Recent SC judgment On Euthanasia and Living Will

In a recent landmark judgement, the Supreme Court held that right to die with dignity is also a fundamental right within the ambit of right to life under Article 21 of the Constitution of India. The judgement also allowed living will by a terminally ill patient and passive euthanasia.

What is euthanasia?

Euthanasia is a method of painless killing of a patient who has been suffering from a painful and incurable disease or is in a perpetual state of coma. There are two forms of euthanasia recognized:

• Active euthanasia-It is the killing of a person directly by injecting with a lethal injection or drug and also includes physician-assisted suicide. It is mostly illegal and is allowed in only few countries-Canada, Switzerland and Netherlands.
• Passive euthanasia-In this case patient is killed by life supporting systems like disconnecting feeding cubes, not providing life-extending drugs or not carrying out any more life-saving operations.

What are living wills?

Living wills are indications by individuals as to the medical treatment to be meted out to them, at a stage when they are in a position to make informed decisions for a time when they can’t decide for themselves.  A person has the right to refuse treatment or right to die with dignity under this living will. The judgement also allows any terminally ill patient to make a living will for a time when his or her condition will be worse so as to not allow the person to make informed decision.

Key Points in the Judgement

The judgement gives out certain broad guidelines that shall remain force till legislation is brought out in this effect.  Some of its aspects are as follows:

Living will

• It specifies any person who has sound mind and health can make a living will which specifies that in case of a terminal medical condition in future his or her life should not prolonged with the help of life support systems.
• He or she can also authorize any relative or friend to decide when to pull out the life support after consulting the medical experts.

Individual consent

• The judgement gives an individual the freedom of choice over his or her health at a time when living becomes futile and struggle between time and space.
• Not allowing the person to die who is not even aware of his or her own heartbeat is denial of dignity who has no choice but to ‘suffer an avoidable protracted treatment’.
• Forced medical intervention has been regarded as an attack on individual autonomy.

Right to health

• It has been stated that since the State machinery fails to provide right to healthcare to all, it is better not to deny a person right to die.
• Further, due to shortage of healthcare facilities it would be futile to keep them engaged behind a person who will never recover and only suffer through use of these. Rather they can be used for a poor person who can survive but can’t afford expensive medical care.

Practice sanctioned by religion

• Reference has been drawn of religions like Buddhism and Jainism which allow right to die by various practices. Only Hinduism, Islam and Christianity condemn this practice.

Additional Safeguards

• In order to prevent misuse of living wills or position of a patient by greedy relatives or friends the Court also laid down certain safeguards.
• These include setting up double medical board which involve judicial magistrate or high court or collector in the time of implementing passive euthanasia or living will of a person.

Active euthanasia

• The judgement clearly lays down that only passive euthanasia is allowed and not active euthanasia. It still criminalizes active euthanasia.

Background to the recent Judgement

• In the year 2011, passive euthanasia had become an issue of debate with the Aruna Shanbaug case. The judgement had allowed withdrawal of life-supporting treatments for patients who were suffering and were not in a position to make informed decision.
• In 241^st Law Commission Report it was stated that passive euthanasia should be allowed with certain safeguards. A law was proposed as Medical Treatment of Terminally Ill Patient (Protection of Patients and Medical Practitioners) Bill, 2016.

Significance in the Criminalization of Suicide debate

The judgement is being hailed as paving the way for decriminalizing suicide as it answers the major question of right to die is a part of right to life. This solves half the debate surrounding criminalization of suicide.