Euthanasia: A Deep Analysis of Right to Die

The author in this article discusses Euthanasia with respect to Right to die and how this request of premature ending of one’s life has been in debate and the constitutionality of the same in various countries.

Introduction

Our country has evolved in technology and medical science in the past years. It has not only progressed in the field of improved general human health but even in finding a cure for the epidemics. In one way or the other, it has also been believed that the dependence of human life on medical treatments has increased. This can be not only painful at times but also against individual independence. And hence, euthanasia is considered to be one of the easiest options to end one’s life when all other medical life-supporting system fails.

Euthanasia has been one of the most controversial issues for discussion at all times. Not only the views differ according to one’s religion but also based on factors like age, gender, etc. The term originated in Greece which means “good death”. It is defined as an intentional ending of the patient life by removing any medical care or life-support system.[1] This request for the premature ending of one’s life has been debatable from a constitutional perspective and each country has its own concerns.

There are mainly 4 types of euthanasia, i.e. active, passive, indirect, and physician-assisted suicide. Active euthanasia involves the feeding of lethal substances to the patient by someone else in mercy[2]. Passive euthanasia is withdrawal or holding of life-supporting treatment/machines either on request of the patient or when extended life is considered to be of vain. Indirect euthanasia involves the prescription of such painkillers which are disastrous in an attempt to relieve suffering. And lastly, physician-assisted suicide refers to medical assistance aiding the patient to end their life upon their request.[3]

Right To die-Granted?

With all countries having different perspectives on legal, social, and economic ramifications, each one has dealt with it in its own way. A long debate is even been going on the point that whether or not there should be a provision dealing with euthanasia. In the year of 2018, an old couple wrote a letter to the President of India to allow active euthanasia. In the month of March 2018, the Supreme Court of India was hearing a plea made by an NGO named Common Cause to include the right to die with dignity within the ambit of the right to live with dignity. Finally the landmark judgment of the case Common Cause v. Union of India[4] pronounced to legalize passive euthanasia in the country. The bench compromised of Chief Justice Dipak Mishra, Justice AK Sikri, AM Khanwilkar, DY Chandrachud, and Ashok Bhushan. The bench observed Article 21 of the Constitution completely in the judgment and came to the conclusion that passive euthanasia is not an offense under the Indian Penal Code. The legalization of passive euthanasia frees the patient from any liability under Section 306 of IPC and that of the doctor under Section 309 of IPC.

And The Court’s Verdict

In the case of Common Cause v Union of India, the final verdict was passed on 9th March 2018, giving legal recognition to passive euthanasia by issuing certain guidelines for the same. The Apex Court permitted passive euthanasia by asking the patient to the first draft a ‘living will’ or advanced medical directives. A living will is a document written by the patient, under no force or coercion in his/her normal state of mind. The will contains the instructions or the acceptance of voluntary euthanasia in case he/she slips into a stage during his/her treatment from where recovery is impossible or irreversible. The court in the judgment discussed that keeping a person alive under unbearable conditions is inhuman and the right to decide whether the treatment should be given or not should also be the decision of the patient. In the case where no advance medical directives are mentioned and the person is at an incurable stage, the relatives or friend[5] of the patient can approach the High Court for granting passive euthanasia. In the situation where the person is of unsound mind or not in a state to make a will, this decision is taken by the medical team treating him keeping in mind all the factors. The court has issued guidelines with respect to who is authorized to give a nod for the same.

Along with these the court with this judgment held that ‘Right to Die’ will now be a part of Article 21 of the constitution and a person has full right to live his life with dignity until death. The court involves a rigorous procedure of interpretation to be given by the patient willing to end his/her life on the debate of the right of life and right to die before executing a living will. Although after this landmark judgment passive euthanasia was legalized for patients with no chance of recovery active euthanasia is still stayed illegal in India.

