Posted on January 28th, 2017

By Dr. Tilak S. Fernando

An article in the “Sunday Times” on 8 January 2017 struck me, which carried a report on a debate by some of the Sri Lankan doctors (Mid Country Psychiatrists) held at the Tourmaline Hotel, Kandy. The seminar apparently had been based on the argument on morality against medical ethics to find out whether a “doctor could turn into God” and kill a terminally ill patient with passive or active euthanasia? One of the psychiatrists at the seminar was quoted as saying, “It is good medical practice – there is no point in resuscitating a person or pull off a life support!”.

Euthanasia has been a topic of discussion the world over for a long period of time, which seems to surface intermittently with varied opinions from most countries, at the end of which even in Parliaments the subject had got wedged, being unable to come to a conclusion. Some British Parliamentarians have raised the issue over and over again with no success at the end.

Euthanasia is categorized into two main areas, passive and active. Withdrawal of medical treatment and putting up a notice on a patient’s bed saying “nil by mouth” carries the message to nurses, “Do not give the patient to eat or drink“. In some instances even saline drip IV is pulled off mercilessly with the knowledge of the medical team that the death of the patient will follow. This is known as passive euthanasia. Medical jargon used in the UK for this type of killing is called “Liverpool pathway“. How can a starved and dehydrated patient’s death, on purpose, be called a “Peaceful Death?” In fact it is the worst type of human torture a helpless patient can endure and experience. Administration of a lethal agent to end life of a patient is active euthanasia. At the Kandy conference it has been revealed that in Sri Lanka “passive euthanasia” exists and some psychiatrists, who gathered there, seem to call it “good medical practice!”

Human life

Human life is sacred and it has a purpose on this earth. Regrettably, not even one per cent of us, who live in this world, does not seem to understand the real significance of being born into this complex planet – without our consent or knowing where we coming from. Some, of course, crudely put the blame on their parents pointing a finger at them calling it due parental sexual pleasure that they have to suffer once born into this unpredictable world.

Religions have their own versions to life. Those who believe in a creator or God believe that their life belongs to God and no one has the right to take it away knowingly. Buddhists and Hindus put emphasis on one’s previous karma (cause and effect) that each one brings forward. Christians call it in a different form – “reap as you sow“. Pope Francis has censured euthanasia calling it as an act of “false sense of compassion, and a sin against God and creation”. All God orientated religions are of the view that killing or committing suicide or even aiding and abetting to commit suicide amounts to manslaughter as every life belongs to the Creator only, who decides how and when a person should be born and die.

The psychiatrists, who were in favour of mercy killing at the conference in Kandy, seemed to believe that “euthanasia is very close to a medical practitioner“. They were being reminded by those who opposed to it by referring to the doctors’ oldest binding commitment known as the Hippocratic Oath, where each doctor commits to the covenant by saying: “I swear by Apollo Physician and Asclepius and Hygeia and Panacea, and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.

I will not use the knife, not even on sufferers from stone, but will withdraw in favour of such men as are engaged in this work”.

Similarly, I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. I will keep to myself, holding such things shameful to be spoken about and do not violate this oath.”


Killing a person is not a comfortable task for another human being. In medical terms when a patient loses his quality of life and becomes beyond “human repair” even that person is not permitted by International Law to be subjected to euthanasia. It becomes an act of intentionally ending a person’s life to alleviate suffering with or without the consent of the patient and / or the patient’s relatives. Against such a backdrop even a doctor giving an overdose of muscle relaxants to a terminally ill cancer patient to end his life will be considered as committing euthanasia. Assisted suicide, in other words, is a meditative act boosting another person to kill himself by someone giving an overdose of tranquilizers thus assisting suicide.

Those who are against mercy killing stress the fact that some patients want to end their life purely with the guilty feeling of becoming a burden on others, thus they lose dignity and become hopeless. For this type of patients anti-euthanasia groups suggest ‘to treat the patient for depression rather than killing them’. The detractors would further argue on the grounds that euthanasia comes under the moral and ethical principle with the maxim: ‘Do unto others, what you wish to be done unto you’.

They boldly question whether the power over life and death should be given to doctors.

International interpretation

The Dutch Penal Code (Articles 293 and 294) makes both “euthanasia and assisted suicide” illegal. However, Rotterdam Court in 1981 has laid down guidelines to the Dutch Courts and Royal Dutch Medical Association in broader terms: “The patient must be experiencing unbearable pain; be conscious; death request must be voluntary; patient should have been offered an alternative to euthanasia with time to consider; there should be no other reasonable alternative; death should not inflict unwanted suffering to others; extreme care should be observed in making the final decision”.

Of late, Germany too has allowed assisted suicide for humane reasons but prohibiting any profitable business out of it. Euthanasia has been legal in Belgium since 2002, where 1, 807 deaths were recorded by euthanasia in 2013, out of which over half of the patients were geriatric aged 70 or over. In Sri Lanka it was recorded that those who become ‘most vulnerable to the abuse of euthanasia are the poor and the old’. Under the English Law and the Terms of the Suicide Act (1961), both assisted suicide and euthanasia are illegal and carry a jail sentence up to 14 years. The Institution of Medical Ethics in the UK believes that doctors should seriously consider patients’ requests who ask for their lives to be terminated emphasising that “intervention by a doctor to end a patient’s life is not in the public interest.” Depending on the circumstances, euthanasia is regarded as either manslaughter or murder.

A typical illustration would be to take a husband whose wife is “technically dead for a long time” and kept on a ventilator. His painful experience in such a situation would be to battle within the law of the country where euthanasia is illegal. He would soon reach a point of saturation and feel like creeping into the ward where his wife assumes a foetal position over the years, with various tubes going through her throat and nose to keep her lungs clear and feed her. He may have prayed to God to bring his wife back from the coma, but he feels there is nothing left for her as a human being. She has turned into just a body and not his wife anymore. He at times feels like a criminal as his thoughts begin to tempt him to kill his own wife for the love of her and not to see her suffering continuously. He would appreciate the legality behind euthanasia but how long could he endure seeing her suffer in that manner?

Euthanasia has thus become the most convoluted topic where humans are fighting to find an answer. In a never-ending debate some, in the belief of relieving the pain of a terminally ill patient, decide to exercise mercy killing for the benefit of the patient and the patient’s family. In a religious dimension, however, will karmic action start boomeranging on them, either in this world or the next, for killing a human being in whatever form.

If a man takes the life of any human being, he shall surely be put to death” – Leviticus 24:17

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