domingo, 11 de marzo de 2018

Landmark Indian court decision on ACDs and withdrawal of treatment

Landmark Indian court decision on ACDs and withdrawal of treatment


Landmark Indian ruling on advanced care directives and withdrawal of treatment
India's Supreme Court has handed down a landmark ruling authorising the use of “living wills” and streamlining the process for the withdrawal of treatment from dying patients.
The ruling -- which was in response to a plea made to the court by the public interest group "Common Cause" -- allows adults to write an advance directive indicating that they do not wish to receive life support if in a comatose or permanent vegetative state. The five-judge panel also outlined a process by which doctors and family members could apply through the courts to have life support withdrawn from a terminally ill and incapacitated patient.
The ruling comes three years after the death of Aruna Shanbaug, an Indian nurse who had been in hospital in a persistent vegetative state for over four decades, after being raped and strangled in 1973. Shanbaug was at the centre of a nationwide debate over the ethics and legality of the withdrawal of treatment.
“This is an important, historic decision, which clears the air,” said supreme court lawyer Prashant Bhushan.
“Everybody will breathe a sigh of relief, because people were earlier apprehensive that if they withdrew life support, they could be prosecuted for culpable homicide,” he added.

A recent US documentary recounts the story of an Oregon couple who committed suicide together in April 2017. The couple, Charlie and Francie Emerick, had both been diagnosed with terminal illnesses. They felt that, after having been married and together for some sixty odd years, it was only fitting that they exit this world as a couple.

Talk of “fittingness” in the context of death draws our attention to a broader topic, namely, the aesthetics of death. Just as we seek beauty in life, so also do we seek beauty in death.

There is a certain beauty to ending the narrative arc of our lives with a “fitting” poetic flourish. And in the context of euthanasia, it seems that many cases are underpinned by a desire not just for a peaceful death, but a beautiful death.

In 2016, a 41-year-old Californian multi-media and performance artist, Betsy Davis, ended her life with lethal medication. Davis wanted her suicide to be a “final act” in her artistic career, and she organised an elaborate weekend of celebrations and performances before consuming the lethal dose on a canopy bed by a hillside.

I wonder if, in seeking a beautiful death, we should look the wisdom the ages, rather than following our own artistic intuitions. The 15th century Latin tract Ars Moriendi provides persons in extremis with guidance for a good death. It encourages readers to face death bravely, to avoid temptations to despair, impatience or pride, and to surround oneself with those loved ones who, in life, have brought joy to one’s soul.

I’m not sure that the authors of the text had assisted suicide in mind when they outlined the elements of the ars moriendi.

Deputy Editor

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