This is a comprehensive presentation on euthanasia updated with whatever latest available information especially in context to India. It includes topic: Types of euthanasia, moral dilemmas, Aruna Shanbaug Case, Chandrakant Narayanrao Tandale Case, Other such prominent Indian cases, Recommendations, Few suggestions to check on the misuse of euthanasia, Opinion of the group as a whole on the topic euthanasia, conclusion and few self composed lines on our thoughts on euthanasia

1. LEGAL FRAMEWORK IN HEALTHCARE
Euthanasia
Group H
Members:
 Saumya Sharma - 0988
 Shanaia Kumar - 0991
 Shivani Vishwakarma - 0996
 Shruti Aggarwal - 1000
 Sonali Taggar - 1004
 Sriram Suresh - 1006
 Subham Mittal - 1009
 Supriya Sen - 1015
 Tanzila Bandmaster - 1024
 Vinny - 1038
 Yash Jain - 1041
Submitted to:
Dr. Ashok Kaushik
Dr. Ashok Peepliwal
Col. Dr. Mahender Kumar

2. INTRODUCTION
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Types of
Euthanasia
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3
Black's Law Dictionary
The act or practice of killing or bringing
about the death of a person who suffers
from an incurable disease or condition,
especially a painful one, for reasons of
mercy
Encyclopedia of ‘Crime and Justice’
An act of death which will provide a relief
from a distressing or intolerable condition
of living.
It is defined as the administration of
drugs with the explicit intention of ending
the patient’s life, at the patient’s request
Painlessly putting individ
uals to death for merciful
reasons
Active or Positive
Death caused when treatment
that is sustaining the life of the
patient is held off
Passive or Negative
It is primarily concerned with
the right to-choice of the
terminally ill patient who
decides to end his or her life
Voluntary Involuntary
A competent patient’s life
is brought to an end
against the wishes of that
patient
Non-voluntary
Ending the life of a person who is not
mentally competent to
make an informed request to die, such
as a coma patient

3. ETHICAL ISSUES
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MORAL
DILEMMAS
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Hippocratic Oath
 "To please no one will I
prescribe a deadly drug nor
give advice which may
cause his death"
 Do no harm
Doctor-Assisted Suicide
Doctor provides the patient with
the medical know how enabling
the patient to take his/her own
life
Is there a moral difference between killing someone and
letting someone die?
Geriatric, Dementia, Coma,
Survivors of severe head
injury, Terminal physical
illness, Incurable mental
illness, Severely impaired
children & adults
Who are these
patients?
Legislative Support
Erodes standard of end-of-life
care, upsets doctor-patient
relationship, available to a
wider group
No substitute for better
Research, Teamwork, Care,
Improved pain & symptom
management
Failure of conventional
treatments for a
terminal illness
Use of experimental drug
with some promise &
unpleasant side effects
Poster:
Posters.pdf

4. Aruna Shanbaug
Case
The Supreme Court specified 2 irreversible
conditions to permit passive Euthanasia
Law in 2011:
1. The brain dead for whom the ventilator
can be switched off
2. Those in Persistent Vegetative State
(PVS)
Aruna Ramchandra Shanbaug, a nurse, was
sexually assaulted by a ward boy, and went into
vegetative state in 1973 till her death in 2015 (42
years)
Writ petition was filed by Pinki Virani claiming that
her right to life guaranteed by the constitution has
been violated – it was rejected by the court after
medical examination
However, later in Aruna Shanbaug vs Union of
India, the Supreme Court in March 2011 held that
passive euthanasia could be allowed in exceptional
circumstances and under strict monitoring of the
apex court
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5. Chandrakant Narayanrao Tandale Case
81 years old
Chandrakant,
a permanent
resident of
Aurangabad
Admitted in
Kamalnayan Bajaj
Hospital, Aurangabad
for the treatment due
to enormous pain.
He was not able to
bear severe pain
Suffering from enormous
pain since June 2018, which
was neither operational nor
curable. Due to back disc
problem, he was bed-ridden
and required assistance for
moving from one place to
another place
Petitioner was mentally and
physically unable to face
severe pain. Hence, sought
permission from the Bombay
High Court to allow him to
have active euthanasia in
view of the Judgment of the
Hon'ble Supreme Court of
India
State/Respondent had
strongly opposed to allow
such prayer by filing
reply-affidavit.
It is the stand of the State
that active euthanasia is
not permissible in law
and if such exercise is
made, it would amount to
an offence
Hon'ble
Supreme Court
in case of
Common
Cause (Supra)
has only given
approval to
passive
euthanasia

