What is the view of the scriptures on euthanasia, or assisted suicide for cases of terminal diseases? Can a doctor abbreviate the suffering of a patient, so to speak, or assist him in doing so? What do the scriptures say about this?
Surprisingly, not much. It seems that this was not a common idea in old times. The natural instinct for all living beings, including human beings is to continue living, not to end one’s life prematurely. The scriptures suggest that in a healthy state of consciousness, a person will try to extend his life, and not shorten it. They thus focus then on helping us accept the idea of death and prepare for it, by severing one’s attachments and fixing one’s consciousness on God, and not on discussing unnatural ways to prematurely go.
Dying before one’s time, and especially killing one’s own body is not considered a good idea. We are all allocated a certain amount of time in this world, and our experience here is tailored by our previous karma, which offers us a set of challenges that can help us gradually improve our consciousness. Material nature can be very hard, and we often face tough challenges, but ultimately these experiences teach us different lessons and gradually change our consciousness. If everything would always be perfect, there would not be any impetus for change. Just like we accept happy experiences when they come, we must also accept pain and suffering when it comes, as part of the package. When suffering come, we should try to see it as an opportunity to remember Krsna and focus in our spiritual practice, and this is especially true at the time of death. We may get distracted by so many material things during our lives, but the time of death, no matter how difficult it may be, is the time to get serious and focus on our spiritual practice, embracing the opportunity to change our consciousness and reaching a higher destination after our passage. It can be an extremely hard experience, but we all have to go through it.
The idea that one can just die peacefully without any pain or discomfort is a myth. There is no painless death. Death always involves suffering. It’s not possible to leave one’s body without pain. It’s always a traumatic experience. A doctor may give some drugs to make a patient unconscious, but this just numbs the external senses and makes people around think that one is at peace, but internally the individual is still suffering. The center of pain and pleasure is not the external body, but the mind, and no drug can stop the work of the mind. Everything it does is to put one in a comatose state, where one can’t properly concentrate on the task of properly leaving his body. Instead of being conscious of the whole experience and having a certain degree of control over it, one just dies like an animal, without any higher consciousness and without any control over where he is going next.
All suffering is due to Karma, and therefore the only way to reduce or eliminate suffering is to attack the root of the problem, by destroying Karma. In the scriptures, we learn that Karma can’t be destroyed by mechanical means, or even by pious material activities. Karma can be destroyed only the the process of devotional service, and especially by chanting the holy names, and thus the only process that can save us from a painful death is to practice devotional service while we are in sound health. Even if one is already on his deathbed, just the chanting or remembrance of the Lord will bring him to a better destination, or even to the spiritual world, where there is no suffering.
Conversely, any attempt to artificially shorten one’s life will just bring more Karma, and thus more suffering. That’s why the different forms of euthanasia or so-called assisted suicide are very dangerous. They do nothing to solve the real problem, and instead just create more suffering for the soul.
So, there is no other way out, apart from agonizing until our last breath? Actually, there is, but it’s a little different from what most people do.
We frequently hear stories of devotees who, attacked by terminal diseases, decide to fast until death. I had the opportunity of staying close to a devotee in this situation and I was amazed by her serenity when she was leaving, contrasted to the misery that death usually entails. I heard other similar accounts from devotees who presenced similar cases.
What exactly is this process of fasting until death? Is it bonafide? What makes it different than just dying in the hospital? How does it feel like?
The process of leaving one’s body by fasting until the end is called Prayopavesa. It’s actually considered one of the most pious acts one can do. In the Vishnu Purana, it’s mentioned that one who leaves the body in this way does not take another birth. In other words, he or she attains liberation.
The scriptures however alert that it should be attempted only by a person who has no desire or ambition left. It’s normally done when death becomes imminent, due to a terminal illness or other factors. The most famous example is, of course, the story of King Pariksit, who decided to perform Prayopavesa after getting notice that he would die in seven days bitten by a snake. His fasting led to the appearance of the Srimad Bhagavatam, from which we all derive benefit.
In most cases, devotees decide to go through Prayopavesa when they are terminally sick, and all hopes of recovery are exhausted. In such cases, fasting until the end is a dignified way to leave on one’s terms, in auspicious circumstances, in a holy place, surrounded by devotees, instead of fighting a painful and hopeless fight in a hospital bed.
To leave one’s body voluntarily by fasting is thus very different from euthanasia, which is just a glorified word for suicide. In any type of suicide, there is always an unnatural, abrupt end to one’s life, caused by feelings of frustration, fear, anger, and so on, which usually leads one to become a ghost. Prayopavesa on the other hand is a natural process that is non-violent and recommended in the scriptures, giving one time to prepare himself and others around him for his demise.
Prayopavesa is not a private affair. One should announce publically his intention of leaving his body, giving opportunity for family members and others to also prepare for his demise. Usually, sadhus came to visit and give him instructions and blessings, which is of course extremely auspicious. We can see that in the case of Maharaja Pariksit the greatest sages of his time went to the banks of the Ganges to support him on his intent.
One obstacle is that many countries have laws that prevent one from leaving in this way, equating it with suicide. This can cause problems for friends and relatives. One may also have problems with “wellwishers” trying to move him to the hospital. To avoid that, one may prefer to do it in India, where this is still respected, even by ordinary persons. Mayapur or Vrindavana are obvious choices.
How does it feel?
According to medical science, one who completely stops eating or both eating and drinking water will not die out of starvation, but rather due to the lack of electrolytes or other essential nutrients. Electrolytes are minerals like sodium, potassium, and magnesium that regulate bodily functions and are necessary for the transmission of the electrical signals that activate muscles, including the heart. Lack of these electrolytes leads to dehydration (the body can’t hold the liquid, even if one is drinking a lot of water) and eventually to organ failure. In most cases, one will die out of a heart attack, when the low levels of electrolytes compromise the normal working of the heart muscles. It’s a less painful way to go than most other options.
Someone who stops completely drinking water, as well as food, will usually die in about two weeks. One who decides to continue drinking water will typically live much longer, up to 40 days, or a little more. During this time one would prepare his consciousness to leave, chanting, hearing about Krsna, asking forgiveness for whomever he may have offended in his life, getting blessings from saintly persons, and so on. This concentration can allow one to tolerate the hunger and thirst of the final days, as well as other bodily discomforts. Let’s have no illusion: death is always a difficult process, regardless of the situation, and is thus essential that one gets all the help he can.
Extended fastings have the power to dramatically increase one’s focus and elevate one’s consciousness, awakening a feeling of detachment and indifference to the material body and everything connected to it. By carefully maintaining the body we develop attachment to it, and conversely, by neglecting the most basic need of the body, eating, this attachment is gradually broken. This is surely desirable for one who is facing the ultimate test.
We can also notice that the scriptures prescribe a great number of fastings, including extended fastings during the Bhisma Panchaka and other dates. This can be taken as an opportunity to prepare ourselves for the final fasting when the time comes.