Euthanasia: India

From Indpaedia
(Difference between revisions)
Jump to: navigation, search
(2016: Towards a law on euthanasia)
(2026: SC allows passive euthanasia for man in coma)
 
(9 intermediate revisions by 2 users not shown)
Line 11: Line 11:
 
[[Category:Places |E ]]
 
[[Category:Places |E ]]
  
=Supreme Court guidelines on Euthanasia=
+
=Legal measures=
 +
==2011: Supreme Court guidelines on Euthanasia==
 
[http://www.thehindu.com/specials/in-depth/aruna-shanbaug-42-yearold-battle-with-life/article7223153.ece ''The Hindu''], May 23, 2015
 
[http://www.thehindu.com/specials/in-depth/aruna-shanbaug-42-yearold-battle-with-life/article7223153.ece ''The Hindu''], May 23, 2015
  
 
'''Active euthanasia''' : Administering of lethal injection to snuff out life is illegal in India
 
'''Active euthanasia''' : Administering of lethal injection to snuff out life is illegal in India
 +
 
Parents, spouse, close kin, "next friend" can decide, in best interests of the patient, to discontinue life support. The decision must be approved by a HC.  
 
Parents, spouse, close kin, "next friend" can decide, in best interests of the patient, to discontinue life support. The decision must be approved by a HC.  
  
In dealing with such a plea,
+
'''In dealing with such a plea,'''
  
 
» Chief Justice of High Court must create a Bench of at least 2 judges to reach a decision.
 
» Chief Justice of High Court must create a Bench of at least 2 judges to reach a decision.
Line 27: Line 29:
 
'''Passive euthanasia''' : Withdrawing life support, treatment or nutrition that would allow a person to live, was legalised by way of SC guidelines in 2011.
 
'''Passive euthanasia''' : Withdrawing life support, treatment or nutrition that would allow a person to live, was legalised by way of SC guidelines in 2011.
  
=Mercy killing: Prevalent in parts of Tamil Nadu=
+
==2016: Towards a law on euthanasia==
 +
[http://www.thehindu.com/opinion/editorial/editorial-on-govts-willingness-to-make-law-on-euthanasia/article8179920.ece ''The Hindu''], February 2, 2016
 +
 
 +
'''Towards a law on euthanasia'''
 +
 
 +
The Union government has informed a Constitution Bench of the Supreme Court that its experts are examining a draft Bill proposed by the Law Commission in its 241st report. However, it has been advised by the Law Ministry to hold back its enactment now, as the matter is pending before the court. Over a decade ago, the government felt that legislation on euthanasia would amount to doctors violating the Hippocratic Oath and that they should not yield to a patient’s “fleeting desire out of transient depression” to die. The government’s latest stand represents forward movement in the quest for a legislative framework to deal with the question whether patients who are terminally ill and possibly beyond the scope of medical revival can be allowed to die with dignity. The question was raised with a great deal of passion in the case of Aruna Shanbaug, a nurse who lay in a vegetative state in a Mumbai hospital between 1973 and 2015. In a landmark 2011 verdict that was notable for its progressive, humane and sensitive treatment of the complex interplay of individual dignity and social ethics, the Supreme Court laid down a broad legal framework. It ruled out any backing for active euthanasia, or the taking of a specific step such as injecting the patient with a lethal substance, to put an end to a patient’s suffering, as that would be clearly illegal. It allowed ‘passive euthanasia’, or the withdrawal of life support, subject to safeguards and fair procedure. It made it mandatory that every instance should get the approval of a High Court Bench, based on consultation with a panel of medical experts.
 +
 
 +
The question now before a Constitution Bench on a petition by the NGO Common Cause is whether the right to live with dignity under Article 21 includes the right to die with dignity, and whether it is time to allow ‘living wills’, or written authorisations containing instructions given by persons in a healthy state of mind to doctors that they need not be put on life-support systems or ventilators in the event of their going into a persistent vegetative state or state of terminal illness. The government’s reply shows that the Directorate-General of Health Services has proposed legislation based on the recommendations of an Experts’ Committee. The experts have not agreed to active euthanasia because of its potential for misuse and have proposed changes to a draft Bill suggested by the Law Commission. However, there seems to be no support for the idea of a ‘living will’, as the draft says any such document will be ‘void’ and not binding on any medical practitioner. It is logical that it should be so, as the law will be designed specifically to deal with patients not competent to decide for themselves because of their medical condition. This has to be tested against the argument that giving those likely to drift into terminal illness an advance opportunity to make an informed choice will help them avoid “cruel and unwanted treatment” to prolong their lifespan. To resolve this conflict between pain and death, the sooner that a comprehensive law on the subject is enacted, the better it will be for society.
 +
 
 +
==2018: SC legalises passive euthanasia, living wills==
 +
[https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar00301&sk=79C1A32B&mode=text  Dhananjay Mahapatra & Amit Anand Choudhary, SC legalises passive euthanasia and living will, says right to life includes right to die, March 10, 2018: ''The Times of India'']
 +
 
 +
[[File: Passive euthanasia paves way for decriminalising suicide.jpg|Passive euthanasia paves way for decriminalising suicide <br/> From: [https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar00301&sk=79C1A32B&mode=text  Dhananjay Mahapatra & Amit Anand Choudhary, SC legalises passive euthanasia and living will, says right to life includes right to die, March 10, 2018: ''The Times of India'']|frame|500px]]
 +
 
 +
''Lays Down Guidelines To Prevent Abuse''
 +
 
 +
In a milestone verdict expanding the right to life to incorporate the right to die with dignity, the Supreme Court on Friday legalised passive euthanasia and approved ‘living will’ to provide terminally ill patients or those in a persistent and incurable vegetative state (PVS) a dignified exit by refusing medical treatment or life support.
 +
 
 +
The verdict, the latest in a string of boosts for individual freedoms by the SC, was delivered by a constitution bench of Chief Justice Dipak Misra and Justices A K Sikri, A M Khanwilkar, D Y Chandrachud and Ashok Bhushan.
 +
 
 +
It empowers a person of sound mind and health to make a ‘living will’ specifying that in the event of him/her slipping into a terminal medical condition in future, his/her life should not be prolonged through a life support system. The person concerned can also authorise, through the will, any relative or friend to decide in consultation with medical experts when to pull the plug.
 +
 
 +
Given Indian sensitivities about life and death, testing the legality of the idea posed a complex medical, philosophical, constitutional and religious jigsaw for the bench.
 +
 
 +
CJI Misra led his colleagues on the bench to harmonise the inevitable yet opposite facets — life and death — and say in unison that “right to die with dignity is an intrinsic facet of right to life guaranteed under Article 21”.
 +
 
 +
With this ruling, the SC has recognised that an individual with terminal illness or in a state of irreversible vegetative condition has the agency to decide whether he/she would like to die, a sphere which was so far constitutionally reserved for the state, which alone could deprive a person of his/her life in accordance with law.
 +
 
 +
However, to prevent possible misuse by greedy relatives eyeing the patient’s property, the SC provided for stringent guidelines for preparing and giving effect to ‘living will’ and administration of ‘passive euthanasia’ by involving multiple medical boards comprising several experts and even judicial officers.
 +
 
 +
'''Only passive euthanasia will come under ambit of Article 21, says CJI'''
 +
 
 +
In a cumulative 538-page judgment containing four opinions, the SC said passive euthanasia, or a provision for passive euthanasia through ‘advance directive’ or ‘living will’, would save “a helpless person from uncalled for and unnecessary treatment when he is considered as merely a creature whose breath is felt or measured because of advanced medical technology”.
 +
 
 +
“There comes a phase in life when the spring of life is frozen, the rain of circulation becomes dry, the movement of body becomes motionless, the rainbow of life becomes colourless and the word ‘life’ which one calls a dance in space and time becomes still and blurred and the inevitable death comes near to hold it as an octopus gripping firmly with its tentacles so that the person ‘shall rise up never’,” CJI Misra said.
 +
 
