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1 April 2017 Question Bank

 

1st APRIL 2017 

QUESTION BANK

(1 Question)


Answer questions in NOT MORE than 200 words each. Content of the answer is more important than its length.

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GS II : POLITY  BILL/ACT

1.     Discuss the major provisions of the Treatment of Terminally Ill Patients Bill, 2016. Should euthanasia be allowed in India? Discuss judicial rulings on the matter.

(Similar question on 8th Oct 2016)

http://www.thehindu.com/opinion/op-ed/terminally-ill-patients-bill-sharpening-a-pro-choice-debate/article17752949.ece


The Treatment of Terminally Ill Patients Bill, 2016 contains several prominent features:

1.     It defines "terminal illness":

  • This Bill defines "terminal illness" as a persistent and irreversible vegetative condition under which it is not possible for the patient to lead a "meaningful life".
  • The use of this subjective phrase would require second parties to decide whether a person in a permanent vegetative state is living a life that is meaningful.
  • It also gives rise to the practical question of how a person in a permanent vegetative state will be able to self-administer the lethal dosage of drugs to commit suicide.

2.     It recognises the validity of advance medical directives by terminally-ill patients, which physicians will be bound to respect while treating them

3.     It emphasises the need to account for palliative care when making end-of-life-care decisions.

4.     However, the provisions most likely to attract popular attention are those permitting physician-assisted suicide for terminally-ill patients.

5.     Right to assisted suicide

  • The first efforts have been made in this direction through this Bill, which recognises the right of terminally-ill patients to withhold and refuse medical treatment. It does not permit active euthanasia.
  • Once the practitioner is satisfied that the patient is competent and has taken an informed decision, the decision will be confirmed by a panel of three independent medical practitioners.
  • In the case of incompetent patients, or competent patients who have not taken an informeddecision about their medical treatment, the Bill lays down the process before any action can be taken for the cessation of life.
  • Once the medical practitioner and independent panel are satisfied that euthanasia is medically advisable, permission would have to be sought from the High Court. The practitioner would then have to receive clearance from the Medical Council of India (MCI).

Euthanasia:

  • Over a decade ago, the government felt that legislation on euthanasia would amount to doctors violating the Hippocratic Oath and that they should not yield to a patient's "fleeting desire out of transient depression" to die.
  • Euthanasia deals with the question whether patients who are terminally ill and possibly beyond the scope of medical revival can be allowed to die with dignity.
  • The question was raised with a great deal of passion in the case of Aruna Shanbaug, a nurse who lay in a vegetative state in a Mumbai hospital between 1973 and 2015.

Judicial rulings

  • In its judgments in theAruna Shanbaug (in 2011)andGian Kaurcases, the Supreme Court has stated that the law currently only permits passive euthanasia, i.e. withdrawal of life-saving treatment.
  • The administration of a lethal drug dose by a physician (active euthanasia) or by the patient herself (assisted suicide) would constitute attempts to commit or abet suicide under the Indian Penal Code, 1860.
  • However, in both these judgments, the court stated explicitly that assisted suicide was only illegal in the absence of a law permitting it. Therefore, assisted suicide could be legalised if legislation was passed by Parliament to that effect.
  • The question before a Constitution Bench of the Supreme Court on a petition by the NGO Common Cause is whether the right to live with dignity under Article 21 includes the right to die with dignity, and whether it is time to allow ‘living wills', or written authorisations containing instructions given by persons in a healthy state of mind to doctors that they need not be put on life-support systems or ventilators in the event of their going into a persistent vegetative state or state of terminal illness.

Centre's stand on euthanasia:

  • After 14 years of debates and several draft Bills, the government has said in January 2016 that it is ready to frame a statutory law on passive euthanasia, the act of withdrawing medical treatment with deliberate intention of causing the death of a terminally-ill patient.
  • The affidavit filed by the Ministry of Health and Family Welfare in the Supreme Court on January 28, 2016 informed the Supreme Court that an expert panel has made changes and cleared the formulation of legislation on passive euthanasia after extensive debates, from July 2014 to June 2015.
  • The committee however refused on legalising ‘active euthanasia' - an intentional act of putting to death a terminally-ill patient - on the grounds that this would lead to potential misuse and is practised in "very few countries worldwide".
  • However, it said its "hands are stayed" because of a pending litigation in the Supreme Court on mercy killing.
  • The issue is under the consideration of a Constitution Bench of the Supreme Court since February 2014.

History of Legislations:

  • The affidavit traces back to how the debate on legalising and regulating euthanasia began with a Lok Sabha private member's Bill - The Euthanasia (Regulation) Bill, 2002 - which was examined by the Health Ministry.
  • The debate kick-started again four years later, following the 196thLaw Commission Report on euthanasia and the drafting of the Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill, 2006.
  • But the Ministry's experts under the Director General Health Services took a stand against euthanasia for reasons that it amounted to "intentional killing" and against the Hippocratic oath.
  • The affidavit said of how the Government even viewed euthanasia as an act against progressive medical science's objective to rehabilitate and treat patients. "Death may be a fleeting desire arising out of transient depression" and doctors should not fall for the patient's wish to escape suffering by embracing death, it said.
  • The affidavit also said the Government's perceptions about euthanasia changed in 2011 when the Supreme Court issued comprehensive guidelines allowing passive euthanasia in the tragic case of the bed-ridden former Mumbai nurse Aruna Shanbaug. In her case the staff of KEM Hospital took care of her till her natural death in 2015.
  • The apex court's guidelines, accepted by the Government, led to the Law Commission's 241stReport recommending a re-look at passive euthanasia in 2012.
  • The Law Commission subsequently took full two years to draft a new law on the subject. The Ministry had received the draft Bill in April 2014 and begun its task to fine-tune the law - The Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill, 2016.
  • However, there seems to be no support for the idea of a ‘living will', as the draft says any such document will be ‘void' and not binding on any medical practitioner. It is logical that it should be so, as the law will be designed specifically to deal with patients not competent to decide for themselves because of their medical condition.
  • The Supreme Court has said Parliament or the "people's court" should be the final judge to decide the legality of passive euthanasia and "Living Will".


 

 

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