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How to Face Terminal Illness: an Analysis Journal of Information and Computational Science ISSN: 1548-7741 How to face Terminal Illness: An Analysis Sourav Kharan Ph. D Scholar Deaprtment of Philosophy Sidho-Kanho-Birsha University Purulia, West Bengal Abstract: Terminal illness being incurable cannot be treated adequately and the final result is death for the patient. It can be categorized under such kind of disease from which patient cannot be recovered in his/her life time with an absolute certainty albeit he/she has been in treatment and a huge amount of money is to be spent . Terminal illness is not neither new in India nor its’ abroad. From the ancient age, the Indians have been trying to discover a way out to face these types of terminal illness. This paper is concerned with the best possible way among the Supreme Court’s ‘living will’, Palliative Care, Life prolonging treatments, Hospice services, Telling the trivial truth and the Spiritual death through which the terminal illnesses could be faced from the Indian perspective. Key words: Terminal, Illness, Spiritual, Death On 9th March, 2018, Indian Supreme Court legalized Passive Euthanasia which is related to terminal illness—a person, who has been suffering from a serious kind of terminal illness and he/she may draft an advance living will. An advance living will is a written document through which a patient can give his explicit instructions in advance about how long the medical treatment to be administered, when he/she has been suffering from a serious kind of terminal illness. When the limited stipulated time, permitted by the patient through his/her advanced will is crossed, the act of Passive Euthanasia can be performed by doctors with the help of the withdrawal of the medicinal treatment along with the deliberate intention to accelerate the death for a long suffered terminally ill patient. On 2018, the Supreme Court of India further declared through the bench constituted of five judges, that the government would honor the advance living wills, only when the terminally ill patient who is in a vegetative state has already given the consent of Passive Euthanasia. But the strict guidelines, in this respect, must be followed. A living will sets out the wishes of the terminally ill patients regarding their treatment i.e. how they want to be treated. The Judges said that the right to die with dignity is a fundamental right and that can be directed Volume 9 Issue 11 - 2019 414 www.joics.org Journal of Information and Computational Science ISSN: 1548-7741 in advance by a person in the form of a living will, could be approved by the court. Petitioners, who argued that people have the right to die with dignity, when they are suffered from terminal illness, should deserve their judgment; said by the Supreme Court. Be noted that a living will is actually the self permission of Passive Euthanasia. When the Passive Euthanasia is applied upon a patient by a medical professional person, it indicates that the patient has died because either the necessary medical supports through which a patient could be alive have been taken away or some similar steps have been taken which failed to keep the patient alive. This might include: (a) switching off life support machines or (b) disconnecting a feeding tube, or(c) not carrying out a life extending operation or (d)not administrating life - extending drugs. In case of Aruna Ramchandra Shanbaug, Supreme Court passed opinion about Passive Euthanasia, for the first time, in the recorded case history in the India, after being in the vegetative state for near about 42 years as a result of sexual assault. The Supreme Court remarked, Passive Euthanasia may be granted only when the doctors are unanimously agreed and a case has been filed in the court. Aruna Ramchandra Shanbaug was paralyzed, because of severe brain damage since 1973, in the city of Mumbai, after being raped and strangled by a ward attendant in the Mumbai hospital where she worked, and eventually died in 2015. Her death sparked a national debate over Euthanasia. In 2018, Supreme Court Judges drafted a detailed ‘guide lines’ for facilitating Passive Euthanasia. The court said that family members, along with the relatives of terminally ill patients who are seeking Passive Euthanasia can appeal in the court in order to get permission for it. A team of doctors would then be appointed by the court, prior giving the sanction order for the implementation of Passive Euthanasia. As the terminal ill patient is human being and there is no alternative of life, some sort of anxiety is quite natural against the verdict of Supreme Court regarding Passive Euthanasia. These anxieties are as follows: The pain of terminally patient should be measured properly ‘Euthanasia’ is an irreversible process, so, before the implementation of euthanasia living will of concerned patient should be justified properly Though Supreme Court has given the verdict for the implementation of euthanasia for the terminal ill patient, hospitals especially the private hospitals may fix extra charge for it The huge amounts of bills are disbursed through the medi-claim policies when the patient died normally. In case of implementation of euthanasia, it is natural to ask questions about the disbursement of amounts through the medi-claim companies, as it is not at all normal death It is a general and ethical obligation of a state to provide health service for every citizen within its territory, when Supreme Court said that the verdict regarding euthanasia is based on the importance of the patient’s will a conflict arises The Indian Constitution Section—21 says about ‘right to live’ as one of the fundamental right. But when the Supreme Court permitted euthanasia i.e. ‘right to die with Volume 9 Issue 11 - 2019 415 www.joics.org Journal of Information and Computational Science ISSN: 1548-7741 dignity’ in order to honour the will of the terminally ill patient, the said fundamental right—‘right to live’ seems to be changed as ‘right to how to live’ In fact, life and death of animate objects depend on the Supreme God. The verdict given by the Supreme Court regarding euthanasia has been formed by the human being that is why it never be the above of questions. There may be debate about the basis of the verdict given by the Supreme Court. Once, the verdict has been disclosed for the public, it should be honored and the best way through which a terminal ill patient could die with honor should be sought out. Let us peep into the different ways through which a terminal ill patient could be relieved. 1. Palliative Care From the definition of World Health Organization, it is known that ‘Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life threatening illness, through the prevention and relief of suffering by means of early indication and impeccable assessment and treatment pain and other problems, physical, psychological and spiritual’. The concept of palliative care regarding the death of a terminal ill patient as a normal process affirms the faith in life. It aims to provide relief from distressing symptoms. Death is actually a natural end of life and as well as any kind of diseases that is why it cannot be postponed indefinitely. Through the Palliative care unit the patient and his family can get an integrated wide support through the multi-disciplinary approaches which include psychological, social and spiritual aspects. It integrates a wide support system not only for the patient, but also for the family as a whole. In 1967, Cicely Saunders opened a palliative care center in the London. Later, different countries have taken initiatives to open palliative care as a part of health policy. In India, Kerala, Maharashtra, Karnataka, Tripura, and now Jammu and Kashmir started to give importance palliative care although some states of India still remain indifferent regarding this matter and keep away palliative care from the health policies. According to WHO’s report, in the world every year only 14% peoples are getting privilege from palliative care where 78% peoples are in the poor or middle income group. 2. Life Prolonging Treatments Advanced technology in modern medical science has introduced entirely new way in end of life care through which lifespan can be prolonged or stretched and consequently death may be postponed. Organs that have stopped functioning and made the patient suffering from incurable diseases could be transplanted and thereby patient would be cured. Some diseases which were called earlier as incurable, the concept of incurable diseases have been changed, because of the possibilities of replacement of organs on the basis of its availability. For example, chronic renal failure, chronic respiratory problem, cardiac and liver failure, leukemia and other blood cancers etc. which were categorized as incurable, but now these are not called as incurable in strict sense. Sometimes, literally speaking, life is brought back from the jaws of death with the help of life prolonging treatments like assisted respirator support, artificial maintenance of nutrition and hydration cardiac pacing and so on. For Volume 9 Issue 11 - 2019 416 www.joics.org Journal of Information and Computational Science ISSN: 1548-7741 example, none can even a doctor can never forecast that a coma patient would never survive in future. 3. Hospice Services Hospice is an approach to care which is not limited only with a specific place. At present Hospice is sometimes provided for ape son who has been suffering from a terminal illness whose doctor has a firm conviction that the patient would die within 6 months or less if the illness runs in its natural process.
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