Euthanasia in India

Supreme Court denies permission to remove a Ryles tube from a patient in a vegetative state, even though the 2018 judgment allows for the withdrawal of life support in terminal cases (passive euthanasia).

What is Euthanasia?

Euthanasia, often referred to as mercy killing, involves the deliberate ending of life to alleviate suffering, particularly in cases of incurable and terminal conditions.

Legal Framework

Supreme Court’s 2018 Judgment: The Supreme Court of India legalised passive euthanasia in 2018, allowing the withdrawal of life support in terminal cases contingent upon the presence of a ‘living will.’

A living will is a legal document specifying an individual’s preferences for medical treatment if they become incapacitated. It must be signed by the individual in the presence of two witnesses and countersigned by a Judicial Magistrate of First Class (JMFC).

Aruna Shanbaug Case, 2011: The Landmark Case allowed passive euthanasia for Aruna Shanbaug, a nurse who remained in a vegetative state for decades after a brutal assault.
Euthanasia Distinction: The SC made a distinction between active and passive euthanasia, permitting the latter under specific conditions.
Harish Rana Case (2024): The SC denied the withdrawal of a Ryles tube from a patient in a vegetative state, stating it is not a life support system.

Law Commission Reports

196th Report (2006): The Law Commission emphasized that withholding or withdrawing medical treatment as per a patient’s instructions is not a breach of professional duty or an offence.
241st Report (2008): The Commission proposed legislation on passive euthanasia and prepared a draft bill, reinforcing the need for a clear legal framework.

Arguments in Favor of Euthanasia

Dignity in Death: By relieving patients from unbearable suffering. In the Netherlands, where euthanasia is legal, patients with terminal illnesses may choose euthanasia to avoid prolonged suffering.
Medical Futility: Withholding treatments that offer no real chance of patient recovery.
Organ Donation: It can potentially save other lives. In Belgium, where euthanasia is regulated, patients who choose euthanasia can consent to organ donation.
Financial Relief: To families by avoiding prolonged and costly treatments.
Judicial Recognition: For the Right to Die with dignity (Article 21) (The Aruna Shanbaug case).

Arguments Against Euthanasia

Religious Opposition: In Christianity and Islam, euthanasia is often opposed because life is a gift from God, and only God has the authority to take it away.
Potential for Abuse: Like non-voluntary euthanasia, where consent is not clear.
Slippery Slope: Leading to a gradual increase in the acceptance of ending lives for less severe conditions.
Undermines Medical Ethics: The World Medical Association (WMA) opposes euthanasia stating that they are inconsistent with the core principles of medical practice.

Way Forward

Strict Legal Guidelines: Implement stringent legal frameworks to regulate passive euthanasia and prevent misuse. The Netherlands enforces strict protocols with mandatory multi-doctor consultations.
Public Awareness: To discuss the ethical and legal aspects of euthanasia. E.g. education on end-of-life care options, such as Advance Care Planning and Advance Medical Directives.
Robust Judicial Oversight: For euthanasia cases, considering ethical, legal, and medical factors. India requires a multi-tier review for passive euthanasia, involving a medical board and High Court judges.
Focus on Palliative Care: To offer compassionate alternatives to euthanasia. E.g. Kerala’s palliative care program improves terminally ill patients’ quality of life, reducing euthanasia demand.

The Supreme Court has affirmed the “right to die with dignity” (Aruna Shanbaug, 2011) while permitting passive euthanasia under strict safeguards (2018 Judgment). Ensuring legal clarity, judicial oversight, and palliative care remains essential to uphold patient autonomy and prevent misuse.

Reference: Indian Express

PMF IAS Pathfinder for Mains – Question 311

Q. Discuss the need for active euthanasia in contrast to passive euthanasia. Evaluate India’s stance on euthanasia and its implications for the right to die with dignity. (250 Words) (15 Marks)

Approach

Introduction: Write a brief definition of Euthanasia and its types, and mention the current status in India.
Body: Discuss the need for active euthanasia in contrast to passive euthanasia, India’s stance on euthanasia and the implications of euthanasia for the right to die with dignity.
Conclusion: Write a futuristic conclusion and mention the future course of action for informed and dignified patient choices.