 +
Writing the lead judgment with Justice Khanwilkar, CJI Misra said, “A dying man who is terminally ill or in PVS can make a choice of premature extinction of his life as being a facet of Article 21. We must make it clear that as a part of the right to die with dignity in a case of a dying man who is terminally ill or in PVS, only passive euthanasia would come within the ambit of Article 21 and not the one which would fall within the description of active euthanasia in which positive steps are taken either by the treating physician or some other person.”
 +
 
 +
Linking life and death with the thread of dignity, the SC said administration of life support system and medicines merely to prolong heart beat in a patient who was not even aware that he/she was breathing amounted to denial of dignity to that person who had no choice but to “suffer an avoidable protracted treatment”. The SC also ruled that a patient had the right to refuse medical treatment.
 +
 
 +
Justice Sikri adopted an unorthodox comparison of rights in his separate yet concurrent judgment and said, “Right to health is part of Article 21. At the same time, it is also a harsh reality that everybody is not able to enjoy that right because of poverty or other reasons. The state is not in a position to translate into reality this right to health for all citizens. Thus, when citizens are not guaranteed the right to health, can they be denied the right to die in dignity?” He also questioned the rationality of limited and costly life saving facilities getting occupied by rich patients in the ‘no return zone’ to deprive others who could be revived.
 +
 
 +
Justice Chandrachud opened yet another aspect of right to life by ruling on autonomy of an individual over his/ her body and ruled in his concurring judgment, “The state cannot compel an unwilling individual to receive medical treatment. While an individual cannot compel a medical professional to provide a particular treatment (this being in the realm of professional medical judgment), it is equally true that the individual cannot be compelled to undergo medical intervention.”
 +
 
 +
Justice Bhushan said, “An adult human being having mental capacity to take an informed decision has the right to refuse medical treatment including withdrawal from live saving devices.” CJI Misra and Justice Khanwilkar said, “His ‘being’ (existence) exclusively rests on the mercy of the technology which can prolong the condition for some period. The said prolongation is definitely not in his interest. On the contrary, it tantamounts to destruction of his dignity which is the core value of life. In our considered opinion, in such a situation, an individual’s interest has to be given priority over state interest.”
 +
 
 +
===2018: What the SC said===
 +
[https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar01407&sk=91390442&mode=text  Dhananjay Mahapatra, In country of poor, why force costly life support, asks SC, March 10, 2018: ''The Times of India'']
 +
 
 +
 
 +
''Clarifies It’s Applying Utilitarian Principle Only In Limited Sense''
 +
 
 +
In the process of building a constitutional link between right to life and right to die, the Supreme Court said the economics of extending the life of a terminally ill person with no hope of revival did not make sense in a country where the majority is not able to afford health services.
 +
 
 +
What forced Justice A K Sikri, part of the five-judge bench led by CJI Dipak Misra, to dwell on economics while favouring passive euthanasia was the spiralling daily expense in hospitals to keep a terminally ill person on life support system, often spelling financial ruin for poor families.
 +
 
 +
Devoting a separate chapter on ‘Economics of Euthanasia’ in his 112-page judgment, Justice Sikri said, “When we consider the matter of euthanasia in the context of economic principles, it becomes another reason to support the aforesaid conclusion. This aspect can be dealt with in two ways.
 +
 
 +
“First, because of rampant poverty where majority of the persons are not able to afford health services, should they be forced to spend on medical treatment beyond their means and in the process compelling them to sell their house property, household things and other assets which may be means of (their) livelihood. Second, when there are limited medical facilities available, should a major part thereof be consumed on those patients who have no chances of recovery?”
 +
 
 +
Explaining the importance of applying cost-benefit test even to constitutional principles, Justice Sikri said, “At times, for deciding legal issues, economic analysis of law assumes importance. It is advocated that one of the main reasons which should prompt philosophers of law to undertake economic analysis seriously is that the most basic notion in the analysis — efficiency or Pareto optimality — was originally introduced to help solve a serious objection to the widely held moral theory, utilitarian.
 +
 
 +
“Utilitarians hold that the principle of utility is the criterion of the right conduct. If one has to evaluate policies in virtue of their effect on individual welfare or utility, one norm of utility has to be compared with that of another. We may clarify that this economic principle has been applied in a limited sense only as a supporting consideration with the aim to promote efficiency.”
 +
 
 +
''Where a majority is not able to afford health services, should people be forced to spend on treatment beyond their means... Secondly, when there are limited medical facilities, should a major part thereof be consumed on those who have no chance of recovery?'': JUSTICE SIKRI
 +
 
 +
===What individual judges said===
 +
[https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar01403&sk=628E1B61&mode=text  March 10, 2018: ''The Times of India'']
 +
 
 +
 
 +
'''Justices Dipak Misra & AM Khanwilkar'''
 +
 
 +
Life sans dignity is an unacceptable defeat... life that meets death with dignity is a value to be aspired for and a moment for celebration
 +
 
 +
'''Justice A K Sikri'''
 +
 
 +
Rote hue aate hain sab, hansta hua jo jaayega. Wo muqaddar ka sikandar jaaneman kehlayega Quoting song from Bollywood film Muqaddar Ka Sikandar. Emphasis: Everyone is bound to die and death must be peaceful
 +
 
 +
'''Justice D Y Chandrachud'''
 +
 
 +
Life and death... inseparable.
 +
 
 +
Our bodies are in a process of continuous change. Millions of cells perish as nature regenerates new ones... Life is not disconnected from death. Both essential in the cycle of existence... To be free of suffering is liberation. Liberty to decide how to be treated when the end is near... essential attribute of personhood
 +
 
 +
'''Justice Ashok Bhushan'''
 +
 
 +
Every life is a gift of God and sacred... has to be protected at all cost... The right to self determination and bodily integrity has been recognised by this Court. The right to execute an advance medical directive is nothing but a step towards protection of that right by an individual...
 +
 
 +
=== Living wills===
 +
[[File: Who can execute a living will?, What should it contain?, Should it be rewarded and preserved?.jpg|Who can execute a living will?, What should it contain?, Should it be rewarded and preserved? <br/> From: [https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/PrintArticle.aspx?doc=TOIM%2F2018%2F03%2F10&entity=ar02303&ts=20180310103218&uq=20180306103613&mode=image  March 10, 2018: ''The Times of India'']|frame|500px]]
 +
 
 +
[[File: When and by whom it can be given effect?, What if permission is denied?.jpg|When and by whom it can be given effect?, What if permission is denied? <br/> From: [https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/PrintArticle.aspx?doc=TOIM%2F2018%2F03%2F10&entity=ar02303&ts=20180310103218&uq=20180306103613&mode=image  March 10, 2018: ''The Times of India'']|frame|500px]]
 +
 
 +
'''See graphics''':
 +
 
 +
''Who can execute a living will?, What should it contain?, Should it be rewarded and preserved?''
 +
 
 +
''When and by whom it can be given effect?, What if permission is denied?''
 +
 
 +
 
 +
==2023: SC Simplifies its order on passive euthanasia==
 +
[https://epaper.timesgroup.com/article-share?article=25_01_2023_201_020_cap_TOI  AmitAnand Choudhary, January 25, 2023: ''The Times of India'']
 +
 
 +
New Delhi : The Supreme Court modified its 2018 order on passive euthanasia to make the procedure of removal of (or withholding) life support from terminally ill patients less cumbersome for the patients, their families and the doctors by limiting the role played by government officials.
 +
 
 +

While the requirement of setting up two medical boards — one primary and other review — to examine the medical condition of the patient has been retained, the SC has done away with the rule mandating that the district collector set up the review board. The court said both boards will be constituted by the hospital and there would be one nominee doctor of the district medical officer in the review board. The medical boards must take a decision on such cases preferably within 48 hours, it added.
 +
 
 +

While the current rules state that the consent of the judicial magistrate is required for conducting passive euthanasia, the new order by a five-judge bench of Justices K M Joseph, Ajay Rastogi, Aniruddha Bose, Hrishikesh Roy and C TRavikumar says the magistrate just needs to be informed.
 +
 
 +
 
 +
==2026: SC allows passive euthanasia for man in coma==
 +
[https://epaper.indiatimes.com/article-share?article=12_03_2026_023_008_cap_TOI AmitAnand.Choudhary, March 12, 2026: ''The Times of India'']
 +
 
 +
New Delhi : In the first approval of passive euthanasia, which was legalised by SC in 2011, the apex court allowed withdrawal of medical treatment to 32-year-old Harish Rana, who has been in a vegetative state for more than 13 years with irreversible and non-progressive brain damage, paving the way for nature to take its course and to end the agony of his parents who had undergo the pain of witnessing their son’s suffering every day. 

