization” in the first place? It is immpressive to see such situation should come up in any form of culture, but more immpressive such situation should be brought to other societies like India that supposedly understand the essence of life and are more respectful of its mystery.

    A healthy society should provide enough spiritual, moral and ethical background to guide its people through each case individually. The key word is simple, Sympathy, to see what the patient sees. I mean natural, genuine Sympathy. Yet a society of the modern western norm doesn’t have this. So it doesn’t matter how sincere its law makers are in attempt to resolve this paradox, its result is most likely a bitter one for it must be a general one.

    Each case is different. This is all we can say and should know.

  9. February 14, 2008 11:39 pm

    great analysis
    what stunned me was the statistics about Asia’s acceptance to this practice of euthanasia or assisted killing
    is it real and is it that unpopular here in India
    a land that has euthanasia in our historic / mythological text of Mahabharata with Bheshma having the power of giving up his life or icha mrityu, is this real or credible and how was the survey done ?
    Never mind the courts – they are never bothered about the real world – or whether justice delayed is justice denied – as far as they get seaside or ridge side bungalows and red siren cars- no wonder the person at the end of the wealth chain has totally lost faith on it..

  10. February 14, 2008 11:58 pm

    This is a controversial topic anywhere you live, I think. We have in the US a physician named Kavorkian, whose name is synonymous with physician-assisted euthanasia. He was recently released from jail after a lengthy sentence.

    Then there was the case of Linda Sciavo, whose parents wanted her on life support, but whose husband wanted her taken off of it. She had been in a vegetative state for months, if not years.

    The religious right, including President Bush, rallied behind the parents, using the case as an example of the fundamental right to life (the name of the anit-abortion movement as well).

    In the Sciavo case, I was completely in favor of taking her off life support. People only used her as a political tool to further their religious values.

    As far as Kavorkian and his type go, I think he’s wading into murky water. Is he really a good enough doctor to judge a patient’s condition? I wouldn’t want that responsibility.

    There’s an excellent film from Spain on this topic, about a true story. In English the title is The Sea Inside. In Spanish, Mar Adentro. You can find it on DVD.

    Interesting post, Nita. I Can’t say exactly what my final opinion is. I know that I abhor suicide. But I also don’t want anyone to live in continuous pain.

  11. February 15, 2008 7:10 am

    Interesting post!

    I think most of the times people are inclined to say that euthanasia is wrong (me included!) But, a brilliant spanish movie “Mar Adentro” (Sea Inside) made me rethink on my beliefs. Now, I feel people with absolutely no hopes of survival should have a choice what they would want to do with their life. But yes, its not as simple as that, as it would allow relatives of terminally ill patients to take advantage of any legal loopholes.

  12. February 15, 2008 7:12 am

    Xylene, it’s an ever present dilemma but as you said that for the one who is on the death bed there is no right or wrong! very nicely put.

    Rajesh, if an old person wants to die because he feels he will be a burden, that is indeed very sad! but yes due to financial difficulties, lack of medical insurance in India and lack of govt. health schemes, it often happens that people don’t have money for treatment. I know of people who have blown up their life savings on taking care of their parents but not everyone can or will do this.

    Prax, we need to always take stats with a pinch of salt but I do believe that certain people in India are strongly against euthanasia as they are religious and I don’t necessarily mean Hindus. ofcourse they are not the majority, but where hindus are concerned, look at it this way:
    A lot of Indians believe in natural treatments (more indians go to homeopathic docs than allopathic, which I will be writing about next week) and therefore refuse treatment for say cancer. But if asked, I doubt whether these people will say they are going for euthanasia. They would not see it as assisted suicide, but a natural death.

  13. February 15, 2008 7:27 am

    Brian, I agree that a person should be allowed to choose, as long he is of sound mind. At times during depression one can make the wrong decision.

    Rambler, true, indian mythology has examples, but our laws are based on british laws. that is why sadly even those who attempt suicide are seen to be criminals. i am not sure whether laws in britain are still like this.

    Ruhi, thanks. I didn’t know of this subtle difference either until i started to research this subject. and true, that myspace guy has written things in a slightly confusing way! that’s why I gave both, but I think after reading your comment, I might delete the second link.
    Finally as you said it doesn’t matter how it’s done. My reading is that this fine distinction is done to protect/prosecute doctors because there are many cases where doctors are only too willing to help and it’s easy for them. once a doc assisted suicide is labeled as that, then I guess, it becomes transparent.

    Christine, thanks. I too have an ambivalent attitude to this, just like you. Certain cases make one think it’s okay but one is fearful of the law permitting it, particularly in countries where it can be easily misused.

    Vasuki, I was at one time very much in favour of suicide! I mean I felt that if a person wanted to die, he should be allowed to, for whatever reason. and it should not be considered a crime. But now I feel differently as a person can change his mind and people around them should try and persuade someone not to take the extreme step, even if it is a decision not to prolong treatment. But finally, the decision should rest with the person who wants to end his life.

  14. February 15, 2008 10:39 am

    Gugin, thanks. Yet again, your comment is a profound one. When you say:

    The only thing law can say should be that, ANY LEGALIZATION OR ILLEGALIZATION OF SUICIDE IS ILLEGAL.

    It really hits the nail on the head!

