Department of Child and Adolescent Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India.
Indian J Psychiatry. 2012 Apr;54(2):177-83. doi: 10.4103/0019-5545.99537.
In our society, the palliative care and quality of life issues in patients with terminal illnesses like advanced cancer and AIDS have become an important concern for clinicians. Parallel to this concern has arisen another controversial issue-euthanasia or "mercy -killing" of terminally ill patients. Proponents of physician-assisted suicide (PAS) feel that an individual's right to autonomy automatically entitles him to choose a painless death. The opponents feel that a physician's role in the death of an individual violates the central tenet of the medical profession. Moreover, undiagnosed depression and possibility of social 'coercion' in people asking for euthanasia put a further question mark on the ethical principles underlying such an act. These concerns have led to strict guidelines for implementing PAS. Assessment of the mental state of the person consenting to PAS becomes mandatory and here, the role of the psychiatrist becomes pivotal. Although considered illegal in our country, PAS has several advocates in the form of voluntary organizations like "death with dignity" foundation. This has got a fillip in the recent Honourable Supreme Court Judgment in the Aruna Shaunbag case. What remains to be seen is how long it takes before this sensitive issue rattles the Indian legislature.
在我们的社会中,晚期癌症和艾滋病等绝症患者的姑息治疗和生活质量问题已成为临床医生关注的重要问题。伴随着这种关注,出现了另一个有争议的问题——安乐死或对绝症患者的“仁慈杀害”。支持医生协助自杀(PAS)的人认为,个人的自主权权利自动使他有权选择无痛死亡。反对者认为,医生在一个人死亡中的角色违反了医疗行业的核心原则。此外,未经诊断的抑郁症和要求安乐死的人可能存在社会“胁迫”,这使得这种行为的伦理原则进一步受到质疑。这些担忧导致了严格的 PAS 实施指南。对同意 PAS 的人的精神状态进行评估已成为强制性要求,在这里,精神科医生的作用至关重要。尽管在我国被视为非法,但 PAS 有一些以“有尊严地死亡”基金会等自愿组织的形式的支持者。在最近的 Aruna Shaunbag 案中,Honourable Supreme Court 判决使这个问题得到了推动。尚待观察的是,这个敏感问题需要多长时间才能撼动印度立法机构。