Legal rulings on suicide in India and implications for the right to die

In this paper I am concerned to address the question of voluntary or self‐willed death from two distinct positions—a particular community's socio‐religious practice (viz. Jaina sallekhanā) and as the matter stands in law (penal code, constitution, judicial wisdom, etc.) in India—in the light of the recent move by a bench of its apex court striking down the penal code section proscribing suicide. I also wish to draw out some implications of these deliberations for the beneficence of medical practice and related bio‐ethical ramifications in the Indian context.     

Autonomy,life as an intrinsic value,and the right to die in dignity

This paper examines two models of thinking relating to the issue of the right to die in dignity: one takes into consideration the rights and interests of the individual; the other supposes that human life is inherently valuable. I contend that preference should be given to the first model, and further assert that the second model may be justified in moral terms only as long as it does not resort to paternalism. The view that holds that certain patients are not able to comprehend their own interests in a fully rational manner, and therefore ‘we’ know what is good for these patients better than ‘they’ do, is morally unjustifiable. I proceed by refuting the ‘quality of life’ argument, asserting that each person is entitled to decide for herself when it is worth living and when it is not. In this connection, a caveat will be made regarding the role of the family. The author’s research interests include bioethics, free speech, tolerance and ethics in the media.     

The right to die at the end of your life

The Missouri case of Nancy Cruzan brings into sharp focus the medical ethics issue of the right to privacy. It also raises the need for definition of life ranging from cellular to personal. What is it about forced feeding that transforms it into an extraordinary means of nonfunctional treatment? There is the question of balancing benefit and cost (whether personal or financial). Currently we are confronted by the problem of balancing human rights violations against efforts to be “helpful” by the use of heroic medical measures, all of this against the background of ever-changing medical technology.     

Competency,and other constructs,in right to die cases

Subjects had to make a “remove” or “do not remove” life-sustaining measures decision in three right to die cases where the patients differed in competence; for half the subjects, a living will was present in all the cases, whereas, for the other half, it was not. Subjects also gave their determinative reasons for their decisions. Support for the right to die varied by case, but not by competency, or by the presence of a living will. The subjects' reasons were highly predictive of their decisions, and related to the way case-specific facts were construed, revealing a number of disparities between the way courts and citizens construe whether the patient's condition is “terminal,” “irreversible,” and “painful,” or not. Beyond construing facts differently, the results also revealed a disparity between evolving case law and the community's “common sense justice” over a fundamental belief: whether dying is seen as private matter, outside the bounds of State intervention, or not.