INTRODUCTION:
The topic of euthanasia sits at an intersection between law, medicine, ethics and human dignity. The fast-developing field of modern medicine has enormaously increased the ability to sustain life through artificial methods. Methods like Ventilators, feeding tubes, and intensive care technologies can keep the patient alive even when the only option for recovery is a miracle. While these developments may keep the patient alive, but it raises extremely important legal and ethical questions which should be understood and discussed:
Should life be prolonged when recovery seems impossible? Does right to life also include the right to die with dignity under Article 21?
These issues are central to the euthanasia controversy. The Supreme Court has progressively created a complex framework that distinguishes between active and passive euthanasia, acknowledging the latter as a component of the right to die with dignity under specific conditions.
UNDERSTANDING EUTHANASIA
The Supreme Court in Common Cause V. Union of India offered multiple concurring opinions that clarified the conceptual distinction between active and passive euthanasia. Ignoring the differences in structure or phrasing, the four opinions establish a coherent doctrinal framework. Chief Justice Dipak Misra emphasized the passive euthanasia fundamentally involves the absence of an overt act, distinguishing it from active euthanasia where a specific act is undertaken to end life. Similarly, Justice A.K. Sikri explained that active euthanasia involves the administration of lethal substances or physician assisted suicide, whereas passive euthanasia arises when doctors withhold or withdraw life sustaining treatment, such as ventilator support or artificial feeding. Justice D.Y. Chandrachud further clarified this distinction by framing active euthanasia as a positive contribution that accelerated death, while passive euthanasia consists of omitting medical steps that might otherwise sustain life, particularly through the withdrawal or withholding of treatment. Justice Ashok Bhushan echoed this resigning, stating the euthanasia in its active form requires a positive act intended to cause death, whereas the withdrawal of medical assistance or life prolonging devices cannot be regarded as such as act, as it merely allows the natural process of dying to occur. Read together, these opinions collectively establish that the constitutional legitimacy of passive euthanasia stems from its character as an omission the respects patient’s autonomy and the natural course of death, while active euthanasia remains impermissible due to the deliberate intervention involved in causing death.[1]
ACTIVE EUTHANASIA: A PROHIBITED INTERVENTION
The main defining feature of active euthanasia is introduction of a new external cause of death. It involves a positive act intended to directly cause death; this can include administering lethal injection or prescribing fatal medication. Indian courts have continuously held that such type of conduct or invention is impermissible.
The Courts have continuously clarified that, while compassion for suffering patients may invoke moral sympathy, the deliberate termination of life through positive cats cannot be justified under Article 21 of the constitution and would fall within the scope of criminal law prohibitions.
PASSIVE EUTHANASIA: ALLOWING DEATH TO OCCUR NATURALLY
Passive euthanasia operated on a rather fundamentally different principle than active euthanasia. Unlike active euthanasia it does not cause death directly, it involves withdrawing or withholding medical treatment that artificially prolongs the life.
Examples of passive euthanasia include:
- Discontinuing ventilator support
- Removing feeding tubes
- Refusing extraordinary medical interventions
- Withholding life extending drugs
In these circumstances death occurs due to the underlying medical condition, not due to external intervention.
The Supreme Court has explained that passive euthanasia essentially involves an omission rather than a positive act, where life-sustaining treatment is withheld or withdrawn, allowing the natural process of death to take place. This conceptual distinction forms the legal foundation upon which Indian euthanasia jurisprudence rests.
ARTICLE 21 AND THE RIGHT TO DIE
Initially, Indian Courts interpreted the provision for Article 21 narrowly. However, as time went on judicial interpretations expanded the scope of Article 21 to include several derivative rights necessary for dignified life. A crucial step in its evolution is marked by Gian Kaur v. State of Panjab, where the Supreme Court held that although the constitution does not recognize the general right of a person to die, the concept of life under Article 21 includes the right to die with dignity in case of terminal illness or natural death.[2] This later on laid the ground work for future development and recognition of passive euthanasia.
The Indian Law Commission has addressed euthanasia in several reports. The 196th Law Commission Report (2006)[3] recommended legal recognition of passive euthanasia and proposed statutory safeguards governing withdrawal of life support systems. This was latter reaffirmed in the 241th Law Commission Report (2012).[4]
MEDICAL FUTILITY AND THE BEST INTEREST OF THE PATIENT
A core concept in jurisprudence related to euthanasia is medical futility. A treatment is considered futile when it offers no realistic prospect of recovery or improvement in the patient’s condition. In such situations, courts rely on the best interests of the patient standard when determining whether life sustaining treatment should continue. In such assessments judges typically consider, a patients’ medical prognosis, the likelihood of recovery, the degree of suffering involved, the patient’s previously expressed wish or the views of family members and caregivers. A person’s best interest is the primary consideration behind any judicial decision.[5]
CONCLUSION
The question of euthanasia forces every individual to confront some uncomfortable but fundamental questions about life, suffering, and dignity. Indian constitutional jurisprudence has evolved from its initial rejection of the right to die toward a more nuanced recognition of the right to die with dignity.
By defriending between active and passive euthanasia, the Supreme Court has attempted to reconcile two concepts of competing values, first the sanctity of life and second the autonomy of the individual. While active euthanasia remains prohibited, passive euthanasia has gained recognition as a constitutionally permissible for patients where medical treatment serves no meaningful purpose.
As modern medicine and technology continue to expand the boundaries of life, the legal system must battle with the ethical implications of prolonging life indefinitely. In the end, the challenges lie in ensuring that the law protects not only life itself but also the dignity that gives life its meaning.
Author(s) Name: Rahul Vikramaditya Gaikwad (Savitribai Phule Pune University)
References:
[1] Common Cause v Union of India (2018) 5 SCC 1, paras 178, 202.6 (Dipak Misra CJ), 219 (Sikri J), 384–385 (Chandrachud J), 602–603 (Bhushan J).
[2] Gian Kaur v State of Punjab (1996) 2 SCC 648.
[3] Law Commission of India, Passive Euthanasia – A Relook (Report No 241, 2012).
[4] Law Commission of India, Medical Treatment to Terminally Ill Patients (Protection of Patients and Medical Practitioners) (Report No 196, 2006).
[5]Harish Rana v Union of India, Misc Application No 2238 of 2025 (Supreme Court of India, 2026).