 +
 
 +
A bench of Justices J B Pardiwala and K V Viswanathan took the “difficult decision” on the basis of reports of two medical boards that approved removal of life support system after personally interacting with Harish’s parents. It said the continuation of medical treatment is not in best interest.
 +
 
 +

SC directed AIIMS Delhi to admit Harish in its palliative care centre and take steps for withdrawal or withholding of his medical treatment. “The resultant effect must not be the abandonment of the patient,” it said.
 +
 
 +
==Harish Rana verdict. SC, 2026==
 +
[https://epaper.indiatimes.com/article-share?article=05_04_2026_006_018_cap_TOI  Kritika.Sharma, April 5, 2026: ''The Times of India'']
 +
 
 +
 
 +
Supreme Court’s landmark judgment allowing withdrawal of life support to Harish Rana will help families in a similar situation because of the guidelines laid down by it, even as it asked the Centre to legislate, Manish Jain, counsel for Rana’s family, says. Injured after a fall when he was a civil engineering student in Chandigarh in 2013, Rana was in a vegetative state for 13 years, and his family fought a long legal battle. After 10 days of withdrawal of life support at AIIMS, under the watch of specialists, Rana died. Jain spoke to TOI about the dilemma before the court, application of ‘right to die with dignity’, the widened definition of life support it accepted, and more. Excerpts:

 +
 
 +
''' Why do you think it was so difficult for the legal system to allow passive euthanasia or withdrawing life support from a person who is beyond recovery? Right to die with dignity was recognised in Common Cause back in 2018. '''
 +
 
 +

Under our laws, if a person has committed a crime, they can be charged under appropriate sections and awarded the death penalty. But when it comes to a person who has not committed any crime, how do you take their life away? If one cannot give life, how can they simply take life? This dilemma has no solution. Because of this dilemma, Article 21, which talks about ‘right to die with dignity’, came into the picture. If someone kills you, that’s an offence. Therefore, a case where a court has to decide on taking someone’s life is always difficult.

 +
 
 +
''' You were a part of the legal team when Harish Rana’s petition was rejected by Delhi HC in 2024 and Supreme Court upheld that. When you moved SC again, what changed about your approach? '''
 +
 
 +

In a case of passive euthanasia, what is acceptable is withdrawal of life support. But Harish Rana did not fall in the ambit of traditional life support because he was not connected to a ventilator or any other such equipment. He was surviving on a PEG (percutaneous endoscopic gastrostomy) tube, which was medical equipment. The first time we went to HC, we said he is surviving through medical support but not traditional life support. Since this was not traditional life support, the judge refused the plea. Against that order, we went to Supreme Court, which ordered medical assistance to Harish Rana. During medical assistance, the family faced many issues. The PEG tube that was used to feed Harish had to be inserted only by a specialist and there are only two doctors in all of NCR who could do it because it needs to be inserted in the stomach. If someone else did it, Harish would catch an infection. At times, even the hospital gave the wrong tube. Because of all these troubles, we approached the court again after six months. We changed our approach simply on the part of definition of life support. We argued that the support system keeping the person alive also needs to be considered as life support. The court considered the PEG tube as life support equipment and eventually allowed withdrawal of that.
 +
 
 +

''' How, in your opinion, has the judgment reshaped end-of-life jurisprudence in India? '''
 +
 
 +

Jurisprudence normally talks about ‘right to life’ and whatever we need for life to flourish like air, water, economics, environment. The same jurisprudence talks about a life of dignity and when that life itself is one that of suffering and there is no support system, it finds a way to address the issue – end of life. This means that when the medical support system affirms that there is no chance of recovery and IPC and BNS also say that it does not fall in their ambit, jurisprudence says that instead of prolonging the pain, it’s better to remove all medical equipment and give salvation.

 +
 
 +
''' Which paragraph in the ruling do you think will be cited most often in courts in future? '''
 +
 
 +

I think this one: ‘Our decision today does not neatly fit within logic and reason alone. It sits in a space between love, loss, medicine and mercy. This decision is not about choosing death but is rather one of not artificially prolonging life. It is the decision to withdraw life-sustaining treatment when that treatment no longer heals, restores, or meaningfully improves life. It is allowing nature to take its course when medicine can only delay the inevitable because survival is not always the same as living’.

 +
 
 +
''' There have been cases before Harish Rana when such pleas have been struck down. In Aruna Shanbaug’s case, too, withdrawal of life support was rejected. '''
 +
 
 +

The basic difference between Aruna Shanbaug’s case and Harish Rana’s case was that Aruna was on a ventilator as a life support system, Harish was not. Aruna would still react to certain tastes like bitter, sweet, but Harish would not. If someone clapped in front of Aruna’s eyes, she would blink. Harish would not. Aruna reacted with her eyes… this meant that she still had some life left in her. That was not the case with Harish. Besides, Harish’s case was filed by his parents, Aruna’s was filed by journalist Pinki Virani, to which the staff of King Edward Memorial College and Hospital raised an objection. The hospital staff did not want Aruna to die because she was family for them and they cared for her deeply. In Harish’s case, there was clear medical evidence supported by the family’s statement that they wanted his suffering to end.

 +
 
 +
''' Is the judgment also a reflection of how society itself has changed? '''
 +
 
 +

Dying is still not very popular, and nobody will agree to let a person die. But yes, with this case, the scope of ‘right to die with dignity’ has definitely expanded.

 +
 
 +
''' How do you see the approach of courts changing in pleas for the right to die with dignity after this? '''
 +
 
 +

Supreme Court, while ruling in this case, has laid down guidelines that when a person is in a state where recovery is out of question, two separate medical boards can certify withdrawal of life support. SC has said the treating doctor can inform a hospital and a primary medical board can be formed to study the patient’s medical reports. If the board, after taking consent of family or next of kin or close friends, certifies in favour of withdrawing life support, a second medical board should be constituted to do another check of all medical records. Only if there is conflict between the decisions of the two boards should the matter go to a high court.

 +
 
 +
''' What do you think this means for families in a similar state where someone is in a permanent vegetative state and they want to let them go with dignity? '''
 +
 
 +

Families will not have to knock on the doors of courts for this. A certificate from the medical board will do. These guidelines will hopefully ease the pain of many people in similar situations.
 +
 
 +
[[Category:Crime|E EUTHANASIA: INDIAEUTHANASIA: INDIA
 +
EUTHANASIA: INDIA]]
 +
[[Category:India|E EUTHANASIA: INDIAEUTHANASIA: INDIA
 +
EUTHANASIA: INDIA]]
 +
[[Category:Law,Constitution,Judiciary|E EUTHANASIA: INDIAEUTHANASIA: INDIA
 +
EUTHANASIA: INDIA]]
 +
[[Category:Places|E EUTHANASIA: INDIAEUTHANASIA: INDIA
 +
EUTHANASIA: INDIA]]
 +
 
 +
=Mercy-killing, state-wise=
 +
==Mercy killing: Prevalent in parts of Tamil Nadu==
 
[http://epaperbeta.timesofindia.com//Article.aspx?eid=31808&articlexml=KIN-WHO-KILL-24052015019014 ''The Times of India''], May 24 2015
 
[http://epaperbeta.timesofindia.com//Article.aspx?eid=31808&articlexml=KIN-WHO-KILL-24052015019014 ''The Times of India''], May 24 2015
  
Line 57: Line 226:
 
Incidentally , when Dr Raja discharges a patient in his care -one who may not have long to live -the patient's relatives sometimes ask him if they could perform the oil bath ritual. These people usually come from places like the rural pockets of Madurai, including villages in and around Usilampatti. “I tell them that it is illegal and that it should never be done, but I do not know if they follow my counsel.“
 
