Hospitals have to set up approval committees for considering cases of passive euthanasia, and any distortion of facts before such panels may lead to a maximum of 10 years in jail and a fine of up to Rs 1 crore, a redrafted bill states.
The panels will decide on applications of “Living will”, a written document that allows patients to explicitly state their desire against life-prolonging measures when recovery is not possible from a terminal condition.
The redrafted bill also provides for palliative care to patients even if they have opted for passive euthanasia, which is the withdrawal of medical treatment and life support system of a terminally-ill patient.
The “Management of Patients with Terminal Illness- Withdrawal of Medical Life Support Bill” states that all super-speciality hospitals should have approval committees on passive euthanasia which will decide on the applications for the execution of a “living will”.
“It also calls for imprisonment of 5-10 years and a fine of Rs 20 lakh to Rs 1 crore in case of misrepresentation of facts or placing forged documents before the approval committees,” provisions of the redrafted bill state.
A senior health ministry official clarified that the redrafted bill does not encourage active euthanasia.
“All provisions of the bill only support passive euthanasia. Passive euthanasia involves giving the right to patients to withhold medical treatment or life support system in the face of an irreversible terminal illness, while active euthanasia is the acceleration of death using injections or overdose of drugs,” he said.
The bill provides for palliative care which means while the medication or medical care will be withdrawn, the family or the hospital staff will continue to take care of the patients in terms of providing nursing care to give relief from pain, physical stress and maintaining cleanliness among others, the official explained.
The redrafted bill terms death from passive euthanasia a “natural death”.
It also has provisions for the protection of competent patients (those who can take decisions on their future treatment), medical practitioners and care givers, who will not be considered guilty for the act of passive euthanasia.
“The bill also provides for unanimous consent of near relatives to apply for withholding or withdrawing of medical treatment of incompetent terminally ill patient,” the official said.
The draft Bill which was earlier called “Medical Treatment of Terminally Ill Patients [Protection of Patients and Medical Practitioners]) Bill” was put in the public domain in May last year and comments and suggestion were sought from various stakeholders.
“Around 70 per cent of the people supported passive euthanasia while giving their suggestions,” the official added.
The Centre, in October, submitted a draft bill to the the Supreme Court, which said there should be adequate safeguards, while the implementation of a living will would be subject to a medical board which would certify if the patients comatose state was irreversible.
The apex court has reserved its order on a public interest plea over the issue filed by an NGO, Common Cause.
The apex court had recognised passive euthanasia in 2011 in Aruna Shanbaugs case by which it had permitted the withdrawal of life-sustaining treatment from patients not in a position to make an informed decision.
Shanbaug, a former Mumbai nurse, was in a coma for 42 years after a sexual assault and declared dead in 2015.