INTRODUCTION
The Constitution of India guarantees the Right to Life under Article 21. Various judgements and decisions by the courts have interpreted this article by widening its scope to include various other rights and privileges. Right to life includes the right to livelihood, right to shelter, right to health and medical assistance, right to free legal aid, right to education etc.[1] The Supreme Court while interpreting this has also observed that the right to die with dignity can also be included within the scope of the right to life. The Supreme Court has stated that the right to life and liberty as given under Article 21 is meaningless unless it includes within its domain individual dignity.[2] This observation by the Apex Court is significant in terms of the concept of euthanasia.
WHAT IS EUTHANASIA?
The word Euthanasia has been derived from the Greek terms ‘Eu’ meaning good and ‘Thanatos’ meaning death. So, translated it means ‘Good Death’. Euthanasia can be defined as ‘the act or practice of painlessly putting to death persons suffering from painful and incurable disease or incapacitating physical disorder or allowing them to die by withholding treatment or withdrawing artificial life-support measures.’[3] Thus, we can say that euthanasia is the practice of ending the pain caused due to a disease or disorder, which in turn ends the suffering of the individual by putting him to death.
While considering the legality of euthanasia, we can consider euthanasia as active and passive. Active euthanasia means giving support to cause death while passive euthanasia means withdrawing the given supportive measures. [4] Thus, active euthanasia includes the act of using certain drugs or medications or injecting them into an individual which ultimately leads to the death of that individual. On the other hand, passive euthanasia means that the medications and the support given to the individual are withdrawn or held off which eventually leads to the death of the person. Justice Markandey Katju stated while clearly stating the difference between the two that ‘In case of active euthanasia something ‘is done’ to end the life of a patient, while in passive euthanasia something ‘is not done’ that would have preserved the patient’s life.’[5]
PASSIVE EUTHANASIA: INDIAN CONTEXT
The Indian Perspective of Euthanasia has evolved over the years. In 1996, the Supreme Court handled the renowned case of Gian Kaur v. State of Punjab.[6], which captivated attention and left a significant impact on the legal community. In this case, the ambit of Article 21, the Right to life was considered concerning the right to die. This judgement not only looked into the legality of suicide attempts but also thoroughly examined the possibility of legalizing euthanasia. The court observed that in the context of a dying man, the ‘right to die with dignity’ comes into the picture only when it is inevitable and unavoidable that death will occur by the termination of the natural course of his life, and the process of natural death has already begun. Thus, the court held that the right to life included the right of a dying man to die with dignity but also stressed the point that this should not be mistaken for the right to die an unnatural death limiting the period of natural life.[7] In this manner, this case opened the window for legalizing euthanasia in India.
After the Gian Kaur case of 1996, which was later overruled, another important case regarding the discussion of euthanasia is the case of Aruna Ramachandra Shanbaug v. Union of India.[8] Here the Apex Court differentiated between active and passive euthanasia. The court observed that ‘the difference between active and passive euthanasia is that in case of active euthanasia something ‘is done’ to end the life of a patient, while in passive euthanasia something ‘is not done’ that would have preserved the patient’s life.’[9] The court then clearly declared passive euthanasia as permissible and stated that ‘failing to save a person would never constitute a crime’.[10] It further also laid down the protocol to be adhered to by the High Court when an application seeking permission for non-voluntary passive euthanasia is filed. In the year 2012, the 241st Law Commission Report also stated that passive euthanasia shall have legal recognition in India and shall not be objectionable from a legal or constitutional point of view.[11] It also recommended the making of legislation regarding Passive Euthanasia and also formulated a draft Bill.
Fast forward to the year 2018, and the legal arena witnessed the notable case of Common Cause v. Union of India.[12], which commanded widespread attention and sparked intense debate. In this case, the Supreme Court meticulously reviewed all preceding judgments as well as the Law Commission Report and then delved into the matter of euthanasia. Additionally, the Court also examined the global perspective on this issue. It took into account the legal stance on euthanasia in the United States, Canada, Australia, Netherlands, and other countries, and also considered international considerations and decisions of the European Court of Human Rights.
While examining the context of euthanasia concerning Article 21, the Supreme Court noted that the wording used in this Article should be interpreted widely and liberally, as such an article can never be rigid.[13] The court specified that the right to die with the dignity of a dying man would include only passive euthanasia and not active euthanasia. The court furthermore, while refusing to use the term ‘Living Will’, stated that an Advance Medical Directive would be a beneficial directive that would clear doubts throughout the process of treatment of a patient. Justice D.Y Chandrachud, while examining euthanasia through the constitutional principles of liberty, dignity, privacy, and autonomy, affirmed the legality of passive euthanasia and acknowledged the significance of Advance Directives. The court finally reaffirmed the fundamental ‘right to die with dignity, previously established by a constitutional bench judge in the Gian Kaur Case. They stated that a mentally competent adult with complete capacity to make informed decisions has the right to decline medical treatment, including the withdrawal from life-saving devices.[14] Additionally, individuals of sound mind are entitled to create Advanced Medical Directives, subject to specified safeguards.
In the year 2019, an application was filed by the Indian Society of Critical Care Medicine requesting further clarification of the judgment reported in the case of Common Cause v. Union of India.[15] The applicant here stated the difficulties that were being encountered by the doctors and medical professionals. Considering the issues stated during the proceedings the court by the judgement of 2023 modified certain directions of the earlier judgement. It relaxed requirements mandating department Heads or Chiefs to perform specific functions, allowing their subordinates to carry out those responsibilities instead. By easing such procedural requirements the judiciary in this case took a significant step towards ensuring individual autonomy and dignity.
CONCLUSION
As we travel through the years, we have witnessed the evolving perspective of the judiciary towards euthanasia and end-of-life care. Over time, societal perspective has also evolved and we see increased recognition of principles of liberty, dignity, privacy, and autonomy in such matters. With the coming together of legal and social approaches, there will certainly be advancement in this field. And… the Right to Die with Dignity will be honoured.
Author(s) Name: Dwiti Nayak (ILS Law College, Pune)
References:
[1] Wide Interpretation of the Right to Life: The Question of Enforceability, Abhinav Pandey
<https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2403191> accessed 22nd April 2024
[2] Common Cause v. Union of India, (2018) 5 SCC 1
[3] Euthanasia, Britannica <https://www.britannica.com/topic/euthanasia> accessed 22nd April 2024
[4] Euthanasia – Review and update through the lens of a psychiatrist, Anindya K. Gupta and Deepali Bansal <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236687/> accessed 22nd April 2024
[5] Aruna Ramachandra Shanbaug v. Union of India, (2011) 4 SCC 454, [43]
[6] AIR 1996 SC 1257
[7] Gian Kaur v State of Punjab, AIR 1996 SC 1257 [21,22]
[8] Aruna Ramachandra Shanbaug v. Union of India, (2011) 4 SCC 454
[9] ibid 4
[10] Zia Mody, 10 Judgements that changed India (first published 2013) 218
[11] Law Commission, Passive Euthanasia- A Relook (Law Com No. 241, 2012) para 14.1
[12] (2018) 5 SCC 1
[13] Common Cause v. Union of India, (2018) 5 SCC 1 [153]
[14] Common Cause v. Union of India, (2018) 5 SCC 1
[15] Common Cause v. Union of India, 2023 INSC 77