Incidentally , when Dr Raja discharges a patient in his care -one who may not have long to live -the patient's relatives sometimes ask him if they could perform the oil bath ritual. These people usually come from places like the rural pockets of Madurai, including villages in and around Usilampatti. “I tell them that it is illegal and that it should never be done, but I do not know if they follow my counsel.“
  
=2016: Towards a law on euthanasia=
+
= Euthanasia in other countries=
[http://www.thehindu.com/opinion/editorial/editorial-on-govts-willingness-to-make-law-on-euthanasia/article8179920.ece ''The Hindu''], February 2, 2016
+
[[File: The concept of euthanasia in other countries.jpg|The concept of euthanasia in other countries <br/> From: [https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar01413&sk=2A9E2554&mode=text  March 10, 2018: ''The Times of India'']|frame|500px]]
  
'''Towards a law on euthanasia'''
+
'''See graphic''':
  
The Union government has informed a Constitution Bench of the Supreme Court that its experts are examining a draft Bill proposed by the Law Commission in its 241st report. However, it has been advised by the Law Ministry to hold back its enactment now, as the matter is pending before the court. Over a decade ago, the government felt that legislation on euthanasia would amount to doctors violating the Hippocratic Oath and that they should not yield to a patient’s “fleeting desire out of transient depression” to die. The government’s latest stand represents forward movement in the quest for a legislative framework to deal with the question whether patients who are terminally ill and possibly beyond the scope of medical revival can be allowed to die with dignity. The question was raised with a great deal of passion in the case of Aruna Shanbaug, a nurse who lay in a vegetative state in a Mumbai hospital between 1973 and 2015. In a landmark 2011 verdict that was notable for its progressive, humane and sensitive treatment of the complex interplay of individual dignity and social ethics, the Supreme Court laid down a broad legal framework. It ruled out any backing for active euthanasia, or the taking of a specific step such as injecting the patient with a lethal substance, to put an end to a patient’s suffering, as that would be clearly illegal. It allowed ‘passive euthanasia’, or the withdrawal of life support, subject to safeguards and fair procedure. It made it mandatory that every instance should get the approval of a High Court Bench, based on consultation with a panel of medical experts.
+
''The concept of euthanasia in other countries''
  
The question now before a Constitution Bench on a petition by the NGO Common Cause is whether the right to live with dignity under Article 21 includes the right to die with dignity, and whether it is time to allow ‘living wills’, or written authorisations containing instructions given by persons in a healthy state of mind to doctors that they need not be put on life-support systems or ventilators in the event of their going into a persistent vegetative state or state of terminal illness. The government’s reply shows that the Directorate-General of Health Services has proposed legislation based on the recommendations of an Experts’ Committee. The experts have not agreed to active euthanasia because of its potential for misuse and have proposed changes to a draft Bill suggested by the Law Commission. However, there seems to be no support for the idea of a ‘living will’, as the draft says any such document will be ‘void’ and not binding on any medical practitioner. It is logical that it should be so, as the law will be designed specifically to deal with patients not competent to decide for themselves because of their medical condition. This has to be tested against the argument that giving those likely to drift into terminal illness an advance opportunity to make an informed choice will help them avoid “cruel and unwanted treatment” to prolong their lifespan. To resolve this conflict between pain and death, the sooner that a comprehensive law on the subject is enacted, the better it will be for society.
+
=In Indian religions=
 +
==A concept accepted in Jainism & Buddhism==
 +
[https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar01401&sk=2B0D0DFB&mode=text  Dhananjay Mahapatra, It’s a concept accepted in Jainism & Buddhism, March 10, 2018: ''The Times of India'']
  
=2018: SC legalises passive euthanasia, living wills=
+
[[File: 1994-2018- The journey of the concept of euthanasia in India’s superior courts.jpg|1994-2018: The journey of the concept of euthanasia in India’s superior courts <br/> From: [https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar01401&sk=2B0D0DFB&mode=text  Dhananjay Mahapatra, It’s a concept accepted in Jainism & Buddhism, March 10, 2018: ''The Times of India'']|frame|500px]]
[https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar00301&sk=79C1A32B&mode=text  Dhananjay Mahapatra & Amit Anand Choudhary, SC legalises passive euthanasia and living will, says right to life includes right to die, March 10, 2018: ''The Times of India'']
+
  
[[File: Passive euthanasia paves way for decriminalising suicide.jpg|Passive euthanasia paves way for decriminalising suicide <br/> From: [https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F10&entity=Ar00301&sk=79C1A32B&mode=text  Dhananjay Mahapatra & Amit Anand Choudhary, SC legalises passive euthanasia and living will, says right to life includes right to die, March 10, 2018: ''The Times of India'']|frame|500px]]
 
  
''Lays Down Guidelines To Prevent Abuse''
+
The Supreme Court found that while Hinduism, Islam and Christianity were against euthanasia, the concept was accepted in Jainism and Buddhism.
  
In a milestone verdict expanding the right to life to incorporate the right to die with dignity, the Supreme Court on Friday legalised passive euthanasia and approved ‘living will’ to provide terminally ill patients or those in a persistent and incurable vegetative state (PVS) a dignified exit by refusing medical treatment or life support.
+
Tracing a regulation under a law which sanctioned passive euthanasia in India, albeit indirectly, Justice Ashok Bhushan said the only statutory provision which referred to euthanasia was the ‘Indian Medical Council (Professional Conduct, Etiquette & Ethics) Regulations, 2002’ framed under the Indian Medical Council Act, 1956.
  
The verdict, the latest in a string of boosts for individual freedoms by the SC, was delivered by a constitution bench of Chief Justice Dipak Misra and Justices A K Sikri, A M Khanwilkar, D Y Chandrachud and Ashok Bhushan.
+
Justice Bhushan said the 2002 regulations prohibited a medical practitioner from practising active euthanasia but carved out an exception “that on specific occasion, the question of withdrawing support devices to sustain cardiopulmonary function even after brain death, shall be decided by a team of doctors and not merely by the treating physician alone”.
  
It empowers a person of sound mind and health to make a ‘living will’ specifying that in the event of him/her slipping into a terminal medical condition in future, his/her life should not be prolonged through a life support system. The person concerned can also authorise, through the will, any relative or friend to decide in consultation with medical experts when to pull the plug.
+
“The regulations further provide that team of doctors shall declare withdrawal of support system,” he added.
  
Given Indian sensitivities about life and death, testing the legality of the idea posed a complex medical, philosophical, constitutional and religious jigsaw for the bench.
+
Justice Bhushan unearthed euthanasia’s link with religion and drew a contrast between the 2,500-year-old Hippocratic Oath of medical practitioners “not to give a lethal drug to anyone nor to advise such a plan” and almost contemporaneous view of Greek philosopher Plato, who did not support medical treatment to those thoroughly diseased.
  
CJI Misra led his colleagues on the bench to harmonise the inevitable yet opposite facets — life and death — and say in unison that “right to die with dignity is an intrinsic facet of right to life guaranteed under Article 21”.
+
Justice Bhushan quoted Plato’s famous work ‘The Republic’, in which he wrote, “But if a man had a sickly constitution and intemperate habits, his life was worth nothing to himself or to anyone else; medicine was not meant for such people and they should not be treated, though they might be richer than Midas.
  
With this ruling, the SC has recognised that an individual with terminal illness or in a state of irreversible vegetative condition has the agency to decide whether he/she would like to die, a sphere which was so far constitutionally reserved for the state, which alone could deprive a person of his/her life in accordance with law.
+
The judge added, “In ancient Indian religion, sanctity was attached to a yogi who could discard his/her mortal coil (body) through the process of higher spiritual practices called yoga. Such state was known as ‘samadhi’.
  
However, to prevent possible misuse by greedy relatives eyeing the patient’s property, the SC provided for stringent guidelines for preparing and giving effect to ‘living will’ and administration of ‘passive euthanasia’ by involving multiple medical boards comprising several experts and even judicial officers.
+
“The Hindu scriptures also say that life and death is the gift of god and no human being has the right to take away the said gift. Suicide is disapproved in Hindu way of life and it is believed that those who commit suicide do not attain moksha or salvation from the cycle of life and death.
  