6. PROMINENT CASES
Mr. Narayan and Mrs. Iravati
Lavate, 2018​
An elderly couple from Mumbai, wrote to
President’s office, seeking permission for
active euthanasia as they feared of falling
terminally ill and of not being able to
contribute to the society sought for permission
of mercy killing
Anamika Mishra, 2018​
A woman Shashi Mishra (59) and her 33-year-
old daughter Anamika Mishra, hailing from
Kanpur were suffering from muscular
dystrophy, with her father also losing life to
the disease, had written to the President
seeking permission for financial aid or passive
euthanasia due to poor financial condition
Dennis Kumar, Tamil Nadu, 2008
Dennis Kumar from Kanyakumari district
asked permission from the district collector
to grant euthanasia for his infant son who was
suffering from an unknown disease since
birth. Unable to bear the expenses for
his treatment or see his son’s suffering, Kumar
asked permission to give euthanasia, which
would relieve both his son and him of their
adversity
Jeet Narayan of Mirzapur in Uttar
Pradesh, 2008
Jeet Narayan pleaded for euthanasia for his
four sons to the president of India, Durgesh
(22), Sarvesh (18), Brijesh (13) and Sushil
(10) – all crippled and paralyzed below the
neck

7. RECOMMENDATIONS
Passive Euthanasia is
permissible under
supervision of law in
exceptional
circumstances, but
Active Euthanasia is
not permitted under
the law
“Liberty to die”’ if not
right in strict sense,
may be read as part of
the right to life
guaranteed by Article
21 of the Constitution
of India
It is felt that a terminally ill
patient who suffers from
unbearable pain should be
allowed to die because spending
valuable time, money and
facilities on a person who has
neither the desire nor the hope
of recovery is nothing but a
waste of time
Passive Euthanasia is
permissible under supervision of
law in exceptional
circumstances, but Active

8. SOME SUGGESTIONS TO CHECK THE MISUSE
Circumstances in which it would be lawful for a
medical practitioner to cease/ authorize the
cessation of life-sustaining treatment of a
patient who has no spontaneous
respiratory and circulatory functions or
whose brainstem does not register any impulses.
Euthanasia request should come from a
patient suffering from unbearable
pain from an incurable condition; the
physician must follow certain ‘due
care’ criterion
The right of medical practitioner responsible for
the treatment of a terminally ill patient to increase
the dosage of medication, with the object of
relieving pain and distress, even if the secondary
effect of this may be to hasten the patient’s death
Termination of life should be in a medically
appropriate fashion. Practice of
administering an injection to render the
patient comatose, followed by a
second injection to stop the heart
A person who is going to die:
(i) Must completely understand what
will happen
(ii) Must know about all other
alternatives to the treatment
Explicit and repeated request by the patient which
leaves no reason for doubt concerning his desire to
die;
Mental and physical suffering of the patient must
be very severe with no prospect of relief

9. Pain, peace and happiness are subjective feelings, so the point at which one
experiences intolerable pain to end up life may be different from someone who has
more tolerance to pain
We can argue that could a death wish have
been a symptom of the psychiatric illness?
This is a poignant question since it will
be difficult to differentiate between a request
based on a genuine and consent form of
unbearable suffering and a request as
a symptom of a severe depression.
In cases of mental disorders, physician-assisted
Death might be justifiable, but only when applicants
are fully informed, and have access to adequate
treatment options and support in (psychic) suffering.
GROUP OPINION
The need for specific criteria and guidelines in assisted
suicide for mental conditions and some unexplained
shortcomings in the practice of psychiatric euthanasia
should be considered.
To sum up, doctors responsible for the end-of-life care are often placed in dilemma of ethics regarding
life and death. Euthanasia can put an end to the suffering of long-term ‘NO CURE’ illnesses, by death.

10. Medical science is progressing in India as in the rest of the world, and hence currently we are having devises
that can prolong life by artificial means.
This may indirectly prolong terminal suffering and may also prove to be very costly for the families of the
subject in question.
Hence, end-of-life issues are becoming major ethical considerations in the modern-day medical science
in India.
CONCLUSION
The proponents and the opponents of euthanasia
are as active in India as in the rest of the world.
However, the Indian legislature does not seem to
be sensitive to these.
The landmark Supreme Court judgment has provided a major boost to pro-euthanasia activists, though it
is a long way to go before it becomes a law in the parliament
Moreover, concerns for its misuse remain a major issue which ought to be addressed before it
becomes a law in our country.
Euthanasia seems to have raised ethical
concerns in the society. Some of the key
issues include ethical, practical
and religious issues.
However, euthanasia encompasses immense ambiguity because there is a total absence of homogeneity
in the societal perception.

11. THANK YOU
“ ना तीर को, ना तलवार को,
ना धर्म के पहरेदार को,
इन पीड़ित सााँसों पे ड़वरार् का अड़धकार है,
के वल र्ेरी इच्छा को |”