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Home / UPSC Editorials / Supreme Court’s View on Active & Passive Euthanasia

Supreme Court’s View on Active & Passive Euthanasia | UPSC Editorials

Last Updated on Jan 27, 2025
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A recent judgment by the Hon'ble Supreme Court reveals the legal as well as ethical confusion surrounding euthanasia in India. A Ryles tube is a device through which food can be passed through the nose into the stomach. Permission sought to remove the tube was denied to parents of Harish Rana, a 32-year-old who has been in a vegetative state for the past 11 years with no chance of recovery. While withdrawal of life-support in cases deemed terminal is allowed in India as per the Supreme Court’s 2018 judgment, a bench headed by Chief Justice of India D.Y. Chandrachud observed on August 20, that “Ryles tube is not a life support system.

Analysis Based On

Editorial Published in Indian Express on ensuring dignity for terminally ill 

Topics for Prelims

Fundamental Right, Judicial Review, Supreme Court, Governance, Government Legislations

Topics for Mains

Ethical issues related to Euthanasia, Transparency, Efficiency, Good Governance, Fundamental Rights, Right to Life, Right to Die

Why Euthanasia is in the News?

 The Supreme Court of India denied a petition from an elderly couple who sought permission for performing "passive euthanasia" for their comatose son, who has been bedridden for 11 years following a fall. This ruling has reignited discussions on the legal and ethical dimensions of euthanasia in India. The Supreme Court denied the permission of performing passive euthanasia and stated that the case did not qualify as passive euthanasia since the patient was not on any life support systems but was receiving nutrition through a Ryles tube. The court held that the process which was sought will come under active euthanasia which remains illegal in India. 

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What is Active Euthanasia?

Active Euthanasia is a process which directly causes the death of a patient through deliberate actions, such as administering a lethal dose of medication. It is usually doen or performed with the intention of relieving a person who is suffering alot, but the key element is that it involves an active intervention to end a patient's life.

What is Passive Euthanasia?

Passive Euthanasia is a process that involves withholding or withdrawing complete or partial medical treatment that would prolong the life of a patient, allowing them to die naturally. This type of euthanasia includes actions such as not performing a life-saving surgery or stopping life-support measures. Unlike active euthanasia, passive euthanasia does not involve directly causing death but rather allowing the natural course of the illness to lead to death.

Recent Changes Made By Supreme Court on Passive Euthanasia

In 2023, the Supreme Court modified the guidelines made in 2018 in order to simplify the process for granting permission for passive euthanasia to terminally ill patients. These are the following modifications that hon’ble Supreme Court has made regarding passive euthanasia in India :

  • Attestation of Living Will: The Supreme Court has done away with the provision of requirement of a judicial magistrate's attestation on a living will. Now, attestation by a notary or even a gazetted officer is sufficient. This has made the process easier for individuals to express their choices.
  • Integration with National Health Digital Record: Living wills which were previously held by district courts, are now required to be part of the National Health Digital Record. This modification h
  • as ensured easier access for hospitals and doctors nationwide and a fast decision making process.
  • Process of Appeal in case of denial of Euthanasia: If a medical board of a particular hospital denies permission to withdraw life support, then the patient’s family can appeal to the relevant High Court which will form a new medical board to reassess the case, ensuring an impartial process.

Status of Active & Passive Euthanasia in India

There is no uniform law or protocol with respect to euthanasia in the world. Every country has a different set of legislations and standard practices regarding euthanasia. The status and legality of euthanasia has kept on changing in India with numerous judgements given by supreme court on a case to case basis. The status of both active and passive euthanasia in India is as follows:

  • The Supreme Court of India, in the landmark judgment of Common Cause vs Union of India, 2018, recognized that a person has the right to life with dignity as well as right to die with dignity and thus permitted passive euthanasia and the execution of a living will to refuse medical treatment.
  • The Supreme Court laid down various guidelines for ‘living wills’ made by terminally ill patients who foresee the possibility of entering a permanent vegetative state. 
  • The Supreme Court for the first time recognized passive euthanasia in the Aruna Shanbaug case in 2011, stating that, “Dignity in the process of dying is implicit under the right to life under Article 21.
  • Thus, as of now Active Euthanasia remains illegal in India.

Read more about Right to life!

Status of Active and Passive Euthanasia in Other Countries

Countries like Netherlands, Luxembourg, Belgium allow both types of euthanasia and also assisted suicide for those individuals who are facing “unbearable suffering” and there is almost no prospect of improvement. In Switzerland, assisted suicide was legalised in 1942, focusing on the premise that it is a personal choice of an individual and only he has control over the dying process, provided that individuals are of sound mind and their decision is not motivate by any selfish reason.

In Australia, both active and passive euthanasia is legal

Ethical Issues Related to Active and Passive Euthanasia

There are many dilemmas when it comes to executing both types of Euthanasia in India and abroad. These are some of the ethical issues related to performing or granting permission for active and passive euthanasia:

  • Consent: Euthanasia respects autonomy of an individual and allows people to decide about their lives, especially to end suffering if they are in their sound mind. It also requires informed consent ensuring that the person totally understands their condition, the process of euthanasia they have to undergo and its consequences in order to avoid any kind of coercion or manipulation. 
  • Way of Life: The debate on euthanasia often revolves around quality of life which holds that life is very valuable and it should not be ended prematurely, reflecting religious or philosophical beliefs. 

Way Forward

The judgment given in the Harish Rana case underscores the necessity for a clear legal distinction between euthanasia and the withdrawal of life-sustaining interventions that may be deemed futile. It is important to involve medical and ethical experts in making judicial decisions to ensure that they are based on evidence based medical understanding and ethical principles. 

A legal framework needs to be established and awareness should be created about it.

Apart from that ethical reforms like looking at a case from an ethical angle is also required. It should be taken care that the dignity of an individual is not harmed in any way while making a decision on their choice.

Conclusion

The denial by the Supreme Court to remove the Ryles tube, despite the patient's prolonged vegetative and terminally ill condition and lack of recovery prospects, emphasizes the need for establishing clear legal guidelines and ethical reforms. As India navigates these issues, it is sine qua non to involve various domain experts like medical and ethical experts in decision-making process and ensure that the right to live life with dignity and die are upheld for all individuals. 

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Q1. The scope of the "Right to Life" under Article 21 of the Indian Constitution has been expanded by the judiciary.Comment. (250 words)

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