Meet the Mumbai Couple Seeking Permission For Their Freedom: Death
Active euthanasia is a slippery slope indeed, and there are chances that in a country like India it may become a cheap substitute for expensive palliative health care, that many have a hard time providing for.

For two people who are asking for permission to die, Narayan and Iravati Lavate, are very lively individuals. They are full of stories about common man's struggles -- have you seen the roads in the monsoon? Where are jobs for Indian youths? and how can people live in this overcrowded city? they ask enthusiastically, as they show me letters from political leaders and newspaper clippings of their own interviews.

Mr and Mrs. Lavate have been in the news since last December, after they wrote to President, Ram Nath Kovind, asking for permission to die with dignity. In fact, they are in favor of legalizing active euthanasia so that those who wish to die in the future, can do so with government consent.

They are quite famous in their Zaoba Bari neighborhood at Thakurdwar (Mumbai), where they live in Laxmi Bai chawl. Every other day, some journalist or an independent filmmaker visit the couple, wanting to know the reason they are seeking permission to die from the president.

"After I reached the age of 85 plus, I felt like it was useless to continue living," says Narayan Lavate. "What is the object of our living? Nothing. We are a burden on the society. So, it is better to go now that we are in a healthy condition." he adds. This is the answer he gives to most reporters, but goad him a little further and ask if he fears death, and he casually replies, 'Why should I? One day or another, we all have to die, isn't it? So, why continue unnecessarily, without any purpose?"

Mr Lavate, who was a supervisor at the Maharashtra State Transport Corporation, talks with immense enthusiasm about the prospect of dying and compulsively thinks about ways in which an individual can end his life. "I have also bought a book on hanging procedures," he tells me.

"There are only two prisons in Maharashtra that allows hanging. It is a very simple process. People who are hanged don't suffer any pain etc. What doctors can do is they can examine an individual to see if he is in a proper state of mind and if so, they can they can then hang them (as a part of active euthanasia)." he adds.

Ironically, all the discussion concerning death loses its morbidness when Lavate talks about having a right to die with dignity. "When we came to this Earth, it was not according to our wishes. We were just thrown into this planet. It wasn't an act of volition. So, one should have a say in matters of dying at least," he argues.

Lavate's fight to make active euthanasia legal in India may face some tough challenges, but he is all set to fight those challenges alone and has therefore not hired a lawyer. "I don't require any leader, or advocate etc, I've drafted the petition myself, and send it and so far nobody has objected to it," he says.

As I perused through legal books on his bookshelf, which is where he is getting all his legal knowledge from, his wife, Iravati, told me many tales of Mr. Narayan Lavate's love for activism. She proudly said, "Everyone knows him at the Mantralaya because he goes there so often,"

Mrs. Iravati too, much like Mr. Narayan wishes to commit state-assisted suicide. "We wish to donate all our organs after our death," she tells me. Mrs. Lavate also revealed that they had decided not to have children because they did not want to bring someone on this planet, which already has limited resources.

Mr. and Mrs. Lavate may wish to die, but the petition they sent to the President has imbued their otherwise humdrum retired lives with a sense of purpose. However, legalizing active euthanasia in India may not be an easy task for the couple.

Earlier this year, in a landmark judgment by the Supreme Court, passive euthanasia was legalized in India. The court allowed 'living will', in which an adult, in his proper state of mind, is permitted to reject medical treatment and die naturally. In about 538 pages long judgment SC categorically defined guidelines for 'living will,' 'passive euthanasia' as well as euthanasia in general.

In the Aruna Shanbaug case, SC also recognized that passive euthanasia is likely to be misused in our country and therefore stated,

"In our opinion, if we leave it solely to the patient's relatives or to the doctors or next friend to decide whether to withdraw the life support of an incompetent person there is always a risk in our country that this may be misused by some unscrupulous persons who wish to inherit or otherwise grab the property of the patient. Considering the low ethical levels prevailing in our society today and the rampant commercialization and corruption, we cannot rule out the possibility that unscrupulous persons with the help of some unscrupulous doctors may fabricate material to show that it is a terminal case with no chance of recovery... The commercialization of our society has crossed all limits. Hence we have to guard against the potential of misuse ... In our opinion, while giving great weight to the wishes of the parents, spouse, or other close relatives or next friend of the incompetent patient and also giving due weight to the opinion of the attending doctors, we cannot leave it entirely to their discretion whether to discontinue the life support or not... the approval of the High Court should be taken in this connection. This is in the interest of the protection of the patient, protection of the doctors, relative and next friend, and for reassurance of the patient's family as well as the public."

Active euthanasia, however, was not legalized during that judgment which disheartened the Lavates. "Both of us are in healthy condition now but we may have an ailment in future and then become candidates of the supreme court judgment (of passive euthanasia). We say that those incurably ill people have the option to die, but why to wait until that time?" asks Mr. Lavate.

While it is a valid question, legalizing active euthanasia will require many measures from the court as well as the government to make sure that the process is not misused in India.

To begin with, one has to understand the difference between active and passive euthanasia clearly. Shruthi Ramakrishnan, Independent Legal Consultant working in the area of child rights and human rights says, "Both active and passive euthanasia is aimed at letting an individual die with dignity."

"While passive euthanasia only requires you to remove all medical intervention which will eventually result in the natural death of a person, active euthanasia needs further steps to end the life of the person and is generally done through the administration of life-terminating drugs," she adds.

While it can be dismissed, a moral line is drawn between the two types of euthanasia by many, saying that active euthanasia involves deliberately killing someone, while passive euthanasia is just the act of withholding medical support.

After the verdict on passive euthanasia, a common question that has been asked repeatedly in public domain is, should active euthanasia be legalized in India?

Active euthanasia is a slippery slope indeed, and there are chances that in a country like India it may become a cheap substitute for expensive palliative health care, that many have a hard time providing for. There are several questions that need to be considered before legalizing active euthanasia. For example, who will be eligible for active euthanasia? Should doctor-assisted suicides be made legal for those suffering from mental illness or just for the terminally ill patients?

"Considering that Supreme Court has repeatedly stated that right to life means right to life with dignity, Active Euthanasia must be legalized. However, it should be provided with adequate safeguards," says Ramakrishnan. The conditions preceding the permitting of such active suicides require to be deliberated carefully, she adds.

The lawyer also points out that in India both abetment of suicide (Section 306, IPC) and attempt to suicide (Section 309, IPC) are criminal offences. Legalising Active Euthanasia will run contrary to both these provisions. "It is high time that 'Attempt to Suicide' be removed from the criminal legal framework," she says.

There may be several moral and religious objections that can be raised against legalizing active euthanasia, but it is a law that has found its place in several western countries. According to a report in Telegraph India, as of March 2018, active euthanasia is allowed in the Netherlands, Belgium, Colombia, Luxembourg, and Canada.

The report also states that assisted suicide is legal in Switzerland, Germany, Japan, the American states of Washington, Oregon, Colorado, Vermont, Montana and California, and in Washington, DC.

Will India follow the suit of these western countries and will Lavates get their death wish? Well, perhaps, not in near future. The Indian Supreme Court is clearly airing on the side of caution, as the passive euthanasia verdict will indicate.