  15. Phantom permalink
    February 18, 2008 9:47 am

    What right does the state have, to prevent a person from escaping the intolerable physical suffering that many terminal/debilitating conditions bring about. Someone who is in constant discomfort and pain, or who appreciates the futility of trying to stay alive, or also the extreme mental/emotional trauma that his close ones are going through….as long as they have taken a decison while in sound mental capacity, and not a knee jerk emotional reaction to a particular bout of pain/discomfort…..shoul;dn;t they be allowed to do what they feel is the right thing.

    Me personally, god forbid, if I were ever in a situation where pain and discomfort were intolerable and a complete lack of possibility of medical improvement, I’d be happy to choose to end this life. After all, there are many more lifetimes in this cycle of life to live….but thats a different discussion, I wont go there :)

    What is the point of having someone on life support, especially when there is no logical expecation of any improvement. From a hardnosed perspecttive, it is only being a financial burden, that other tax payers eventually have to shouder. Yes, it is easy to say this as an outsider, but just as in the marie schiver case the husband of the woman on life support had accepted his decison for his wife to be taken off the life support….similarly, we should appreciate that there comes a point, when we just have to move on….the patient has to be given release from the dicomfort, the close ones have to get closure, and move on. After all….isnt it better to know when your loved one is going to depart, rather than lose them in a sudden tragedy like a heart attach, stroke, accident, suicide???? A terrible justtification I know, but worth a thought.

    Its pointless to compare euthanasia with suicide, as the latter is mostly a function of the person uin question being pushed to that point by a progressively increasing depression, sadness…for which there can be a large variety of reasons. IN euthanesia the patient is seeking closure for himself as well as for his close ones…its a noble act if u ask me…..in most cases suicide is indicative of a weakened phychological condition…….which can often be cured by suitable therapy, change in circumstances/fortune etc. However debilitating/terminal physical conditions cannot be cured, and hence this comparison is unjustified. MOreover, in euthanesua, there is complete transparency and the close ones are not left feeling betrayed or have any guit imposed on them for perhaps being responsible for the suicude.,

  16. dalia permalink
    July 3, 2008 7:54 am

    hi nita,
    i’m doing a debate for homework on why euthanasia should stay illegal. by the way i am against euthanasia .
    but i believe you shouldn’t be afraid of death. but what if it was you who was dying in to much pain. would you want to end your life without pain. or what if u were the doc and they asked you to inject them. what would you do?

  17. Brisbane permalink
    April 23, 2009 4:01 pm

    Please take Australia of that list of places where euthanasia is legal.

    euthanasia used to be legal in the Norther Territory ( a territory in Australia) but it is not legal anymore, anywhere in Australia.

  18. SkinnyT permalink
    December 2, 2009 7:32 pm

    hi and thanks. found intresting for my coursework. skinny t

  19. monisha permalink
    January 14, 2010 6:56 pm

    Dear Nita,
    I hv gone through your views on euthanasia. its very useful for me . I m doing my Ph.D. on “”A Comparative study of euthanisain its philosophical,moral,legal and theogical perspective; with special refrence to india”‘. my Chapeterization scheme is as meaning, concept ,nature and scope of euth. euth.& Human Rights, euth. & international law, EUth.and indian constitution, Social legal perspective of india.
    now i request u, would u like to help me in providing material on these aspects. if time permits you pls help me and send material on such subject. i will be highly oblized to you. thx.

    I am unable to help anyone with their projects. I get scores of such requests every month. It is quite impossible, that too on a thousand different subjects. I have collected information and presented it here and I am glad it was useful to you. – Nita

  20. Dr T. S. Amara nath permalink
    March 20, 2010 2:36 am

    Dear Nita, I am studying about euthanasia since some months.I most of the times was getting web sites & articles of foreign authors. After reading your article Iam proud that even in our country i.e., India also there are like minded people like you who say euthania must be implemented in India. Though law is not allowing euthanasia in our country behind the scene it is going on. Legalising euthanasia with a strict vigil of judiciary and the court order must be made mandatary before allowing mercy killing. Corrupt people are everywhere who missuse the law for their gains. so intervension of judiciery in very important before allowing mercy killing. Here I do not want to use word KILLING. Instead Iprefer to use the word GIVING MOKSHA FROM UNBEARABLE PAIN

  21. JoOD permalink
    May 4, 2011 5:57 pm

    It is very interesting topic

    actually I’m writing a research paper about it so I took some statistics from this article

    and I have to cite the so Nita can you give me your family name please?

  22. JoOD permalink
    May 7, 2011 5:41 am

    thanks a lot Nita =)

  23. MELISSA permalink
    October 31, 2011 5:56 pm

    I LOVE HARRY POTTER TOO BETH!!!!!!

  24. Tanazia permalink
    April 4, 2012 6:26 pm

    i dont think that eutanasia is a good choice because of the family and the person. a person could be misdiagnosed and could acually be alive but then get killed by this procedure. i also think that the person should hav the right to say earlier if they want to be euthanised or get the plug pulled on them, either way it is sad and really plays a big role in a families sorrow.

  25. SJBC permalink
    May 10, 2012 12:23 am

    I think that Euthanasia should be legal, to end ones suffering when they shall die later, in greater pain. Of course, this is only if they are terminally ill. Also, Tanazia, it’s HIGHLY unlikely that someone is going to be ‘alive and then killed by this procedure’ to use your words. There are several procedures that have been and would be put into place: such as the 5 month signature plan! Know what you are talking about!!!

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