'''Only passive euthanasia will come under ambit of Article 21, says CJI'''
+
“Muslims also strongly condemn suicide as they believe life and death of a person depends on Allah’s will and human beings are prohibited in going against his will... Christianity also disapproves taking of one’s life. Bible says human being is a temple of god and the spirit of god dwelleth in the body and no man can defile the temple...”
  
In a cumulative 538-page judgment containing four opinions, the SC said passive euthanasia, or a provision for passive euthanasia through ‘advance directive’ or ‘living will’, would save “a helpless person from uncalled for and unnecessary treatment when he is considered as merely a creature whose breath is felt or measured because of advanced medical technology”.
+
However, Justice Bhushan said, “Tenets of Jainism talk about the practice of religiously nominated self-build death called ‘Sallkhana’, meaning ‘fast unto death’. Buddhist scriptures state that Lord Buddha had allowed self-build death for the extremely ill person as an act of compassion.
  
“There comes a phase in life when the spring of life is frozen, the rain of circulation becomes dry, the movement of body becomes motionless, the rainbow of life becomes colourless and the word ‘life’ which one calls a dance in space and time becomes still and blurred and the inevitable death comes near to hold it as an octopus gripping firmly with its tentacles so that the person ‘shall rise up never’,” CJI Misra said.
+
==In Hinduism, Buddhism==
 +
[https://epaper.timesgroup.com/Olive/ODN/TimesOfIndia/shared/ShowArticle.aspx?doc=TOIDEL%2F2018%2F03%2F15&entity=Ar02204&sk=0D21ADF0&mode=text  Sumit Paul, Death Wish: Saying Goodbye With Dignity, March 15, 2018: ''The Times of India'']
  
Writing the lead judgment with Justice Khanwilkar, CJI Misra said, “A dying man who is terminally ill or in PVS can make a choice of premature extinction of his life as being a facet of Article 21. We must make it clear that as a part of the right to die with dignity in a case of a dying man who is terminally ill or in PVS, only passive euthanasia would come within the ambit of Article 21 and not the one which would fall within the description of active euthanasia in which positive steps are taken either by the treating physician or some other person.”
 
  
Linking life and death with the thread of dignity, the SC said administration of life support system and medicines merely to prolong heart beat in a patient who was not even aware that he/she was breathing amounted to denial of dignity to that person who had no choice but to “suffer an avoidable protracted treatment”. The SC also ruled that a patient had the right to refuse medical treatment.
+
Bidding farewell to the world with one’s head held high is every individual’s fundamental as well as inalienable right; we need to welcome the Supreme Court ruling that legalises passive euthanasia. Centuries ago Roman emperor-philosopher Marcus Aurelius wrote in ‘Dignity in death’ (Translated from Latin by Derek A Walcott): “How I die is my decision How I depart is my intention My life is mine, so is my death How I depart is my tension.
  
Justice Sikri adopted an unorthodox comparison of rights in his separate yet concurrent judgment and said, “Right to health is part of Article 21. At the same time, it is also a harsh reality that everybody is not able to enjoy that right because of poverty or other reasons. The state is not in a position to translate into reality this right to health for all citizens. Thus, when citizens are not guaranteed the right to health, can they be denied the right to die in dignity?” He also questioned the rationality of limited and costly life saving facilities getting occupied by rich patients in the ‘no return zone’ to deprive others who could be revived.
+
Dignity in death is most vital to an individual’s right to exercise free will. Blessed with Icchha Mrityu, the grand patriarch of Mahabharata, Bhishma, told Arjuna, ‘Na kinchitam sarvey pranatohasmi devanam, yatkinchit mrityu parvedham karunarpite.’ ‘This is the manner of death that I’ve chosen for myself because a sense of awareness in death is far better than being at the mercy of others.’ All Greek gymnosophists and philosophers chose how and when to die. Socrates was given a bowl of hemlock to drink because he wanted to stay aware till his last breath. Hemlock causes slow but peaceful death with complete awareness. It was not just Socrates who desired to die consciously but also other philosophers like Frencasier, Diostephele and Gurnimoren.
 
+
Justice Chandrachud opened yet another aspect of right to life by ruling on autonomy of an individual over his/ her body and ruled in his concurring judgment, “The state cannot compel an unwilling individual to receive medical treatment. While an individual cannot compel a medical professional to provide a particular treatment (this being in the realm of professional medical judgment), it is equally true that the individual cannot be compelled to undergo medical intervention.”
+
 
+
Justice Bhushan said, “An adult human being having mental capacity to take an informed decision has the right to refuse medical treatment including withdrawal from live saving devices.” CJI Misra and Justice Khanwilkar said, “His ‘being’ (existence) exclusively rests on the mercy of the technology which can prolong the condition for some period. The said prolongation is definitely not in his interest. On the contrary, it tantamounts to destruction of his dignity which is the core value of life. In our considered opinion, in such a situation, an individual’s interest has to be given priority over state interest.
+
  
 
=See also=
 
=See also=
 
[[Aruna Shanbaug]]
 
[[Aruna Shanbaug]]
 +
 +
[[Insurance (life): India]]

Latest revision as of 01:21, 30 May 2026

This is a collection of articles archived for the excellence of their content.

Contents

[edit] Legal measures

[edit] 2011: Supreme Court guidelines on Euthanasia

The Hindu, May 23, 2015

Active euthanasia : Administering of lethal injection to snuff out life is illegal in India

Parents, spouse, close kin, "next friend" can decide, in best interests of the patient, to discontinue life support. The decision must be approved by a HC.

In dealing with such a plea,

» Chief Justice of High Court must create a Bench of at least 2 judges to reach a decision.

» Bench must nominate three reputed doctors

» A copy of the doctors's panel report must be provided to close kin and State govt. Only then can verdict be reached.

Passive euthanasia : Withdrawing life support, treatment or nutrition that would allow a person to live, was legalised by way of SC guidelines in 2011.

[edit] 2016: Towards a law on euthanasia

The Hindu, February 2, 2016

Towards a law on euthanasia

The Union government has informed a Constitution Bench of the Supreme Court that its experts are examining a draft Bill proposed by the Law Commission in its 241st report. However, it has been advised by the Law Ministry to hold back its enactment now, as the matter is pending before the court. Over a decade ago, the government felt that legislation on euthanasia would amount to doctors violating the Hippocratic Oath and that they should not yield to a patient’s “fleeting desire out of transient depression” to die. The government’s latest stand represents forward movement in the quest for a legislative framework to deal with the question whether patients who are terminally ill and possibly beyond the scope of medical revival can be allowed to die with dignity. The question was raised with a great deal of passion in the case of Aruna Shanbaug, a nurse who lay in a vegetative state in a Mumbai hospital between 1973 and 2015. In a landmark 2011 verdict that was notable for its progressive, humane and sensitive treatment of the complex interplay of individual dignity and social ethics, the Supreme Court laid down a broad legal framework. It ruled out any backing for active euthanasia, or the taking of a specific step such as injecting the patient with a lethal substance, to put an end to a patient’s suffering, as that would be clearly illegal. It allowed ‘passive euthanasia’, or the withdrawal of life support, subject to safeguards and fair procedure. It made it mandatory that every instance should get the approval of a High Court Bench, based on consultation with a panel of medical experts.

The question now before a Constitution Bench on a petition by the NGO Common Cause is whether the right to live with dignity under Article 21 includes the right to die with dignity, and whether it is time to allow ‘living wills’, or written authorisations containing instructions given by persons in a healthy state of mind to doctors that they need not be put on life-support systems or ventilators in the event of their going into a persistent vegetative state or state of terminal illness. The government’s reply shows that the Directorate-General of Health Services has proposed legislation based on the recommendations of an Experts’ Committee. The experts have not agreed to active euthanasia because of its potential for misuse and have proposed changes to a draft Bill suggested by the Law Commission. However, there seems to be no support for the idea of a ‘living will’, as the draft says any such document will be ‘void’ and not binding on any medical practitioner. It is logical that it should be so, as the law will be designed specifically to deal with patients not competent to decide for themselves because of their medical condition. This has to be tested against the argument that giving those likely to drift into terminal illness an advance opportunity to make an informed choice will help them avoid “cruel and unwanted treatment” to prolong their lifespan. To resolve this conflict between pain and death, the sooner that a comprehensive law on the subject is enacted, the better it will be for society.

