Landmark ruling: SC legalizes passive euthanasia and 'living will'

Posted March 11, 2018

The Supreme Court has framed strict guidelines and formed a medical panel for passive euthanasia. "With the passage of time, this court has expanded the spectrum of Article 21 to include within it the right to live with dignity as the component of the right to life and liberty", the judgement authored by the CJI on behalf of him and Justice A M Khanwilkar said.

It seeks to allow a patient faced with terminal illness not to sustain life through medical treatment in the form of artificial support system. This led journalist-activist Pinky Virani, who published a book regarding her case, titled Aruna's Story, to file a writ petition with the Supreme Court asking for the legalization of euthanasia so that Aruna's suffering could be terminated by withdrawing medical support.

The bench was hearing the PIL filed in 2005 by the NGO which said when a medical expert is of the opinion that a person afflicted with a terminal disease has reached a point of no return, he should be given the right to refuse life support.

In the absence of a living will, decisions about medical care become the responsibility of the spouse, family members or other third parties.

In a separate opinion, Justice Chandrachud observed that modern medical science should balance its quest to prolong life with need to provide patients quality of life.

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Like the privacy judgment, the right to die with dignity is a way for courts to support people living life on their own terms rather than being infantilised by government or exploited by commerce.

The apex court said that advance directives for terminally-ill patients could be issued and executed by the next friend and relatives of such a person after which a medical board would consider it.

Procedure for incompetent patients: In case of an incompetent patient (persons of unsound mind, etc), a near relative, medical practitioner etc, can apply to the High Court for granting permission to withdraw or withhold medical treatment.

The court said a doctor should give "due weight" to the instructions in the document.

The bench said if the board certified that the advance directive should be carried out, the hospital should forthwith inform the collector who would set up another medical board.

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Passive euthanasia is a condition where there is withdrawal of medical treatment with the deliberate intention to hasten the death of a terminally-ill patient.

Dr Ravi Bapat, former dean of the KEM Hospital, who was the first to find Shanbaug in the basement after she was brutally assaulted, did not react to the Supreme Court's verdict.

Passive Euthanasia has been made legal as doctors are not condemned for failing to save a life.

The judgment, delivered by a panel of five judges, permits a "living will" that patients can authorize in advance, which will allow family members to approve turning off artificial life support. "Without pronouncing any order on that prayer, the court invited a constitution bench to resolve the matter on whether to allow euthanasia or not".

Active euthanasia, in which death is brought about by an act such administering a lethal injection, remains illegal in India.

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Meena Ganesh, MD and CEO of Portea Medical, says, "Forcing someone to remain on life-support can be very hard and the increasing costs of stay and care compound the situation". Advance directives (ADs) talk about whether the documents a person completes while still in possession of decisional capacity.