It is heartening that a five-judge Constitution bench of the Supreme Court has recognised a person’s right to die with dignity while giving sanction to ‘passive euthanasia’ and ‘living will’. Passive euthanasia is a condition where there is the withdrawal of medical treatment with the deliberate intention to hasten the death of a terminally-ill patient. In 2011, the apex court had recognised passive euthanasia in Aruna Shanbaug’s case by which it had permitted withdrawal of life-sustaining treatment from patients not in a position to make an informed decision.
However, active euthanasia, which is an intentional act of causing death of a patient in great suffering continues to be illegal in India. A living will is a concept associated with passive euthanasia. In it, a person can outline whether or not he or she wants life to be artificially prolonged in the event of a devastating illness or injury. That the apex court has re-examined the issue is in the right spirit and with sound motivation. Significantly, the Centre government had opposed recognition of ‘living will’ and said the consent for removal of artificial support system given by a person may not be an informed one and without being aware of medical advancements.
That view has not been accepted by the apex court. The Supreme Court says it has laid down guidelines on who would execute the will and how nod for passive euthanasia would be granted by the medical board. The apex court further added that its guidelines and directives shall remain in force till a legislation is brought to deal with the issue. Only time will tell whether the recognition given to ‘living will’ will prove efficacious in actual practice. There is a human intervention involved which will be under intense scrutiny. Besides, the ball will now be in the Central government’s court to speedily bring forth legislation to set up an effective mechanism for implementation.
The trigger for the case, Aruna Ramchandra Shanbaug, was a nurse who was assaulted by a ward boy in a hospital in Mumbai and strangulated with a dog chain around her neck which cut off oxygen supply from her brain leaving her blind, deaf, paralysed and in a vegetative state for the next 42 years. Her death in 2015 sent a wave of sympathy for her leading up to the question of allowing passive euthanasia.