Author: PARNOB Bhattacharya, Galgotias University
“My ultimate aim is to make euthanasia a positive experience.” -Jack Kevorkian (American Pathologist)
ABSTRACT:-
The controversy over active euthanasia—deliberately taking a patient’s life to relieve suffering—has emerged as a major ethical, legal, and societal problem in India. With advances in medical technology extending life, frequently at the expense of dignity and quality, the call for legal acceptance of active euthanasia has grown. While the Supreme Court of India allowed passive euthanasia in 2018 with tight limits, active euthanasia is still outlawed because to concerns about ethical misuse, religious convictions, and cultural norms.
The discourse shows a conflict between traditional Indian viewpoints that value the sanctity of life and a modern emphasis on individual autonomy and the right to die with dignity. Proponents claim that active euthanasia is a humane alternative for terminally ill people suffering from unbearable agony, while opponents fear a sliding slope of abuse and moral degradation. The study investigates the legal precedents, societal attitudes, and ethical difficulties that shape the discussion, highlighting the importance of strong protections, transparent frameworks, and a balance of compassion and caution. As India grapples with this controversial topic, a decision on active euthanasia might create a precedent for blending progressive beliefs with deeply ingrained traditions.
INTRODUCTION:-
The Common Cause vs. Union of India case marked a significant milestone in the legal and ethical debate over euthanasia in India. The Supreme Court decided this momentous case in 2018, recognizing the constitutional right to die with dignity and legalizing passive euthanasia under tight safeguards. The decision underlined the significance of human autonomy and the sanctity of life while also recognizing the need for regulation to prevent misuse. The Court established the legitimacy of advance medical directives, which allow people to express their preferences for medical treatment in situations where they are unable to communicate. This case not only reaffirmed the right to life guaranteed by Article 21 of the Indian Constitution, but also expanded its scope to encompass a dignified dying. The decision establishes a critical precedent for future discussions on end-of-life care by addressing the complicated interplay of law, morality, and medical ethics.
BACKGROUND ON EUTHANASIA:-
Euthanasia, or mercy killing, is the practice of intentionally ending a life to relieve pain and suffering. It is broadly classified into two categories:
Active Euthanasia: Deliberate action to cause death, such as administering a lethal injection.
Passive Euthanasia: Withholding or withdrawing medical treatment necessary to sustain life.
The debate over euthanasia is centered on the inherent contradiction between the sanctity of life and individual autonomy. Proponents say that people suffering from excruciating pain or fatal illnesses should be permitted to choose a dignified death. Critics, on the other hand, warn against potential abuse and emphasize the value of life as inscribed in diverse religious and cultural traditions.
Euthanasia was widely believed illegal in India until the Supreme Court ruled in Aruna Shanbaug vs. Union of India (2011). This case established the notion of “Passive euthanasia,” which allows for the cessation of life-sustaining care for patients in a Permanent Vegetative State (PVS) under specific conditions. However, the legal structure remained unclear, requiring additional court review.
THE CASE- COMMON CAUSE VS. UOI:-
Petitioner: Common Cause, a non-governmental organization (NGO) that advocates for public causes, filed a writ petition under Article 32 of the Indian Constitution. The petition sought the enforcement of the “right to die with dignity” as part of the right to life guaranteed under Article 21.
Respondent: Union of India, representing the Central Government.
KEY ISSUE RAISED:-
Should the “right to die with dignity” be recognized as a fundamental right under Article 21?
Can individuals draft advance medical directives (living wills) to express their wishes regarding end-of-life care?
What safeguards should be instituted to prevent misuse of euthanasia?
ARGUMENTS PRESENTED:-
Arguments by the Petitioner:-
Right to Die with Dignity: The petitioner argued that the “right to life” under Article 21 encompasses the right to live with dignity. This right, they contended, includes the ability to choose a dignified end when life becomes unbearable due to terminal illness or incapacitation.
International Precedents: The petition cited legal frameworks in countries like the Netherlands, Belgium, and Canada, where euthanasia or assisted dying is regulated and permitted under certain conditions. These examples were used to argue for a progressive interpretation of Indian law.
Advance Medical Directives: Common Cause emphasized the need for legal recognition of living wills, enabling individuals to make informed decisions about their end-of-life care. This, they argued, would empower patients and reduce the burden on families and medical professionals.
Arguments by the Respondent:-
Sanctity of Life: The Union of India contended that the sanctity of life is paramount and that legalizing euthanasia could lead to potential misuse, particularly against vulnerable individuals such as the elderly and disabled.
State Responsibility: The government emphasized its role in preserving life and argued that allowing euthanasia might contravene its duty to provide adequate healthcare and palliative care.
Ethical and Religious Concerns: Drawing from India’s diverse cultural and religious ethos, the respondent highlighted the potential societal implications of recognizing euthanasia.
THE SUPREME COURT DECISION:-
On March 9, 2018, a five-judge Constitution Bench of the Supreme Court, led by Chief Justice Dipak Misra, delivered its judgment. The Court recognized the “right to die with dignity” as an intrinsic part of Article 21 and laid down a framework for the implementation of passive euthanasia and advance medical directives.
Key Highlight of the Judgment:-
Recognition of the Right to Die with Dignity: The Court ruled that Article 21, which guarantees the right to life, also includes the right to live with dignity and the right to die with dignity. The judgment emphasized that forcing individuals to endure prolonged suffering infringes on their fundamental rights
Legalization of Passive Euthanasia: The Court reaffirmed the principles established in the Aruna Shanbaug case and provided a detailed procedure for permitting passive euthanasia. This involves withdrawing or withholding life-sustaining treatment for patients who are terminally ill or in a permanent vegetative state.
