FROM THE SCRAPBOOK :: 2

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Euthanasia

I had heard about Euthanasia, the process of physician-assisted death of terminally sick patients or of patients suffering from progressive incurable diseases, more than forty years ago. It was being talked about in the newspapers when cancer was slowly assuming menacing proportions with practically no cure available. In those days it went by the term “mercy killing”.

My late brother who was at one time Special Assistant to Dr. Karan Singh, the then Health Minister, also once happened to tell me that the minister wanted to know more about the process. No progress has, however, been made since then and Euthanasia, as an alternative to acutely suffering patients from several kinds of fatal diseases, continues to remain only in the realms of possibilities with no prospects in the near future of its being introduced.

In the United States euthanasia was introduced in the state of Oregon as far back as in 1997 and since then it was introduced in several other states like Montana, Colorado, Vermont, Washington DC etc. Perhaps, California, known as the trend-setting state, was so far the last to put into effect only in 2016 the law relating to assisted suicide. According to the available data as many as 504 terminally ill patients have requested for life-ending drugs since the law came into force. While the state authorities have not released any figures it is presumed that the overall figure would be much higher. Nonetheless, it is apparent that the law in question is working pretty well. The families of those who have made the choice have indicated that the law has provided comfort and relief to the dying from intolerable suffering. Some see providing the option to the dying as a logical evolution in the current medical care system.

Euthanasia has been in medical discourses for quite some time. I recall having read the depositions of elderly people in the West who did not wish to spend their last days in nursing homes or hospices regardless of the high quality of nursing care in them. The prospects of suffering from Alzheimer’s, dementia, insufferable body and joint aches, chronic constipation and all other diseases that are associated with failing vital organs as advancing age chips away at the system is frightening to them, as it is to all of us. Most of them demanded the choice of assisted suicide particularly when there was no hope of recovery and the suffering was likely to pile on by the day. What they wished for was a self-willed dignified death without the hassles associated with interminable deep suffering – both physical and mental.

If one wishes to see the sufferings of the terminally ill patients a visit to any cancer hospital would be fruitful. I have had occasions to see from time to time the agony on the faces of these patients in the local JL Nehru Cancer Hospital. However much the hospital provides palliative treatment to those who are at the terminal stage the effort only marginally lightens the patients’ sufferings. Perhaps, an option for assisted death would be far more welcome than the prolonged pain and agony from which release is unlikely. Forcing a terminally sick patient to live out his life of acute pain and misery in keeping with the prevailing societal mores would not seem to be making any sense. An option for termination of life, if exercised, would release not only a patient from his/her unbearable, insufferable and intolerable pain, agony and misery but also relieve his/her family and well-wishers from prolonged exposure to the sufferings of a loved one that heavily impacts their psyche.

Unfortunately, in this country there is neither enough social cohesion for making a demand for euthanasia nor are the governments so enlightened as to enact such laws on their own. Besides, the leaders of the society are far too busy in garnering votes at future elections. Even the medical fraternity has failed to propose such a measure which apart from providing relief to terminally ill patients would make their own life a little easier. Besides, in the prevailing environment of shortages and inadequacy numerous beds/wards could be released for treatment of those who have better chances of recovery to lead a healthy life.

One tends to feel that the debate on the matter needs to resume. A time seems to have come when a scientific and more modern view of this important matter is taken by people in authority. After all, when medical science, despite its rapid advancement, is not able to provide release from pain and suffering to a patient wouldn’t it make sense that the patient, if he so wished, could ask for a dignified termination of his miserable life?

CICLOVIA

Somehow or other Colombia has been at the vanguard of urban transport initiatives. The Bus Rapid Transit System, BRTS for short, though established first in Curitiba in Brazil, it is Bogota in Colombia that we in India drew inspiration from. The country has a fascinating rapid transit system which we have tried to emulate but have miserably failed in the effort for varied reasons that need not be gone into here.

A fresh initiative has come from Colombia and this time it is not about the polluting diesel buses that are used in the bus rapid transit system. It is about good old bicycle and an attempt to resurrect it after it was virtually pushed into oblivion as a means of personal mobility. The Colombian initiatives have had emphasis on conservation of environment. Just as the BRTS was meant to apply brakes on the rapidly increasing green house gases in the atmosphere the new initiative that goes by the name Ciclovia attempts to popularize  emission-free transport as also to improve the health of people and their general wellbeing.

Ciclovia is not, in fact, a new initiative. It was commenced around 1974 when sections of roads were closed on Sundays for motor vehicles for half a day and only cyclists, walkers and joggers were allowed on them. The Indian Ambassador in Colombia writes that what started as a small exercise now covers more than 121 kms. of Bogota’s roads with the participation of one fourth of the population of the town of eight million on every Sunday and on other holidays that work out to 68 days in a year. He says, from 7.00 AM to 2.00 PM young and old come out in colourful apparels to give themselves an outing in their own city.

Many cities of Colombia and Latin America have adopted Ciclovia. Apparently people like the initiative prompting the administrations to add hundreds of kilometers cycle routes in Bogota and elsewhere. Ciclovia’s popularity is being used by commercial firms to broadcast their messages through various cycling events. Even the Indian Embassy is reported to have celebrated the International Yoga Day in June 2016 using Ciclovia.

We in India were at one time totally dependent on the bicycle. It was the only vehicle for quicker mobility for the blue collared workers as also of a few sections of white collars and students. The middle class and the lower classes back then had no other alternative as four wheeled motorized vehicles were much beyond their reach andpublic transport run by the governments or their agencies was unavailable. I remember during our college days in the mid 1950s many of our professors used to cycle down to the college. They would be immaculately dressed in three-piece suits in winters with matching felt hats. In summers, it would be shirt sleeves and sola hats, bicycles remaining as the means of commuting. Reports used to be received of Pune having the largest number of bicycles. With changing shifts in factories swarms of cyclists would choke the streets. Today, however, things have changed; it is now the motorised two-wheeler or a car; a bicycle is used, if at all, for pleasure rides.

Nonetheless, efforts are being made to popularise the use of bicycles. In Bhopal already around 10 kilometres of cycle tracks have been constructed and bicycles are on offer on rent – somewhat in the pattern of Paris and other European cities after this movement took off more than a decade ago. For us in India the weather is a great hindrance, particularly in summers when due to searing heat of the sun none would like to expose oneself to the unfriendly elements. During the rest of the year, however, cycling could be promoted for hobby as also for commuting.

That is precisely what Ciclovia, with all its multiple environmental and health benefits, would seemingly seek to suggest to us.  

*Photos from internet