SC permitted passive euthanasia in Harish Rana vs UOI, applying the Best Interest of the Patient Principle.
Passive euthanasia involves withholding/withdrawing life support; active euthanasia (lethal drugs) is illegal in India.
SC urged Parliament to enact a law for end-of-life care and directed High Courts on administrative directives.
In Summary
Supreme Court (SC) applies Passive Euthanasia framework for first time
The SC in Harish Rana vs Union of India judgement permitted the withdrawal of artificial life support of a man who has been in a vegetative state for more than 12 years on the basis of Best Interest of the Patient Principle.
The SC waived the usual 30-day consideration period as the patient’s parents and both medical boards unanimously agreed that recovery was impossible.
Euthanasia refers to the hastening of a patient’s death to relieve suffering and is broadly classified into two types- Passive and Active (refer to box).
Passive euthanasia
Under it, a patient is allowed to die naturally by withholding or withdrawing medical treatment that sustains life.
Active Euthanasia
Active euthanasia refers to the physician's deliberate act, usually the administration of lethal drugs, to end an incurably or terminally ill patient’s life.
Active euthanasia is illegal in India.
Legalised in countries like the Netherlands, Belgium, etc.
Legal status:
Aruna Ramchandra Shanbaug case (2011): SC rejected a plea for euthanasia, but allowed passive euthanasia under strict conditions for terminal and irreversible patients.
In Common cause judgment (2018), SC recogniseditand held that right to die with dignity is a fundamental right under Article 21.
In this case, it laid down guidelines for it and recognised the concept of a 'living will', with oversight involving DMs, judicial officers and medical specialists.
The court had held that passive euthanasia could be carried out using Advance Medical Directives.
Modified Guidelines issued by the SC in 2023: A primary and a secondary medical board will have to be formed for an expert opinion on the withdrawal of artificial life support for a patient in a vegetative state.
Other key highlights of Judgement
Enact a Comprehensive law: Court urged the Parliament to enact a comprehensive, coherent statutory framework governing end-of-life care and passive euthanasia.
Administrative Directives: To improve the process for future cases, the court directed High Courts to ensure that judicial magistrates are informed by hospitals whenever medical boards decide to withdraw or withhold life support.
Written instructions concerning a person's medical care preferences, including decisions about life-sustaining treatment, to be followed if they are no longer able to make those decisions themselves. Passive euthanasia can be carried out using these directives.
Article 21
A fundamental right in the Indian Constitution that guarantees the right to life and personal liberty. It has been interpreted by the Supreme Court to include the right to privacy and dignity, which are challenged by unchecked digital state power.
Living Will
An advance medical directive where an individual specifies their wishes regarding medical treatment, including life support, in the event they become incapacitated and unable to communicate. The Supreme Court of India has recognized the validity of living wills for passive euthanasia.
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