Advance Medical Directives: The Court recognized the validity of living wills, enabling individuals to outline their preferences for end-of-life care. It prescribed safeguards to ensure that such directives are genuine and not influenced by external pressures.
Safeguards Against Misuse: The judgment included stringent guidelines to prevent the misuse of euthanasia and advance directives. These include:
Verification by a medical board comprising specialists.
Mandatory approval by a judicial magistrate.
Periodic review of the patient’s condition.
Role of State and Medical Professionals: The judgment underscored the importance of strengthening palliative care and sensitizing medical professionals to ethical dilemmas surrounding euthanasia.
BROADER IMPLICATIONS:-
1. Legal and Ethical Clarity: The judgment provided much-needed clarity on the legal status of euthanasia in India. By distinguishing between active and passive euthanasia and establishing procedural safeguards, it struck a balance between individual autonomy and societal concerns.
2. Empowerment of Patients: Recognizing living wills empowered individuals to make informed decisions about their end-of-life care, reducing emotional and financial burdens on families.
3. Ethical Challenges for Medical Professionals: The judgment posed ethical dilemmas for healthcare providers, requiring them to navigate the delicate balance between preserving life and respecting patient autonomy.
4. Strengthening Palliative Care: The Court’s emphasis on palliative care highlighted the need for accessible and affordable healthcare services to ensure that euthanasia is not sought due to inadequate medical support.
5. Societal Attitudes towards Death: The judgment prompted a broader societal conversation about death, dignity, and the ethical implications of end-of-life care in India’s multicultural and religiously diverse society.
CRITICISM AND CHALLENGES:-
Despite its progressive nature, the judgment faced criticism on several fronts:
Ambiguity in Implementation: Critics argued that the procedural safeguards, while necessary, could make it difficult for patients and families to navigate the legal system.
Cultural and Religious Sensitivities: The recognition of euthanasia continues to clash with traditional beliefs that consider life sacred and inviolable.
Risk of Misuse: Concerns persist about the potential for coercion or exploitation, particularly in cases involving vulnerable individuals.
Lack of Awareness: The concept of living wills remains unfamiliar to many, necessitating widespread public education and awareness campaigns.
FAQS
What is passive euthanasia, and how is it different from active euthanasia?
-Passive euthanasia involves withholding or withdrawing medical treatment that is keeping a terminally ill person alive, allowing the person to die naturally. For example, stopping life support or not performing a life-saving surgery.
Active euthanasia entails taking specific steps to cause a person’s death, such as administering a lethal injection. Active euthanasia remains illegal in India.
What was the Supreme Court’s decision in this case?
-On March 9, 2018, the Supreme Court of India delivered a unanimous judgment:
Recognized the legality of Passive Euthanasia under certain conditions.
Allowed individuals to make an Advance Directive (living will), specifying their medical treatment preferences in case they become terminally ill or unable to express consent.
Declared that the right to die with dignity is part of the fundamental right to life under Article 21 of the Constitution.
What was the significance of this judgment?
– The judgment:
Affirmed the right to die with dignity as a fundamental aspect of the right to life under Article 21.
Provided clarity on the legal framework for passive euthanasia in India.
Empowered individuals to make decisions about their end-of-life care, reducing the ethical dilemmas faced by families and medical professionals.
Is active euthanasia legal in India following this judgment?
– No, active euthanasia remains illegal in India. The court only allowed passive euthanasia under strict conditions.
What safeguards did the Supreme Court impose for implementing passive euthanasia and living wills?
-The court outlined detailed safeguards, including:
For passive euthanasia:
Medical practitioners must confirm the patient’s condition as terminal or irreversible.
Approval from a medical board constituted by the hospital is mandatory.
Judicial oversight may be required in certain cases.
For living wills:
The document must be voluntarily created by the individual while they are of sound mind.
It must be signed and attested in the presence of witnesses and a judicial magistrate.
When the living will is invoked, it requires confirmation by a medical board and judicial authority.
CASE LAWS:-
P. Rathinam vs Union Of India (1994):- The case dealt with the decriminalization of suicide under Section 309 of the IPC. The court initially ruled that Section 309 was unconstitutional, as the right to die could be derived from Article 21.
Gian Kaur vs State of Punjab (1996):- Gian Kaur and her husband were convicted under Section 306 of the Indian Penal Code (IPC) for abetment of suicide. The court held that the “right to life” under Article 21 does not include the “right to die”.
Aruna Shanbaug vs Union Of India (2011):- Aruna Shanbaug was a nurse who remained in a vegetative state for 42 years after being assaulted in 1973. A petition was filed by a journalist seeking euthanasia for her. The court rejected active euthanasia but allowed passive euthanasia under strict conditions.
CONSLUSION
The case of Common Cause vs Union of India was a breakthrough moment in Indian law, broadening the scope of the right to life under Article 21. By recognizing the “right to die with dignity,” the Supreme Court protected the ideals of individual autonomy and human dignity while instituting strong protections against abuse. However, the route forward necessitates collaborative efforts from all parties, including the judiciary, legislation, healthcare providers, and civil society. Raising awareness, improving palliative care, and addressing ethical and cultural concerns are all critical to ensuring that the right to die with dignity is practiced responsibly and compassionately.
As India continues to deal with the issues of euthanasia, the legacy of this landmark case serves as a reminder of the delicate balance between law and ethics and humanity in shaping a just and compassionate society.