Constitutional Validity of Section 309[6] IPC – The Landmark Judgments

The Landmark Judgments

  1. Maruti Shripati Dubal v. State of Maharashtra[7]–This was the first case tried for the right to die before the court. The petitioner in the case is a police constable, who met with a road accident and had been mentally ill since then. After the incident he attempted to commit suicide by pouring kerosene over himself and light a match. Thankfully this act of his was prevented but he was prosecuted under Section 309 of IPC. The division bench of Hon’ble Bombay High Court collide with Section 309 as ultra vires vide Article 14 and 21 of the Constitution. The two articles of the constitution talks about the right to life and personal liberty. The court held that the right to life not only includes right to live but also end the same on his/her own desire.
  2. P. Rathinam v. Union of India[8]–In 1994, the division bench of Supreme Court having Justice R.M.Sahai and B.L.Hansaria, by way of approving the judgments of Bombay and Delhi High court and overruling the judgment of Andhra Pradesh. The bench strike down Section 309 of IPC on the grounds of cruel and irrational, violate to Article 21 of the constitution. The court in the same judgment expanded the ambit of Article 21 by stating that the right to lifw includes the right to not live a forced life. This permits the person to end his own life if he desires to.
  3. Gian Kaur v. State of Punjab[9]–In this case, the appellant and her husband Kulwant Kaur were convicted under Section 306[10] IPC. In the special plea before the court, the appellant challenged this conviction on the grounds that in the judgment passed in 1944, the court held section 309 as unconstitutional and hence the nature of section 306 inter alia is unconstitutional. This petition was rejected by the court and overturned the judgment held in the case of P.Raithnam. The court denied with it and said the right to life does not include right to die as per Article 21 of the Constitution of India.
  4. Aruna Ramchandra Shanbaug[11]– Pinki Virani on behalf of a patient named Aruna Shanbaug who was in a critical condition filed a request under Article 32 of the constitution for withdrawal of artificial feeding. Aruna was admitted in KEM hospital, Mumbai for the past 36 years in a vegetative state. The court in course of pronouncing the final judgment, took opinion of the medical staff in-charge of Aruna and declined the request after due consideration. Although during this case, the bench did a deep study of passive euthanasia and issued guidelines which will be followed until and unless the contrary is decided by the state and central government. It was held that, the request of passive euthanasia needs approval of the high court in order to avoid any mischief by relatives or friends with interior motive.[12] And finally in the year 2018, the Supreme Court in the case of Common Cause v. Union of India gave a landmark verdict and legalized passive euthanasia by allowing the living will or advanced medical directives.

Conclusion

It can be seen from the above cases that the Court has taken a liberal perspective with respect to the cases related to passive euthanasia. It has based its decision on the principles of autonomy and the best interests of the patient. It would be important to note here that there is a huge difference between active and passive euthanasia. Active euthanasia is killing a terminally-ill patient by administering him or her with a lethal drug. But passive includes removal of life-support systems etc. People supporting palliative care do not support passive euthanasia as a form of euthanasia at all. The state is acting as the protector of life, thereby putting itself in a dilemma of whether to legalize euthanasia or not. There are countries which have already legalized euthanasia of both kinds. It should be noted that the Court has delved upon the moral distinction between active and passive euthanasia. There is another argument by the medical experts that there is a provision in the medical code of ethics where a panel of doctors can withdraw the life-support system if the patient is brain-dead in specific cases. The next point would be whether India is ready for the law which requires sensitivity and maturity in the individuals. There are high chances of misuse of law if there is no proper law as the death of old people may be hastened in order to recover a hefty amount of life insurance cover. The Supreme Court has taken an active step towards the issue of euthanasia. It will depend on the response of the center as to whether there must be law recognizing.

Also read Attempt to Commit Suicide: Legal Implications


[1] Dillman RJM &Legemaate J. Euthanasia: Is the debate over?

[2] Attitudes of health care professionals, relatives of advanced cancer patients and public towards euthanasia and physician assisted suicide, available at https://pubmed.ncbi.nlm.nih.gov/20488575/

[3] Changes in attitudes towards hastened death among Finnish physicians over the past sixteen years, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975714/

[4] W.P. (Civil) 215 of 2005

[5] Rateesh Sareen, India Decides on Euthanasia: Is the Debate Over? Health Care: Current Reviews, Vol.7 Iss. 3 (2018)

[6] Attempt to commit suicide

[7] (1987) Cr LJ 473 (Bom.)

[8] AIR 1994 SC 1844

[9] AIR 1996 SC 1257

[10] Abetment of Suicide

[11] (2011)4 SCC 454

[12] SC Constitution Bench holds passive euthanasia and living wills permissible, available at https://www.thehindu.com/news/national/sc-recognises-living-will-by-terminally-ill-patients-for-passive-euthanasia/article22991873.ece