Supreme Court to Hear Plea on Passive Euthanasia
Jurisprudence of Dignity, Article 21 and the Right to Die with Dignity
Syllabus: UPSC (GS-2)
1. Introduction: Why This Case Matters
The Supreme Court of India has agreed to hear a fresh petition seeking clarity and reform in the legal framework governing passive euthanasia and Living Wills (Advance Medical Directives).
This is not merely a medical or moral issue. It strikes at the heart of Article 21 of the Constitution, which guarantees the Right to Life and Personal Liberty. Over the last two decades, the Court has transformed this provision from a guarantee of mere biological existence into a guarantee of dignified human living — and dignified human dying.
The present plea reflects continuing problems in implementing the Court’s guidelines: procedural delays, hospital confusion, and emotional distress for families of terminally ill patients.
2. Constitutional Foundation: Expansion of Article 21
The Supreme Court has redefined the Right to Life as not simply the right to survive, but the right to live — and die — with dignity, autonomy and meaning.
In Common Cause v. Union of India (2018), the Court held that:
The right to life includes the right to die with dignity.
Dignity was constitutionalised as an inherent attribute of personhood, not a privilege given by the State. The Court defined dignity through three constitutional values:
- Autonomy – The right to make fundamental choices about one’s own body
- Liberty – Freedom from unwanted state or medical intrusion
- Privacy and Bodily Integrity – The right to be free from unwanted medical intervention
After Justice K.S. Puttaswamy (2017), the right to privacy became the legal foundation for a patient’s right to refuse medical treatment. Any medical procedure without informed consent is legally a battery. Hence, refusing life support is not suicide — it is the exercise of a fundamental right.
3. Evolution of the Law on Euthanasia
India’s euthanasia law developed through three landmark cases:
| Case | Legal Position | Significance |
|---|---|---|
| Gian Kaur (1996) | No right to die, but dignity in dying recognised | Distinguished suicide from dying with dignity |
| Aruna Shanbaug (2011) | Passive euthanasia allowed with court approval | Recognised withdrawal of life support |
| Common Cause (2018) | Passive euthanasia + Living Wills recognised | Right to die with dignity made part of Article 21 |
The Common Cause judgment corrected a misreading in Aruna Shanbaug. It clarified that Gian Kaur never required Parliament to legalise euthanasia. Passive euthanasia was already implicit in Article 21 as part of the natural dying process.
Thus, withdrawing life support is not killing; it is allowing nature to take its course.
4. What is Passive Euthanasia?
Passive euthanasia means withdrawing or withholding life-sustaining treatment such as ventilators, feeding tubes, or dialysis when the patient is terminally ill or irreversibly unconscious.
It is distinct from:
- Active euthanasia (giving a lethal injection) – illegal
- Assisted suicide – illegal
Passive euthanasia is an “authorised omission”, where death is caused by disease, not by the doctor.
5. Voluntary and Non-Voluntary Euthanasia
The Court recognises two forms:
- Voluntary – based on the patient’s Living Will (Advance Directive)
- Non-voluntary – when the patient is unconscious and decisions are taken by surrogates in the patient’s best interest
However, India prioritises the Substituted Judgment Standard:
“What would this patient have wanted?”
6. Living Wills and Advance Medical Directives
A Living Will allows a person to state in advance that they do not want life-prolonging treatment if they become terminally ill or permanently unconscious.
To prevent misuse, the Supreme Court created a strict procedural framework:
- Written document with two witnesses
- Countersigned by a Judicial Magistrate
- Stored in digital and court records
- Reviewed by:
- Hospital Medical Board
- District Medical Board (20-year senior doctors)
- One-month cooling-off period for objections
This ensures that family greed, hospital pressure, or cost considerations cannot override genuine patient autonomy.
7. Ethical Balance: Life vs. Dignity
The Court rejects “vitalism” — the idea that life must be preserved at all costs. It distinguishes between:
- Sanctity of Life – Respect for human existence
- Futile Vitalism – Forcing a person to suffer with no hope of recovery
Doctors are bound by the Hippocratic Oath, but a patient’s right to bodily integrity overrides forced medical intervention.
8. Why the Supreme Court is Hearing a New Plea
Despite earlier judgments, hospitals still face:
- Legal confusion
- Fear of criminal liability
- Bureaucratic delays
Families of dying patients suffer prolonged emotional and financial distress. The Court is now re-examining whether procedures should be further simplified to ensure that constitutional dignity is not defeated by procedural complexity.
9. Global Perspective
India’s approach is cautious but progressive:
- UK and USA allow withdrawal of life support
- Netherlands and Switzerland allow active euthanasia
- India allows only passive euthanasia with safeguards
The aim is to balance compassion with protection from abuse.
10. Conclusion
The Supreme Court’s evolving jurisprudence on passive euthanasia represents one of the most humane applications of constitutional law. By embedding dignity, autonomy and privacy into Article 21, the Court has ensured that Indians are not forced to endure meaningless suffering in the name of survival.
The present hearing is not about choosing death — it is about choosing dignity over suffering, and ensuring that the Constitution remains a guardian of humanity even in life’s final moments.
