Understanding 'passive' euthanasia the Indian way

India's Health Ministry recently invited public reactions to a draft bill that aims to make passive euthanasia legal. Called the Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill, it seeks to legalize "passive euthanasia", which allows a person to die without actually doing anything to speed that process along.

The move is in response to a Supreme Court judgment in 2011, which permitted passive euthanasia and set parameters for withdrawing medically unproductive aid to terminally ill patients. The court at that time wanted the federal government to frame a law to monitor it. The Supreme Court also ruled that active euthanasia is unconstitutional.

Passive euthanasia in its cultural form is familiar to Indians. Religious thoughts in India have a long history of choosing voluntary renunciation of food and water as a means to withdraw from the world.

The practice of Sallekhana or Santhara — literally thinning one's body and passions — is a well known practice among Jains that goes back 2,000 years.

There is "an immense power and dignity in the Jain way of choosing to end life by choice, in full possession of one’s faculties, as the climax to a life well lived, abandoning worldly ties, including attachment to the body. Jains believe voluntary embrace of death purifies the soul and ensures the final release (moksha, nirvana) from the otherwise eternal cycle of birth and death," according to Sandhya Jain, a follower of that religion.

The Hindu understanding of kashi yatra and mahaprasthana — where people walk to their last destination — must be linked to salvific concepts of samadhi and nirvana. All these are part of the heritage of Indian thinking.

In this context the Manusmriti, the most ancient legal text of Hinduism, says: "When a householder sees he's wrinkled and gray, and when he sees the children of his children, he should take himself to the wilderness. The householder should set out in a north-easterly direction and walk straight ahead, diligently engaged in consuming nothing but water and air, until the body collapses."

Such renunciation of life continues to happen in India. The most eminent examples in contemporary India include Veer Savarkar who fought for independence from the British and who renounced food and water when he realized his end was near andpassed away in 1966; and Vinoba Bhave, a disciple of Mahatma Ghandhi who refused food and medication for a week and died in 1982.

In the Catholic Church, its catechism teaches when medical treatment can be refused or stopped. "Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of 'over-zealous' treatment," says the Catechism of the Catholic Church. Here one does not will to cause death; one's inability to impede it is merely accepted.

The same view is echoed in the documents of Vatican II. "Our tradition, declaring a moral obligation to care for our own life and health and to seek such care from others, recognizes that we are not morally obligated to use all available medical procedures in every set of circumstances. But that tradition clearly and strongly affirms that as a responsible steward of life one must never directly intend to cause one's own death, or the death of an innocent victim, by action or omission.”

As the Second Vatican Council declared, "euthanasia and willful suicide" are "offenses against life itself" which "poison civilization." They "debase the perpetrators more than the victims and militate against the honor of the Creator [Pastoral Constitution on the Church in the Modern World, No. 27]."

The Vatican Congregation for the Doctrine of the Faith in its 1980 Declaration on Euthanasia said "nothing and no one can in any way can permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, or and old person, or one suffering from an incurable disease, or a person who is dying."

Moreover, we have no right "to ask for this act of killing" for ourselves or for those entrusted to our care; "nor can any authority legitimately recommend or permit such an action." We are dealing here with a "violation of person, a crime against life, and an attack on humanity," it said.

Considering the teachings of the church, and Indian religious thoughts, I would support the bill provided it is passed to take care of people with respect and reverence for their lives.

Removing suffering and the financial burden alone cannot be seen as the reason for passive euthanasia. There are larger issues like relationships and human dignity when we consider passive euthanasia. It should be available only in the "rarest of rare cases," as the Supreme Court had earlier suggested in the case of the death penalty.

Human dignity and respect for the individual life of the patient should be reaffirmed in the bill, to preempt any misuse of the bill by relatives who seek monetary gain.

We need to ask: As it is visualized in the proposed bill, can young people above 16 years be allowed to seek passive euthanasia? Should we not take seriously the view of their parents and close relatives?

On the whole, I would go for the bill, provided it is undertaken cautiously, keeping in mind the sacredness of life and the dignity of the individual concerned.

Father Kuruvila Pandikattu SJ is a professor of philosophy, science and religion at the Jnana-Deepa Vidyapeeth institute of philosophy and religion in Pune, India.