[edit] 2018: SC legalises passive euthanasia, living wills

Dhananjay Mahapatra & Amit Anand Choudhary, SC legalises passive euthanasia and living will, says right to life includes right to die, March 10, 2018: The Times of India

Lays Down Guidelines To Prevent Abuse

In a milestone verdict expanding the right to life to incorporate the right to die with dignity, the Supreme Court on Friday legalised passive euthanasia and approved ‘living will’ to provide terminally ill patients or those in a persistent and incurable vegetative state (PVS) a dignified exit by refusing medical treatment or life support.

The verdict, the latest in a string of boosts for individual freedoms by the SC, was delivered by a constitution bench of Chief Justice Dipak Misra and Justices A K Sikri, A M Khanwilkar, D Y Chandrachud and Ashok Bhushan.

It empowers a person of sound mind and health to make a ‘living will’ specifying that in the event of him/her slipping into a terminal medical condition in future, his/her life should not be prolonged through a life support system. The person concerned can also authorise, through the will, any relative or friend to decide in consultation with medical experts when to pull the plug.

Given Indian sensitivities about life and death, testing the legality of the idea posed a complex medical, philosophical, constitutional and religious jigsaw for the bench.

CJI Misra led his colleagues on the bench to harmonise the inevitable yet opposite facets — life and death — and say in unison that “right to die with dignity is an intrinsic facet of right to life guaranteed under Article 21”.

With this ruling, the SC has recognised that an individual with terminal illness or in a state of irreversible vegetative condition has the agency to decide whether he/she would like to die, a sphere which was so far constitutionally reserved for the state, which alone could deprive a person of his/her life in accordance with law.

However, to prevent possible misuse by greedy relatives eyeing the patient’s property, the SC provided for stringent guidelines for preparing and giving effect to ‘living will’ and administration of ‘passive euthanasia’ by involving multiple medical boards comprising several experts and even judicial officers.

Only passive euthanasia will come under ambit of Article 21, says CJI

In a cumulative 538-page judgment containing four opinions, the SC said passive euthanasia, or a provision for passive euthanasia through ‘advance directive’ or ‘living will’, would save “a helpless person from uncalled for and unnecessary treatment when he is considered as merely a creature whose breath is felt or measured because of advanced medical technology”.

“There comes a phase in life when the spring of life is frozen, the rain of circulation becomes dry, the movement of body becomes motionless, the rainbow of life becomes colourless and the word ‘life’ which one calls a dance in space and time becomes still and blurred and the inevitable death comes near to hold it as an octopus gripping firmly with its tentacles so that the person ‘shall rise up never’,” CJI Misra said.

Writing the lead judgment with Justice Khanwilkar, CJI Misra said, “A dying man who is terminally ill or in PVS can make a choice of premature extinction of his life as being a facet of Article 21. We must make it clear that as a part of the right to die with dignity in a case of a dying man who is terminally ill or in PVS, only passive euthanasia would come within the ambit of Article 21 and not the one which would fall within the description of active euthanasia in which positive steps are taken either by the treating physician or some other person.”

Linking life and death with the thread of dignity, the SC said administration of life support system and medicines merely to prolong heart beat in a patient who was not even aware that he/she was breathing amounted to denial of dignity to that person who had no choice but to “suffer an avoidable protracted treatment”. The SC also ruled that a patient had the right to refuse medical treatment.

Justice Sikri adopted an unorthodox comparison of rights in his separate yet concurrent judgment and said, “Right to health is part of Article 21. At the same time, it is also a harsh reality that everybody is not able to enjoy that right because of poverty or other reasons. The state is not in a position to translate into reality this right to health for all citizens. Thus, when citizens are not guaranteed the right to health, can they be denied the right to die in dignity?” He also questioned the rationality of limited and costly life saving facilities getting occupied by rich patients in the ‘no return zone’ to deprive others who could be revived.

Justice Chandrachud opened yet another aspect of right to life by ruling on autonomy of an individual over his/ her body and ruled in his concurring judgment, “The state cannot compel an unwilling individual to receive medical treatment. While an individual cannot compel a medical professional to provide a particular treatment (this being in the realm of professional medical judgment), it is equally true that the individual cannot be compelled to undergo medical intervention.”

Justice Bhushan said, “An adult human being having mental capacity to take an informed decision has the right to refuse medical treatment including withdrawal from live saving devices.” CJI Misra and Justice Khanwilkar said, “His ‘being’ (existence) exclusively rests on the mercy of the technology which can prolong the condition for some period. The said prolongation is definitely not in his interest. On the contrary, it tantamounts to destruction of his dignity which is the core value of life. In our considered opinion, in such a situation, an individual’s interest has to be given priority over state interest.”

[edit] 2018: What the SC said

Dhananjay Mahapatra, In country of poor, why force costly life support, asks SC, March 10, 2018: The Times of India


Clarifies It’s Applying Utilitarian Principle Only In Limited Sense

In the process of building a constitutional link between right to life and right to die, the Supreme Court said the economics of extending the life of a terminally ill person with no hope of revival did not make sense in a country where the majority is not able to afford health services.

What forced Justice A K Sikri, part of the five-judge bench led by CJI Dipak Misra, to dwell on economics while favouring passive euthanasia was the spiralling daily expense in hospitals to keep a terminally ill person on life support system, often spelling financial ruin for poor families.

Devoting a separate chapter on ‘Economics of Euthanasia’ in his 112-page judgment, Justice Sikri said, “When we consider the matter of euthanasia in the context of economic principles, it becomes another reason to support the aforesaid conclusion. This aspect can be dealt with in two ways.

“First, because of rampant poverty where majority of the persons are not able to afford health services, should they be forced to spend on medical treatment beyond their means and in the process compelling them to sell their house property, household things and other assets which may be means of (their) livelihood. Second, when there are limited medical facilities available, should a major part thereof be consumed on those patients who have no chances of recovery?”

Explaining the importance of applying cost-benefit test even to constitutional principles, Justice Sikri said, “At times, for deciding legal issues, economic analysis of law assumes importance. It is advocated that one of the main reasons which should prompt philosophers of law to undertake economic analysis seriously is that the most basic notion in the analysis — efficiency or Pareto optimality — was originally introduced to help solve a serious objection to the widely held moral theory, utilitarian.

“Utilitarians hold that the principle of utility is the criterion of the right conduct. If one has to evaluate policies in virtue of their effect on individual welfare or utility, one norm of utility has to be compared with that of another. We may clarify that this economic principle has been applied in a limited sense only as a supporting consideration with the aim to promote efficiency.”

Where a majority is not able to afford health services, should people be forced to spend on treatment beyond their means... Secondly, when there are limited medical facilities, should a major part thereof be consumed on those who have no chance of recovery?: JUSTICE SIKRI

[edit] What individual judges said

March 10, 2018: The Times of India


Justices Dipak Misra & AM Khanwilkar

Life sans dignity is an unacceptable defeat... life that meets death with dignity is a value to be aspired for and a moment for celebration

Justice A K Sikri

Rote hue aate hain sab, hansta hua jo jaayega. Wo muqaddar ka sikandar jaaneman kehlayega Quoting song from Bollywood film Muqaddar Ka Sikandar. Emphasis: Everyone is bound to die and death must be peaceful

Justice D Y Chandrachud

Life and death... inseparable.

Our bodies are in a process of continuous change. Millions of cells perish as nature regenerates new ones... Life is not disconnected from death. Both essential in the cycle of existence... To be free of suffering is liberation. Liberty to decide how to be treated when the end is near... essential attribute of personhood

Justice Ashok Bhushan

Every life is a gift of God and sacred... has to be protected at all cost... The right to self determination and bodily integrity has been recognised by this Court. The right to execute an advance medical directive is nothing but a step towards protection of that right by an individual...

