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Assaulted Woman to Be Kept Alive, Rules India Court

Mar 14 2011
Until the story of Aruna Shanbaug, I had never heard the phrase "passive euthanasia," let alone grappled with whether or not I participated in it nearly 20 years ago.

On March 7, India's Supreme Court decided a landmark case that will allow life support to be legally removed from some terminally ill patients. The ruling involved the case of a woman who has been in a vegetative state since she was sexually assaulted and suffered brain damage 37 years ago. Her parents are dead, and a friend wanted hospital staff to stop "force-feeding" her mashed-up food. While the court ruled that Aruna Shanbaug be kept on life support, it distinguished between "active euthanasia" and "passive euthanasia," allowing the latter for certain terminally ill patients.

Until I read these reports, I had never heard the phrase "passive euthanasia," let alone grappled with whether or not I participated in some such cruelty.

It was nearly 20 years ago. An elderly relative had been badly deteriorating in a residential care facility for a few years when she was hospitalized with congestive heart failure. She was initially conscious, but quickly lapsed into a coma. Tests showed she had minimal brain function. The doctor said she wouldn't recover. Although there was a medical directive in place that prohibited heroic measures, a feeding tube was inserted.

After a week or so, we were told the feeding tube had been removed because it had a kink in it. Everyone knew that if she went back to the nursing home with the tube, it would take a court order to remove it again. It was left to her family to decide what to do. The feeding tube was not reinserted. She was given intravenous fluids to keep her comfortable and she died a few days later.

Even if the hospital staff was lying about the kink in the tube and removed it of their own accord, I don't believe this was "passive euthanasia." I believe it was resisting, or correcting, medical encroachment.

I wonder now, though, if medicine will make murderers of us all.

In a 2010 talk at the Center for Bioethics and Human Dignity annual conference, Ryan Nash, M.D., an assistant professor at the University of Alabama School of Medicine Center for Palliative and Supportive Care, argued from the work of bioethicist Jeffrey Bishop that in the relatively new field of palliative medicine, death is not only being redefined from a biological standpoint, it is being redefined psychologically, socially, and spiritually.

Whereas the hospice movement sought to return death and dying to the community, Nash said specialists are now trying to control all aspects of death in pursuit of "optimal dying." He blamed this development in part on a redefinition of medicine from a discipline that sought to care, cure, and comfort to one that frames it as a duty to relieve suffering. Nash warned that such a duty could lead health-care professionals to believe that euthanasia and assisted suicide are encompassed within their responsibility because it isn't always possible to adequately relieve patients' suffering, especially their spiritual, psychological, and social pain.

Related Topics:Death; India; Life Ethics

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