A five-judge Supreme Court constitutional bench led by Chief Justice of India Dipak Misra on March 9, 2018 ruled that under specific circumstances, a person has the right to decide against artificial life support by creating a living will.
- The SC bench upheld a person’s right to choose passive euthanasia by creating an Advance Medical Directive — commonly referred to as a living will in the eventuality of a terminal illness with no hope of recovery, an irreversible coma or a permanent vegetative state.
What the SC says?
- The right to life and liberty, enshrined under Article 21 of the Indian Constitution, also includes the right to die peacefully and with dignity.
- The refusal to take treatment and allowing disease to take its natural course is not suicide. The Passive euthanasia is a “mere acceleration of the inevitable conclusion.” Active euthanasia is unlawful. Suicide involves “overt acts” which culminates in an unnatural death. A valid ‘Living Will’ facilitates passive euthanasia.
- “Meaningful existence” includes a person’s right to self-determination and autonomy to decide his medical treatment, the court held.
- The right to a dignified life includes a “dignified procedure of death.”
- Though religion, morality, philosophy, law and society have conflicting opinions about whether right to life includes the right to die, they all agree that a person should die with dignity.
Strict conditions
- The Supreme Court while upholding the passive euthanasia, laid down strict conditions for creating and executing a living will. These conditions are;
- It must be made by an adult “in his normal state of health and mind.
- It should be voluntarily executed based on informed consent
- The document should indicate the circumstances when treatment which will “only delay the process of death that may otherwise cause him or her pain, anguish and suffering and leave the executor in a state of indignity” may be withdrawn. Unclear and ambiguous living wills would not be executed, the bench said.
- The living will should also name a guardian, who can be a relative or a friend, to give consent for stopping the treatment. It must be signed by a first class Judicial Magistrate.
- A copy should be forwarded to the district court registry and another copy should be handed to a municipal corporation, municipality or panchayat.
- A medical board will be constituted by the hospital to decide on the passive euthanasia.
- After certification from the medical board, the hospital will inform the district collector. Collector will also constitute another medical board for final opinion.
- The second medical board’s opinion will be conveyed to the judicial magistrate who after visiting the patient will authorize the decision.
What was central government’s view?
- The central government opposed passive euthanasia based on living will and argued that patients may not be aware of medical advancements that could cure them.
Who filled the writ?
- The SC judgment was delivered on a public interest litigation filed by Delhi-based non-governmental organisation Common Cause in 2005. In their PIL, the litigant was pleading for an individual’s right to make a living will document for passive euthanasia.
Active and Passive Euthanasia
- Passive euthanasia is the act of withdrawing or withholding medical support to a dying patient who has no hope for revival or cure. By contrast, active euthanasia is the act in which death is medically administered using a lethal injection, continues to be illegal in India.
About Living Will
- It is a document of a person to decide on ending life in case he becomes terminally ill, gets into vegetative state and has no hope of recovery .