[edit] Living wills

Who can execute a living will?, What should it contain?, Should it be rewarded and preserved?
From: March 10, 2018: The Times of India
When and by whom it can be given effect?, What if permission is denied?
From: March 10, 2018: The Times of India

See graphics:

Who can execute a living will?, What should it contain?, Should it be rewarded and preserved?

When and by whom it can be given effect?, What if permission is denied?


[edit] 2023: SC Simplifies its order on passive euthanasia

AmitAnand Choudhary, January 25, 2023: The Times of India

New Delhi : The Supreme Court modified its 2018 order on passive euthanasia to make the procedure of removal of (or withholding) life support from terminally ill patients less cumbersome for the patients, their families and the doctors by limiting the role played by government officials.


While the requirement of setting up two medical boards — one primary and other review — to examine the medical condition of the patient has been retained, the SC has done away with the rule mandating that the district collector set up the review board. The court said both boards will be constituted by the hospital and there would be one nominee doctor of the district medical officer in the review board. The medical boards must take a decision on such cases preferably within 48 hours, it added.


While the current rules state that the consent of the judicial magistrate is required for conducting passive euthanasia, the new order by a five-judge bench of Justices K M Joseph, Ajay Rastogi, Aniruddha Bose, Hrishikesh Roy and C TRavikumar says the magistrate just needs to be informed.


[edit] 2026: SC allows passive euthanasia for man in coma

AmitAnand.Choudhary, March 12, 2026: The Times of India

New Delhi : In the first approval of passive euthanasia, which was legalised by SC in 2011, the apex court allowed withdrawal of medical treatment to 32-year-old Harish Rana, who has been in a vegetative state for more than 13 years with irreversible and non-progressive brain damage, paving the way for nature to take its course and to end the agony of his parents who had undergo the pain of witnessing their son’s suffering every day. 


A bench of Justices J B Pardiwala and K V Viswanathan took the “difficult decision” on the basis of reports of two medical boards that approved removal of life support system after personally interacting with Harish’s parents. It said the continuation of medical treatment is not in best interest.


SC directed AIIMS Delhi to admit Harish in its palliative care centre and take steps for withdrawal or withholding of his medical treatment. “The resultant effect must not be the abandonment of the patient,” it said.

[edit] Harish Rana verdict. SC, 2026

Kritika.Sharma, April 5, 2026: The Times of India


Supreme Court’s landmark judgment allowing withdrawal of life support to Harish Rana will help families in a similar situation because of the guidelines laid down by it, even as it asked the Centre to legislate, Manish Jain, counsel for Rana’s family, says. Injured after a fall when he was a civil engineering student in Chandigarh in 2013, Rana was in a vegetative state for 13 years, and his family fought a long legal battle. After 10 days of withdrawal of life support at AIIMS, under the watch of specialists, Rana died. Jain spoke to TOI about the dilemma before the court, application of ‘right to die with dignity’, the widened definition of life support it accepted, and more. Excerpts:


Why do you think it was so difficult for the legal system to allow passive euthanasia or withdrawing life support from a person who is beyond recovery? Right to die with dignity was recognised in Common Cause back in 2018.


Under our laws, if a person has committed a crime, they can be charged under appropriate sections and awarded the death penalty. But when it comes to a person who has not committed any crime, how do you take their life away? If one cannot give life, how can they simply take life? This dilemma has no solution. Because of this dilemma, Article 21, which talks about ‘right to die with dignity’, came into the picture. If someone kills you, that’s an offence. Therefore, a case where a court has to decide on taking someone’s life is always difficult.


You were a part of the legal team when Harish Rana’s petition was rejected by Delhi HC in 2024 and Supreme Court upheld that. When you moved SC again, what changed about your approach?


In a case of passive euthanasia, what is acceptable is withdrawal of life support. But Harish Rana did not fall in the ambit of traditional life support because he was not connected to a ventilator or any other such equipment. He was surviving on a PEG (percutaneous endoscopic gastrostomy) tube, which was medical equipment. The first time we went to HC, we said he is surviving through medical support but not traditional life support. Since this was not traditional life support, the judge refused the plea. Against that order, we went to Supreme Court, which ordered medical assistance to Harish Rana. During medical assistance, the family faced many issues. The PEG tube that was used to feed Harish had to be inserted only by a specialist and there are only two doctors in all of NCR who could do it because it needs to be inserted in the stomach. If someone else did it, Harish would catch an infection. At times, even the hospital gave the wrong tube. Because of all these troubles, we approached the court again after six months. We changed our approach simply on the part of definition of life support. We argued that the support system keeping the person alive also needs to be considered as life support. The court considered the PEG tube as life support equipment and eventually allowed withdrawal of that.

How, in your opinion, has the judgment reshaped end-of-life jurisprudence in India?


Jurisprudence normally talks about ‘right to life’ and whatever we need for life to flourish like air, water, economics, environment. The same jurisprudence talks about a life of dignity and when that life itself is one that of suffering and there is no support system, it finds a way to address the issue – end of life. This means that when the medical support system affirms that there is no chance of recovery and IPC and BNS also say that it does not fall in their ambit, jurisprudence says that instead of prolonging the pain, it’s better to remove all medical equipment and give salvation.


Which paragraph in the ruling do you think will be cited most often in courts in future?


I think this one: ‘Our decision today does not neatly fit within logic and reason alone. It sits in a space between love, loss, medicine and mercy. This decision is not about choosing death but is rather one of not artificially prolonging life. It is the decision to withdraw life-sustaining treatment when that treatment no longer heals, restores, or meaningfully improves life. It is allowing nature to take its course when medicine can only delay the inevitable because survival is not always the same as living’.


There have been cases before Harish Rana when such pleas have been struck down. In Aruna Shanbaug’s case, too, withdrawal of life support was rejected.


The basic difference between Aruna Shanbaug’s case and Harish Rana’s case was that Aruna was on a ventilator as a life support system, Harish was not. Aruna would still react to certain tastes like bitter, sweet, but Harish would not. If someone clapped in front of Aruna’s eyes, she would blink. Harish would not. Aruna reacted with her eyes… this meant that she still had some life left in her. That was not the case with Harish. Besides, Harish’s case was filed by his parents, Aruna’s was filed by journalist Pinki Virani, to which the staff of King Edward Memorial College and Hospital raised an objection. The hospital staff did not want Aruna to die because she was family for them and they cared for her deeply. In Harish’s case, there was clear medical evidence supported by the family’s statement that they wanted his suffering to end.


Is the judgment also a reflection of how society itself has changed?


Dying is still not very popular, and nobody will agree to let a person die. But yes, with this case, the scope of ‘right to die with dignity’ has definitely expanded.


How do you see the approach of courts changing in pleas for the right to die with dignity after this?


Supreme Court, while ruling in this case, has laid down guidelines that when a person is in a state where recovery is out of question, two separate medical boards can certify withdrawal of life support. SC has said the treating doctor can inform a hospital and a primary medical board can be formed to study the patient’s medical reports. If the board, after taking consent of family or next of kin or close friends, certifies in favour of withdrawing life support, a second medical board should be constituted to do another check of all medical records. Only if there is conflict between the decisions of the two boards should the matter go to a high court.


What do you think this means for families in a similar state where someone is in a permanent vegetative state and they want to let them go with dignity?


Families will not have to knock on the doors of courts for this. A certificate from the medical board will do. These guidelines will hopefully ease the pain of many people in similar situations.

[edit] Mercy-killing, state-wise

[edit] Mercy killing: Prevalent in parts of Tamil Nadu

The Times of India, May 24 2015

Padmini Sivarajah

Thalaikoothal

Mercy killing is illegal in India, but in parts of Tamil Nadu, it is alive in the form of a gruesome tradition

A very crude form of `mercy killing' still survives in some villages in south India.Here, people take it upon themselves to `cull' elderly persons who are bedridden and considered a burden to the family , with something as innocuous as oil and coconut water. And though villagers claim they've buried the gruesome tradition, social activists say they haven't seen the last of it yet. “We no longer do it, but it was called `thalaikoothal',“ says G Anusha of Innam Reddiarpatti in Virudhunagar district. “ A person who was suffering and bedridden was given an oil bath at dawn and then plied with multiple glasses of tender coconut juice, which resulted in the body cooling considerably , eventually causing high fever. In a day or two they died,“ she says, insisting that the practice has now dwindled. Her neighbour Kuruvamma credits improved facilities like transport and medical support for the decline of the tradition. “I myself look after two elders in the family . We want them to live as long as they are destined to,“ she claims.

