Author: Sreya Shah, Woxsen University.
To the point
The right to die with dignity– Euthanasia has been a burning issue in India for several years. After several constant debates, it was the case, Common Cause v. Union of India (2018), in which the Supreme Court of India recognized the constitutional validity of passive euthanasia and the right to execute advance medical directives. In its broader reading of Article 21, the Court acknowledged that dignity at the end of life is as essential as dignity during life. In a country where cultural and religious beliefs strongly influence public opinion, this case forced India to confront long-overdue debates around autonomy, dignity, and the right to die.
Abstract
In 2018, the Supreme Court of India delivered a landmark judgment in the case Common Cause v. Union of India, affirming the right of terminally ill patients to die with dignity through passive euthanasia. This ruling not only legalised the withdrawal of life support from patients in a permanent vegetative state under strict restrictions, but also permitted the execution of advance medical directives, giving patients the autonomy to outline their healthcare choices before any procedure is initiated. This article analyzes the impact of this landmark verdict on patients who have lost their right to live their lives to the fullest and with dignity due to their prolonged illness. It explores the legal reasoning behind the case and how it shaped the Indian legal framework.
Legal Jargon
The landmark case, Common Cause v. Union of India (2018), revolved around terms such as active and passive euthanasia, Advance medical directives, informed consent, bodily autonomy, and provisions such as Article 21. Active euthanasia involves an intentional act causing the death of a person and is considered illegal under Indian law. On the other hand, passive euthanasia consists of withdrawing life support or withholding medical treatment that would prolong life. Passive euthanasia is a legalised action under Indian law, but it is subject to strict restrictions. In India, passive euthanasia can be performed only under specific circumstances with proper consent. The definition of passive euthanasia highlights the term ‘consent’; the patient must voluntarily permit the act of euthanasia, and if the patient is not capable of consenting, then the consent must be given willingly by the patient’s legal guardian. Informed consent protects the patient’s right to make decisions concerning their body and healthcare, and it ensures that the decision was not coerced upon the patient or his/her guardian.
A key element of this case revolves around Article 21 of the Indian Constitution, which safeguards every citizen’s right to life and personal freedom. Through this case, Article 21 picked up a broader interpretation. The Court declared the right to die with dignity as a fundamental right under Article 21. Further, the court recognized the execution of advance medical directives. An Advance medical directive is a legal document that allows a person to predefine their wishes regarding medical treatment in case they become incapable of making decisions in the future, especially in end-of-life situations.
The proof
The landmark case, Common Cause v. Union of India, paved the way for the right to die through passive euthanasia in cases where an individual is suffering from terminal illness or irreversible coma. It subsequently dismissed all the former legal interpretations concerning euthanasia except the criminalization of active euthanasia. The case was initiated through a Public Interest Litigation filed by Common Cause, a registered society, which urged the Supreme Court to legalise passive euthanasia and recognise advance medical directives (also known as living wills). This case addressed the prolonged debate, or rather a question, whether a person can choose to refuse life-prolonging medical treatment when facing a terminal illness or irreversible coma.
Before passive euthanasia was legally recognized in India, patients who were in a permanent vegetative state had no legal support to end their sufferings and misery voluntarily. The doctors who performed euthanasia were held liable for murder, and in the case of voluntary euthanasia, doctors were punishable for culpable homicide. It was in the case of Aruna Ramchandra Shaunbaug v. Union of India, the Court passed a judgement stating that passive euthanasia can be permitted under rarest circumstances when the respective High Court (under article 226) issues a notice stating the allowance of passive euthanasia after thoroughly ananlysing the state of the patient and consuting the close relatives of the patient.
However, the idea of a legal right to die remained unacknowledged in Indian constitutional law until the Supreme Court’s verdict in Common Cause v. Union of India. In its ruling in Gian Kaur v. State of Punjab, the Supreme Court held that the constitutional right to life does not extend to a right to end one’s life, rejecting the notion of a legal right to die. Through the case of Common Cause, the Supreme Court recognised the will of the patient to die with dignity and relieve them from a prolonged, undesired misery caused by their permanent vegetative state. It acknowledged that prolonging the life of a person in a persistent vegetative state through artificial means could violate their dignity and bodily autonomy. Further, it upheld the validity of the lawful execution of living wills, while also providing a structured mechanism to execute them.
This case raised cultural, religious, and ethical issues among some of the citizens of the country, considering that end-of-life decisions are often influenced by cultures and emotions, especially in a country where religion, family values, and collective morality hold a significant sway. Critics argued that legalising euthanasia, even passively, could create pressure on vulnerable patients. Apart from this, several other negative factors such as corruption, female foeticide, organ-trading, and dowry killings can influence the practice of passive euthanasia. It can be misused by people who side with these heinous crimes. On the other hand, proponents viewed the judgment as a long-overdue recognition of individual agency and relief from unnecessary suffering.
However, this case was a defining moment in India’s legal history, where the idea of life was no longer confined to survival but expanded to include the right to a peaceful and dignified end.
Conclusion
It is gut-wrenching to imagine the mental state of the patients who no longer have control over their bodies and have to rely on artificial machines to survive. These conditions of the patients with prolonged illness or irreversible coma sparked debates over the right to die. In virtue of these constant debates and sufferings of patients, the Supreme Court of India, through the landmark judgment in the case Common Cause v. Union of India (2018), validated the right to die as a fundamental right and legalised the practice of passive euthanasia under strict regulations. Further, the court permitted the execution of advance medical directives that allowed individuals to make decisions regarding their medical treatments in advance. This judgment brought about a significant change in the legal framework concerning the right to die. As debates around autonomy and end-of-life care evolve, this decision stands as a thoughtful yet cautious step toward balancing individual choice with safeguards against misuse.
Case laws
Gian Kaur v. State of Punjab (1996) –
In this case, the Supreme Court refused to recognize ‘right to die’ as a part of ‘right to live’. The Court ruled that suicide is not a fundamental right and upheld the constitutional validity of Section 309 IPC (attempt to suicide). However, it left open the possibility of allowing a dignified death in cases of terminal illness, laying the conceptual groundwork for future debates on euthanasia.
Aruna Shanbaug v. Union of India (2011)
This case involved a nurse who had been in a vegetative state for over 40 years after a brutal assault. Through this case, the Court declared active euthanasia illegal and permitted the practice of passive euthanasia only if the respective High Court’s permission is obtained. It was the first legal recognition of euthanasia in India and paved the way for Common Cause by distinguishing between active and passive euthanasia.
Airedale NHS Trust v. Bland (1993) [UK Case]
Though a British case, it was cited extensively in Indian judgments. The House of Lords allowed the withdrawal of life-sustaining treatment from a patient in a persistent vegetative state. The case became a leading precedent for passive euthanasia and helped shape the Indian judiciary’s understanding of end-of-life autonomy.
FAQS
1. What is passive euthanasia?
Passive euthanasia refers to the withdrawal or withholding of medical treatment to allow a terminally ill patient to die naturally, without artificially prolonging life.
2. What is an advance medical directive or living will?
It is a legal document in which a person declares their wish to refuse life-sustaining treatment in the event they become terminally ill or unconscious and unable to communicate.
3. Is euthanasia legal in India?
Active euthanasia is illegal. Passive euthanasia is legal in India as per the Supreme Court’s ruling in Common Cause v. Union of India (2018), provided that stringent procedural safeguards are met.
