Is Passive Euthanasia recognized by Indian Law?
Recently, The Supreme Court of India has given legal sanction to passive euthanasia in a landmark verdict, permitting ‘living will’ by patients on withdrawing medical support if they slip into an irreversible coma. It was declared a landmark because the question was whether giving legal sanction to the condition would cause an infringement of the Right to Life
So What is Passive Euthanasia?
The word euthanasia, originated in Greece means good death. Euthanasia encompasses various dimensions. They are:-
- Active (introducing something to cause death) to passive (withholding treatment or supportive measures)
- Voluntary (consent) to Involuntary (consent from guardian)
- Physician-assisted (where physicians prescribe the medicine and the patient or the third party administers the medication to cause death)
Thus, Passive euthanasia can be defined as a condition where there is the withdrawal of medical treatment with the deliberate intention to hasten the death of a terminally-ill patient. It is legal in India unlike the controversial active Euthanasia, which entails the use of lethal substances to either voluntarily or involuntarily end a life.
Development of Passive Euthanasia in recent times
Article 21 of the Indian Constitution enables the person to live life with dignity. However, the recent judgment was given by the Supreme Court of India in March 2018, also recognizes the need of a person to die with dignity.
A five-judge bench of the apex court headed by the Chief Justice of India Dipak Misra and comprising Justices A.K. Sikri, A.M. Khanwilkar, D.Y. Chandrachud, and Ashok Bhushan, issued guidelines in recognition of “living will” made by terminally-ill patients. These guidelines include who can execute the will and under what conditions can the medical board endorse passive euthanasia.
The pressing issue was brought to attention by the PIL filed by NGO Common Cause in 2005 and represented by a noted lawyer, Advocate Prashant Bhushan. He argued that when a medical expert suggests that a patient suffering from a terminal disease has reached a point of no return, she should have the right to refuse artificial life support — medically referred to as passive euthanasia — to avoid prolonged agony.
The bench had earlier reserved its judgment on October 11, 2017, while observing that the right to die in peace could not be separated from the Right to Life under Article 21 of the constitution.
In the Gian Kaur case, the apex court held that Article 21 speaks of life with dignity, and only aspects of life that make it more dignified could be read into this Article, thereby pointing out that the right to die was inconsistent with it.
However, later in Aruna Ramchandra Shanbaug vs Union Of India, the Supreme Court in March 2011 held that passive euthanasia could be given a nod in case of exceptional circumstances and under strict monitoring of the apex court. Aruna Shanbaug had been in a vegetative state since 1973, and on her behalf, Pinki Virani, a social activist, journalist, and writer, had filed a writ petition claiming that her right to life guaranteed by the constitution had been violated.
The Supreme Court was of the opinion that such a decision regarding the death of an individual could not be solely left to the discretion of the patient’s relatives or the ‘next friend’ — like the nursing staff in the case of the Shanbaug case. The Centre at the time opposed recognition of ‘living will’ and said consent for removal of artificial support system given by a patient may not be an informed choice. The decision could stem from a lack of awareness of medical advancements.
In passive euthanasia, death is brought by omission. In other words, by not carrying out any medical intervention to save the person’s life.
Euthanasia is regarded as the only viable option when all life care interventions fall short of ensuring a better life for the terminally ill patient or one who is in a vegetative state.
Living Will
A living will is a written document allowing a patient to give instructions in advance about the medical treatment to be administered when he/she is terminally ill or no longer able to express informed consent, including withdrawing life support if a medical board declares that all life saving medical options have been exhausted.
The Central Government of India had opposed the concept of a living will, stating that there was a risk of misusing such a provision as it may not be viable as a part of public policy.
However, in 2011, the Supreme Court recognized passive euthanasia in Aruna Shanbaug’s case by which it had permitted withdrawal of life-sustaining treatment from patients not in a position to make an informed decision.
Is it Recognized by Law?
On January 15, 2016, the Centre had said the 241st report of the Law Commission stated that passive euthanasia should be allowed with certain safeguards and there was also a proposed law — Medical Treatment of Terminally Ill Patient (Protection of Patients and Medical Practitioners) Bill, 2006.
It had said that on specific occasions, the question of withdrawing supporting devices to sustain cardio-pulmonary function even after brain death, shall be decided only by a doctors’ team and not by the treating physician alone.
Takeaways
The Indian Legal System has come a long way since the enactment of the Constitution of India. From the removal of Section 377 of The Indian Penal Code to recognizing the importance of Passive Euthanasia, it is a testament that the Indian Law is anything but rigid and can adapt to the present time and needs of the people it governs.
