Euthanasia, often referred to as “mercy killing” or “assisted dying,” is a practice aimed at ending prolonged suffering and pain. The term itself originates from Greek roots meaning “good death.” In societies where ethics, morality, and religious beliefs hold significant sway, euthanasia poses complex ethical dilemmas.
There are two primary philosophical perspectives on euthanasia. One viewpoint emphasizes the sanctity of human life, arguing that intentionally ending a life contradicts the natural order and infringes upon the prerogative of a higher power. Conversely, proponents of euthanasia argue for an individual’s right to die with dignity, asserting that the right to life should encompass the right to end one’s life to escape unbearable suffering.
Legal perspectives on euthanasia have evolved over time. Initially, courts did not recognize the right to end a person’s life. However, the “Aruna Shanbaug case” prompted legal distinctions between active and passive euthanasia.
Passive euthanasia involves letting a person die by withholding or withdrawing life-sustaining treatment. This can include actions like turning off life support systems or refraining from administering treatments that would artificially prolong life.
Passive euthanasia can further be categorized into voluntary and involuntary forms. Voluntary passive euthanasia occurs when a competent patient gives explicit consent to end their life, typically due to terminal illness or irreversible suffering. In contrast, involuntary passive euthanasia involves a decision made on behalf of an incompetent patient, often by family members or legal guardians.
Active euthanasia, on the other hand, directly causes death through a deliberate act, such as administering a lethal injection. In many jurisdictions, active euthanasia is a crime under section 302 (punishment for murder) of the IPC or at the very least Section 304 of the IPC which deals with the punishment for culpable homicide not amounting to murder.
GIAN KAUR V STATE OF PUNJAB, 1996
A Trial Court found Gian Kaur and her husband Harbans Singh guilty in accordance with Section 306 of the Indian Penal Code. They were found guilty of encouraging Ms. Kulwant Kaur’s suicide and received a sentence of six years in prison and a fine of Rs. 2,000. Anyone who assists in a suicide is punished under Section 306, and anyone who makes an attempt at suicide is punished under Section 309. It was argued that the right to die is a part of the Article 21 right to life, as decided in P. Rathinam v. Union of India. Thus, encouraging suicide only amounts to supporting the application of Article 21. P. Rathinam was overruled by a Supreme Court bench consisting of five judges.
ARUNA SHANBAUG V UNION OF INDIA, 2011
The Aruna Shanbaug case, a landmark legal proceeding in India, revolved around the petition filed by the “next friend” of Aruna Shanbaug, a nurse who had been in a Persistent Vegetative State (PVS) since 1973 after a brutal sexual assault. The case sought permission from the Supreme Court to discontinue her feeding and allow her to die peacefully, framing the issue of euthanasia under Indian law. The doctors studied her complete medical history and concluded that her brain was not dead. She exhibited a unique way of understanding and reacting to situations. Additionally, her body language did not suggest any desire to end her life. The nursing staff also showed diligence in taking care of her. As a result, the court believed that euthanasia was not necessary in this case.
The Supreme Court, while not permitting the withdrawal of medical treatment for Aruna Shanbaug, extensively deliberated on euthanasia. It distinguished between active euthanasia, involving direct intervention to end life, and passive euthanasia, which entails withholding or withdrawing life-sustaining treatment. The court’s decision acknowledged the legality of passive euthanasia in certain circumstances, marking a significant shift in Indian jurisprudence. Importantly, the court invoked the principle of Parens Patriae (parent of the nation), asserting its role as the ultimate authority in determining what is best for incapacitated patients.
The apex court laid down specific procedures and guidelines for granting passive euthanasia in the “rarest of rare circumstances,” rejecting the petitioner’s plea. It extended this authority to High Courts under Article 226 of the Constitution, outlining a procedural framework for cases involving euthanasia. This framework mandates that requests for passive euthanasia must be evaluated by a medical board, and decisions should involve consultations with family and state authorities.
The judgment in the Aruna Shanbaug case set a precedent in India, providing clarity on the distinction between types of euthanasia and establishing procedural guidelines where legislation was absent. It highlighted the complexities and ethical considerations surrounding euthanasia while laying down a structured approach for future cases. Moreover, the case spurred discussions on legal reforms, including the repeal of Section 309 of the Indian Penal Code, which criminalizes attempted suicide.
the Aruna Shanbaug case remains pivotal in Indian legal history for its impact on euthanasia legislation, defining the parameters under which passive euthanasia can be considered lawful and establishing a judicial framework for such sensitive decisions.
COMMON CAUSE (A Regd. Society) V UNION OF INIDA, 2018
Subsequently, in the Common Cause case, the Supreme Court addressed whether Article 21 of the Indian Constitution, which guarantees the right to life, also encompasses a right to die with dignity. Affirming this, the Court underscored that fundamental rights are dynamic and evolve over time. Following the Puttuswamy I judgment which reaffirmed individual dignity under Article 21, the Court interpreted the right to life with dignity as extending to a dignified death. This interpretation allows individuals in a terminal condition or persistent vegetative state to opt for passive euthanasia, safeguarding their right to a dignified end under Article 21.
To facilitate this right, the Court in Common Cause issued guidelines on Advance Directives (AD), documents that outline a patient’s preferences regarding medical treatment and designate a competent decision-maker in case they become incapacitated. While these guidelines were revised in February 2023 to improve accessibility, they still impose significant requirements. Each AD must be validated by two medical boards, and their decisions can only be challenged through a writ petition under Article 226. This places a considerable administrative burden on patients’ families, who must navigate a rigorous bureaucratic process to validate ADs, which are notarized documents endorsed before a judicial magistrate.
CONCLUSION
The ongoing global discussions surrounding euthanasia provoke intense ethical and legal debates. Advocates emphasize compassion and respect for individual autonomy, while opponents express concerns about potential abuses, the erosion of medical ethics, and the risk of involuntary euthanasia.
In India, the debate on euthanasia remains open as no specific legislation has been enacted, leaving medical practitioners and individuals to rely on court guidelines. The legal framework continues to evolve, as evidenced by the 2018 judgment amended on January 24, 2023, to enhance the practicality of Advanced Directives and Living Wills. This indicates a work in progress, with final resolution likely awaiting comprehensive legislation by the Legislature.
In conclusion, euthanasia remains a deeply divisive issue influenced by moral, ethical, religious, and legal perspectives. The ongoing discourse highlights the intricate balance between individual rights, societal values, and the ethical responsibilities of medical professionals in end-of-life care.
By Aanya Bhargava (intern)