Seventy-five-year-old, bespectacled Sankaramma sits rolling paper tubes for a fireworks factory . “I have to work as long as I can to be able to eat,“ she says, insinuating that she literally has to safeguard her living. But then she cautiously mentions that she has known elderly people who were given thalaikoothal deaths. “But that was then, she hastily adds.

Is this staunch denial really an eyewash? A social activist from Usilampatti, M P Raman, concedes that this indigenous form of mercy killing still prevails, but is kept under wraps for fear of prosecution. His words are echoed by C Radhakrishnan, senior manager at Help Age India, Madurai. “Though villagers claim it isn't practiced anymore, thalaikoothal is more prevalent now than ever before,“ he states, citing greater employment as one of the reasons. “Unlike those days when at least one member of the family was at home to look after the elderly, everybody in a household today is employed and a bedridden person becomes a big responsibility,“ he explains.

Apparently thalaikoothal is no random act of extermination, but a well-oiled death ritual provoked by poverty and abetted by custom. An old, ailing individual, with an already weakened immune system is pushed over the edge with oil baths and coconut juice guaranteed to induce a fever that will eventually do the person in. And even as preparations for the thalaikoothal are under way , family will start arranging for the funeral as well.

“I came to know that invalid elders are given a final oil bath and forced to drink tender coconut juice, followed by tulsi juice and then milk (a customary predeath drink), with the relatives standing around chanting, `kasi', `kasi',“ Radhakrishnan says. But they are not the only devices employed. In some cases, hard pieces of murukku (a savoury) are forced down a resistant individ ual's throat, causing him or her to choke to death. Mud mixed with water is also used, with hopes that the watery Hemlock would cause indigestion -almost surely fatal to an already compromised body .

According to Dr N Raja, a geriatrician and private practitioner in Madurai, an oil bath followed by tender coconut juice, a coolant, results in the body's temperature falling to 94 or 92 degrees F from the normal of 98.4 degrees F. “It can also cause electrolyte imbalance, which can play havoc with the body's metabolism. And for a person who is already sick, it can even lead to cardiac arrest,“ he says.

Tirunelveli N Kannan, pro fessor of sociology , Manonmaniam Sundaranar University, says that this was an age-old practice which was not confined to any specific community. “I have heard people doing it in villages in Virudhunagar and also Usilampatti in Madurai, he says. “If closely researched we may see similar practices in many countries. “The issue of the person's consent in this practice, did not rise as in many cases he or she was terminally ill and almost unconscious. No person would willingly agree to being killed, but the community as a whole took the decision on his behalf, and went ahead with it,“ says Kannan. This was something that had social acceptance, he added.

S Alagarsamy , 78, says he has no fear of forced death. Although age has restricted his mobility , he believes he won't be a burden to his widowed daughter because of the free rations doled out by the state. “Mercifully the government provides us with free rice. Moreover, my daughter looks after me well, otherwise I would have feared the thalaikoothal, he says.

Radhakrishnan points out that death by thailakoothal is almost always signed off by a certifying doctor as death due to natural causes -old age in their case. “The truth will emerge if these deaths are better investigated,“ the NGO worker claims.

Incidentally , when Dr Raja discharges a patient in his care -one who may not have long to live -the patient's relatives sometimes ask him if they could perform the oil bath ritual. These people usually come from places like the rural pockets of Madurai, including villages in and around Usilampatti. “I tell them that it is illegal and that it should never be done, but I do not know if they follow my counsel.“

[edit] Euthanasia in other countries

The concept of euthanasia in other countries
From: March 10, 2018: The Times of India

See graphic:

The concept of euthanasia in other countries

[edit] In Indian religions

[edit] A concept accepted in Jainism & Buddhism

Dhananjay Mahapatra, It’s a concept accepted in Jainism & Buddhism, March 10, 2018: The Times of India

1994-2018: The journey of the concept of euthanasia in India’s superior courts
From: Dhananjay Mahapatra, It’s a concept accepted in Jainism & Buddhism, March 10, 2018: The Times of India


The Supreme Court found that while Hinduism, Islam and Christianity were against euthanasia, the concept was accepted in Jainism and Buddhism.

Tracing a regulation under a law which sanctioned passive euthanasia in India, albeit indirectly, Justice Ashok Bhushan said the only statutory provision which referred to euthanasia was the ‘Indian Medical Council (Professional Conduct, Etiquette & Ethics) Regulations, 2002’ framed under the Indian Medical Council Act, 1956.

Justice Bhushan said the 2002 regulations prohibited a medical practitioner from practising active euthanasia but carved out an exception “that on specific occasion, the question of withdrawing support devices to sustain cardiopulmonary function even after brain death, shall be decided by a team of doctors and not merely by the treating physician alone”.

“The regulations further provide that team of doctors shall declare withdrawal of support system,” he added.

Justice Bhushan unearthed euthanasia’s link with religion and drew a contrast between the 2,500-year-old Hippocratic Oath of medical practitioners “not to give a lethal drug to anyone nor to advise such a plan” and almost contemporaneous view of Greek philosopher Plato, who did not support medical treatment to those thoroughly diseased.

Justice Bhushan quoted Plato’s famous work ‘The Republic’, in which he wrote, “But if a man had a sickly constitution and intemperate habits, his life was worth nothing to himself or to anyone else; medicine was not meant for such people and they should not be treated, though they might be richer than Midas.”

The judge added, “In ancient Indian religion, sanctity was attached to a yogi who could discard his/her mortal coil (body) through the process of higher spiritual practices called yoga. Such state was known as ‘samadhi’.

“The Hindu scriptures also say that life and death is the gift of god and no human being has the right to take away the said gift. Suicide is disapproved in Hindu way of life and it is believed that those who commit suicide do not attain moksha or salvation from the cycle of life and death.

“Muslims also strongly condemn suicide as they believe life and death of a person depends on Allah’s will and human beings are prohibited in going against his will... Christianity also disapproves taking of one’s life. Bible says human being is a temple of god and the spirit of god dwelleth in the body and no man can defile the temple...”

However, Justice Bhushan said, “Tenets of Jainism talk about the practice of religiously nominated self-build death called ‘Sallkhana’, meaning ‘fast unto death’. Buddhist scriptures state that Lord Buddha had allowed self-build death for the extremely ill person as an act of compassion.”

[edit] In Hinduism, Buddhism

Sumit Paul, Death Wish: Saying Goodbye With Dignity, March 15, 2018: The Times of India


Bidding farewell to the world with one’s head held high is every individual’s fundamental as well as inalienable right; we need to welcome the Supreme Court ruling that legalises passive euthanasia. Centuries ago Roman emperor-philosopher Marcus Aurelius wrote in ‘Dignity in death’ (Translated from Latin by Derek A Walcott): “How I die is my decision How I depart is my intention My life is mine, so is my death How I depart is my tension.”

Dignity in death is most vital to an individual’s right to exercise free will. Blessed with Icchha Mrityu, the grand patriarch of Mahabharata, Bhishma, told Arjuna, ‘Na kinchitam sarvey pranatohasmi devanam, yatkinchit mrityu parvedham karunarpite.’ ‘This is the manner of death that I’ve chosen for myself because a sense of awareness in death is far better than being at the mercy of others.’ All Greek gymnosophists and philosophers chose how and when to die. Socrates was given a bowl of hemlock to drink because he wanted to stay aware till his last breath. Hemlock causes slow but peaceful death with complete awareness. It was not just Socrates who desired to die consciously but also other philosophers like Frencasier, Diostephele and Gurnimoren.

[edit] See also

Aruna Shanbaug

Insurance (life): India

Personal tools
Namespaces

Variants
Actions
Navigation
Toolbox
Translate