What Does Supreme Court Permitting Passive Euthanasia Mean?

The Supreme Court building in New Delhi

The legal experts today welcomed the Supreme Courts landmark decision recognising a terminally-ill patients right to execute a "living will" to refuse medical treatment, saying the verdict has brought clarity for doctors, patients and their relatives on what is permitted and what is not. The living will is defined as the person's right to issue a pre directive where in which he or she allows the withdrawal of life support or discontinuation of medicine if a situation arises in future of person being in a terminally ill state.

The apex court laid down principles relating to the procedure for execution of advance directive or "living will" and spelt out guidelines and safeguards to give effect to passive euthanasia in both circumstances, that is where there are advance directives and where there are none.

The decision, given by the Bench of Chief Justice Dipak Misra, Justices AK Sikri, AM Khanwilkar, DY Chandrachud and Ashok Bhushan, said, "The right to live with dignity (a component of right to life and liberty under Article 21) also includes the smoothening of the process of dying in case of a terminally-ill patient or a person in PVS with no hope of recovery". Friday's Supreme Court verdict is a major step in the direction of allowing passive euthanasia in India.

The Indian Medical Association (IMA) said the judgement was long overdue and would pave the way in ensuring that everybody is granted the "right to die with dignity".

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So far, pulling the plug on a terminally-ill patient posed a grave moral and ethical dilemma to the family as also to the treating doctor and hospital who ran the risk of criminal prosecution for abetting murder. "But before passive euthanasia comes the question of the living will". "Neither the law nor the Constitution compels an individual who is competent and able to take decisions, to disclose the reasons for refusing medical treatment nor is such a refusal subject to the supervisory control of an outside entity", Justice Chandrachud said.

What is the government view on passive euthanasia?

The court also considered such cases where no living will or directive is left behind. M R Rajagopal, chairman of Pallium India and a co-author of the study, said there are an estimated 10 million patients in India requiring palliative care every year.

An NGO based in Delhi, Common Cause, had moved the court in 2005 with a plea to make living will a reality.

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K Venkatesh: A young 25-year-old man from Hyderabad suffering from Muscular Dystrophia pleaded before the authorities to help him end his life only to die two days after his plea was rejected by the Andhra Pradesh High Court.

Aruna Shanbaug: The KEM nurse who was strangulated and sodomised by a sweeper in 1973 leading to her spending the rest of her life in vegetative state drew a wide spread attention. "We do not support active euthanasia", says Jha. He was seen on the TV lauding the verdict as a "historical ruling" and said, "The whole world takes birth crying, but Mahavira taught us to die laughing".

In the absence of a law authorizing doctors to invoke an advance directive, they keep incurable patients on life support, he said.

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