Author: Mansi Singh, City Law College
Abstract
Passive euthanasia in India occupies a delicate yet significant space at the intersection of constitutional law, medical ethics, and human dignity. As medical science extends biological life beyond natural limits, the law has been compelled to confront an uncomfortable but unavoidable question: does the right to life include the right to die with dignity? Indian jurisprudence, through a series of landmark judgments, has answered this question affirmatively — albeit cautiously. Passive euthanasia, understood as the withdrawal or withholding of life-sustaining treatment in terminal or irreversible medical conditions, has been recognised as legally permissible under stringent procedural safeguards. This article examines the evolution of passive euthanasia in India, tracing its constitutional foundation under Article 21, analysing key judicial pronouncements, scrutinising legal proof and safeguards, and assessing the ethical and practical challenges involved. Through case law and doctrinal reasoning, the article argues that passive euthanasia is not an abandonment of life, but an affirmation of dignity at the end of life.
To the Point
Passive euthanasia is legal in India, subject to Supreme Court-mandated safeguards.
Active euthanasia remains illegal and punishable.
The right to die with dignity is recognised as part of Article 21 of the Constitution.
Landmark cases: Aruna Shanbaug (2011) and Common Cause (2018).
Advance Directives (Living Wills) are legally valid.
Judicial oversight and medical board approvals are mandatory.
Understanding Passive Euthanasia: A Human and Legal Perspective
Euthanasia is often reduced to a sterile legal debate or a polarised moral argument. Yet, at its core, it concerns deeply human experiences — suffering, loss of autonomy, prolonged dependency, and the quiet erosion of dignity. Passive euthanasia does not involve killing; it involves allowing death to occur naturally when medicine can no longer heal but only prolong biological existence.
In legal terms, passive euthanasia refers to an omission — the withdrawal or withholding of extraordinary life-sustaining measures such as ventilators, feeding tubes, or artificial nutrition, where continued treatment serves no curative purpose. The law distinguishes this from active euthanasia, which involves a positive act to cause death and remains impermissible in India.
The ethical justification for passive euthanasia lies in the recognition that life is not merely survival, but a condition of dignity, autonomy, and minimal suffering. When these elements irreversibly collapse, the law is called upon to protect not life at all costs, but life with meaning.
Constitutional Foundation: Article 21 and the Right to Die with Dignity
Article 21 of the Constitution of India states:
“No person shall be deprived of his life or personal liberty except according to procedure established by law.”
Initially interpreted narrowly, Article 21 has been transformed by judicial creativity into a reservoir of unenumerated rights — privacy, health, shelter, and dignity. The Supreme Court has consistently held that the right to life is not confined to mere animal existence.
The crucial jurisprudential shift occurred when the Court recognised that dignity does not vanish at the threshold of death. A life artificially prolonged through invasive medical intervention, in the absence of consciousness or hope of recovery, may violate rather than protect Article 21.
Thus, passive euthanasia derives legitimacy not from a “right to die”, but from the right to refuse medical treatment and the right to a dignified death — both of which are embedded within personal liberty.
Statutory Context and Penal Law Concerns
India lacks a dedicated statute on euthanasia. Consequently, apprehensions arose regarding potential liability under the Indian Penal Code, particularly:
Section 309 IPC – Attempt to commit suicide
Section 306 IPC – Abetment of suicide
However, the judiciary has clarified that passive euthanasia, when carried out under court-approved procedures, does not constitute suicide or its abetment. The intent is not to cause death but to respect the patient’s autonomy and medical futility.
The decriminalisation of attempt to suicide under the Mental Healthcare Act, 2017 further reinforces this compassionate legal approach, signalling a shift from punishment to dignity and care.
Judicial Evolution: Case Law Analysis
1. Aruna Ramchandra Shanbaug v. Union of India (2011)
The Aruna Shanbaug case represents a watershed moment in Indian medico-legal history.
Facts:
Aruna Shanbaug, a nurse in Mumbai, was brutally assaulted in 1973, resulting in irreversible brain damage. She remained in a persistent vegetative state for over four decades. A plea was filed seeking permission to withdraw life support.
Judgment:
The Supreme Court rejected the immediate plea but recognised passive euthanasia in principle. It distinguished between active and passive euthanasia and permitted the latter under judicial supervision.
Legal Significance:
First judicial recognition of passive euthanasia
Introduced the concept of parens patriae — the State acting as guardian
Laid down interim guidelines pending legislation
The Court balanced compassion with caution, ensuring that life was not terminated arbitrarily.
2. Common Cause v. Union of India (2018)
This Constitution Bench decision provided constitutional legitimacy and procedural clarity.
Key Holdings:
The right to die with dignity is a fundamental right under Article 21
Passive euthanasia is lawful
Advance Directives (Living Wills) are legally enforceable
Living Will:
A living will enables a person to express, in advance, their wish to refuse life-prolonging treatment in the event of terminal illness or incapacity.
Safeguards Introduced:
Verification of the living will
Approval by hospital medical boards
Secondary review by an independent board
Documentation and transparency
This judgment humanised constitutional law by recognising that autonomy does not disappear when speech or consciousness does.
Legal Proof and Procedural Safeguards
The legality of passive euthanasia rests on procedural legitimacy, not discretion.
Advance Directive as Legal Proof
A living will serves as primary evidence of the patient’s intent. It ensures that decisions reflect the patient’s values, not external pressures.
Medical Expertise
Decisions are grounded in professional medical assessment, establishing:
Irreversibility of condition
Absence of curative options
Proportionality of treatment
Judicial Oversight
Judicial involvement prevents misuse, coercion, or premature withdrawal of care, ensuring compliance with natural justice.
Together, these safeguards form a chain of legal proof, insulating passive euthanasia from arbitrariness.
Ethical and Social Dimensions
Indian society traditionally reveres life as sacred. Yet, it also values dignity, compassion, and non-violence. Passive euthanasia aligns with these values by:
Preventing prolonged suffering
Respecting patient autonomy
Avoiding futile medical intervention
Critics argue that vulnerable populations may face pressure. However, safeguards and judicial scrutiny act as counterweights. The ethical question is not whether death should be allowed, but whether unnecessary suffering should be imposed.
Challenges in Implementation
Despite legal clarity, practical challenges persist:
Low awareness of living wills
Bureaucratic delays
Uneven hospital compliance
Emotional burden on families
The absence of comprehensive legislation leaves reliance on judicial guidelines, necessitating statutory codification.
Conclusion
Passive euthanasia in India is not a retreat from the sanctity of life, but a profound affirmation of its dignity. Through constitutional interpretation, the Supreme Court has acknowledged that the right to life includes the right to refuse a life of suffering when recovery is impossible. The law does not permit killing; it permits letting go with dignity.
As medical technology advances, the law must continue to evolve — not as a cold arbiter, but as a humane guardian of constitutional values. Passive euthanasia, when regulated with care, compassion, and accountability, reflects a mature legal system that understands that dignity must endure, even at life’s end.
FAQS
Q1. Is passive euthanasia legal in India?
Yes, it is legal under Supreme Court guidelines.
Q2. Is active euthanasia allowed?
No, active euthanasia remains illegal.
Q3. What is a living will?
A legal document expressing refusal of life-prolonging treatment in terminal conditions.
Q4. Can family members request passive euthanasia?
Yes, in the absence of a living will, subject to medical and judicial approval.
Q5. Does passive euthanasia violate IPC provisions?
No, when performed as per legal guidelines.
