When a person decides to end his or her own life purposely to get rid of the pain and the suffering that he or she is going through, is called euthanasia. There are five types of euthanasia, namely:

1. Active euthanasia: When a patient is given drugs intravenously to end their life on purpose by someone.

2. Passive euthanasia: When a patient dies as the required treatment to live life is withheld by a doctor.

3. Voluntary euthanasia: When a patient decides to die consciously and requests assistance in the same.

4. Non-voluntary euthanasia: When someone else decides for the patient (in cases where the patients are incapable of giving permission themselves) that he or she has to die, based on their previous wishes.

5. Involuntary euthanasia: When a patient dies against his or her own wish i.e. they are killed [1].

HISTORY:

Year - Event
• 5 B.C.E - 1 B.C.E.: Greeks & Romans tolerated infanticide, active euthanasia & suicide; the Hippocratic Oath prevented physicians from assisting in active euthanasia but many of them backed voluntary death instead of extended pain to the patient.

• 1st Century A.D. - 16 Century: Voluntary death in the medieval ages was hardly seen; almost the entire medical fraternity turned against it.

• 17 Century: The common law approach was followed by most of the early American colonies.

• 17th - 18th Century: No discussion on euthanasia & suicide was possible due to the authoritarian approach of the Church.

• Late 18th Century: Rejection of euthanasia & suicide prevailed amongst Americans.

• 1828 New York allows assisted suicide to be carried out- the 1st US state to do so.

• 1885 : Euthanasia discouraged by American Medical Association.

• 1935: Formation of Voluntary Euthanasia Legislation Society.

• 1936: In Britain’s Upper House of Parliament, the Euthanasia Legalization bill gets a thumbs down.

• 1950: A big 'NO' to euthanasia from the World Medical Association.

• 1970s: Patients beginning to be empowered so that they choose between continuing or ending their own life at the end.

• 1990s: Support for PAD from more than half the American population

• 2001: Euthanasia is legalized in the Netherlands

• 2008: Euthanasia & PAD is legalized in Luxembourg [2]


STATISTICS:

In the US:

Euthanasia is illegal, all over the US.

1. 54% of the doctors gave their consent for euthanasia.

2. 86% of the common people backed euthanasia for the dying.

3. 55% of the patients are in pain when dying [3].

4. States that permit Physician-assisted suicide (PAD): California, Montana, New Jersey, Oregon, Texas, Washington, Vermont [4].

Some of the groups that encourage euthanasia & PAD in the US

- Exit International [5]
- Compassion & Choices [6]
- Euthanasia Research & Guidance Organization [7]
- Patient Choices [8]

In the UK & Scotland:

In the UK & Scotland, euthanasia is illegal till date [9],[10].
Some of the groups that encourage euthanasia in the UK & Scotland:
- Compassion in Dying [11]
- Voluntary Euthanasia Society of Scotland [12]
- Friends at the End [13]

In Australia:

Euthanasia is illegal here as well.

1. 70.6% of the Australian people are of the opinion that there should be legalization of euthanasia.

2. 54.4% are of the opinion that if a dementia patient cannot identify with his immediate kith & kin and wants to end his or her own life with someone’s assistance, then that option should be allowed [14].

Some of the groups that encourage euthanasia & PAD in Australia:
- West Australian Voluntary Euthanasia Society [15].
- Syndicated Australian Voluntary Euthanasia Youth Advocates [16].
- Dying with Dignity NSW [17].

In India:

Legalization of Passive Euthanasia was done in March 2011 by the Supreme Court of the country (active euthanasia still goes against the laws of the land) [18].
There is no research that has been carried out till now to gauge the public & professional sentiment related to euthanasia in India [19].

