Right to a Dignified Death: Passive Euthanasia & Living Wills in India
Context: The Supreme Court of India is currently grappling with the practical challenges of implementing its own landmark judgments on passive euthanasia, as seen in the case of Harish Rana—a man in a persistent vegetative state for 12 years.
More on News:
- While the Court has legally recognised the right to a dignified death under Article 21 of the Constitution, the procedural labyrinth created to operationalise this right has rendered it nearly inaccessible.
- This situation highlights the vast gap between judicial pronouncement and ground reality, sparking a debate on the need for simpler legal provisions that respect individual autonomy at life’s end.
I. Understanding Euthanasia: Definitions and Classification
Euthanasia is the intentional act of ending a life to relieve unbearable suffering from an incurable condition. It is categorized based on the method and the patient’s consent:
- Active Euthanasia: Deliberate intervention (e.g., a lethal injection) to cause death.
- Passive Euthanasia: Withholding or withdrawing life-sustaining medical treatment, allowing the natural progression of the underlying disease to cause death.
- Voluntary Euthanasia: Conducted with the explicit, informed consent of the patient.
- Non-Voluntary Euthanasia: Conducted when the patient is incapable of giving consent (e.g., in a coma).
- Assisted Suicide: A physician provides the means (like drugs) for a patient to end their own life.
II. The “Living Will”: An Advance Medical Directive
A Living Will, or Advance Medical Directive (AMD), is a legal document prepared by a mentally competent adult. It specifies their wishes regarding medical treatment if they eventually enter a terminal state or a persistent vegetative state (PVS) where they can no longer communicate.
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Purpose: To exercise individual autonomy over one’s body at the end of life.
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Legal Standing: Linked to the fundamental Right to a Dignified Death under Article 21 of the Indian Constitution.
III. Judicial Evolution in India: A Timeline
India’s journey toward legalizing passive euthanasia has been defined by three major judicial milestones:
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Aruna Shanbaug Case (2011): The Supreme Court recognized passive euthanasia for the first time, establishing strict guidelines while rejecting active euthanasia.
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Common Cause v. Union of India (2018): A Constitutional Bench legalized passive euthanasia and recognized the validity of Living Wills, stating that “Right to Life” includes the right to die with dignity.
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2023 Revision: Recognizing the 2018 process was too cumbersome, a 5-judge bench simplified the execution of Living Wills, reducing the role of judicial magistrates and empowering medical boards.
IV. The Ground Reality: Hurdles and Implementation Gaps
Despite the law, several barriers prevent families from accessing these rights:
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Procedural Complexity: Confirmation requires two independent medical boards (Primary and Secondary). Disputes currently necessitate a High Court writ petition.
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Definition Ambiguity: There is confusion over what constitutes “life support.” In Harish Rana’s case, the court debated whether a feeding tube counts as medical support that can be withdrawn.
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Administrative Inertia: By mid-2025, only a handful of states (like Kerala and Karnataka) have appointed the necessary custodians for Living Wills.
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Moral and Social Stigma: Deep-seated cultural and religious views on the “sanctity of life” often clash with the concept of medical autonomy.
V. The Way Forward: Easing the Provisions
To bridge the gap between judicial pronouncement and practical reality, the following steps are essential:
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Comprehensive Legislation: Parliament should enact a statutory law to replace complex judicial guidelines with a uniform process.
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Simplification: Shift the primary decision-making power to the family, treating physician, and a hospital ethics committee.
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Digital Registries: Create a centralized, accessible digital registry for Advance Directives to ensure they are retrievable during emergencies.
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The Source’s Authority and Ownership of the Article is Claimed By THE STUDY IAS BY MANIKANT SINGH