Organizations that encourage euthanasia & PAD in India:
- Society for the Right to Die with Dignity [20]

THE ISSUES:

• Ethical issues:

Can Voluntary Euthanasia (VE) or Assisted Suicide (AS) be reasonable enough for any type of unmanageable pain or suffering? Palliative care is another option that exists for patients at the end of their lives. It covers the aspects of pain such as physical, emotional, social and spiritual. Also, the public backs VE/AS for patients suffering from unmanageable physical pain as opposed to the mental aspect of it. The end-of-life care even reduces the amount of repeated calls for VE/AS. Forcible legalization of euthanasia would result in distrust towards healthcare providers; hence, raising the discomfort & suffering levels amongst patients.

One should not reduce patients who are at the end of their lives to only biological creatures- by keeping them alive through costly equipments only. Care has to be given to the entire human being rather than to a particular organ.

When we give autonomy to patients in choosing VE/AS for themselves, it would be very hard to tell if the choice of death is informed, voluntary, competent & sincere (since terminally ill patients are often affected by confusion, depression & their economic circumstances). Hence, safeguards should be there to reduce the pressure on the patients while making their own decisions.

'Good death' is a concept rejected by persons who provide palliative care for terminally ill patients while for those persons who want VE/AS legalized, it should not be a hindrance to patients whose quality of life is already on the downside [21].


• Moral issues:

The utilitarian approach is that VE/AS is morally right as it reduces pain & suffering of countless number of patients who are terminally ill. Today’s approach is a bit different: stress is laid on respect for human rights, freedom & justice. For e.g. a terminally ill patient does not want to give up his life. But according to the above mentioned thinking it would be right on our part to put this patient to rest. This would increase happiness all around, by reducing his misery. But on the other hand this would amount to murder which is also not acceptable to anyone.

In a different situation, if patients themselves ask for voluntary euthanasia then there is no question of trampling with an individual’s rights.

Hence, this approach is still a formidable entity [22].

• Legal Issues:

Different Acts and guidelines have been passed in various countries- arguing in favor of and against euthanasia. But all around the world, euthanasia can be legally carried out in some states of the US and the whole of Netherlands, Belgium and Columbia [23].


REFERENCES:

1. http://www.nhs.uk/conditions/euthanasiaandassistedsuicide/Pages/Introduction.aspx

2. http://euthanasia.procon.org/view.timeline.php?timelineID=000022#5th-century-bc-16th-century-ad

3. http://www.statisticbrain.com/euthanasia-statistics/

4. http://en.wikipedia.org/wiki/Euthanasia_in_the_United_States

5. http://www.exitinternational.net/page/AboutUs

6. http://www.compassionandchoices.org/what-we-do/

7. http://www.finalexit.org/

8. http://patientchoices.org/about/

9. http://en.wikipedia.org/wiki/Euthanasia_in_the_United_Kingdom

10. http://www.eauk.org/current-affairs/politics/scottish-parliament-rejects-euthanasia-bill.cfm

11. http://www.dailymail.co.uk/news/article-1381321/Euthanasia-charity-launches-die-helpline.html

12. http://www.euthanasia.cc/vess.html

13. http://www.friends-at-the-end.org.uk/information/59-why-we-support-assisted-dying-and-voluntary-euthanasia.html

14. http://www.heraldsun.com.au/news/national/most-want-euthanasia-legalised-in-australia/story-fndo317g-1226519320608

15. http://www.waves.org.au/

16. http://www.linkedin.com/groups/SAVEYA-Syndicated-Australian-Voluntary-Euthanasia-4550804

17. http://www.dwdnsw.org.au/page/links.php

18. http://en.wikipedia.org/wiki/Euthanasia_in_India

19. Tadros G, Khan F. Physician-assisted suicide and Euthanasia in Indian context: sooner or later the need to ponder! Indian Journal of Psychological Medicine. 2013; 35[2]: 101-105.

20. http://ibnlive.in.com/news/ftn-the-euthanasia-debate/107330-3.html

21. Hurst S A, Mauron A. The ethics of palliative care and euthanasia: exploring common values. Palliative Medicine. 2006; 20: 107-112.

22. Rachels J. The Morality of Euthanasia (Chapter 17). The Right Thing to do. 2007; 4: 151-155.

23. http://www.ask.com/question/what-countries-is-euthanasia-legal-in



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