Euthanasia in India

GS II-Governance

Understanding Euthanasia

Euthanasia, commonly referred to as mercy killing, involves intentionally ending a person’s life to relieve suffering, particularly in cases of irreversible and terminal illnesses.

Legal Framework of Euthanasia in India

Supreme Court’s 2018 Judgment

The Supreme Court legalized passive euthanasia in 2018, allowing the withdrawal of life support in terminal cases, provided a living will exists.

• A living will is a legal document outlining an individual’s healthcare preferences in situations where they are no longer able to express consent.
• It requires the individual’s signature in the presence of two witnesses and must be countersigned by a Judicial Magistrate of First Class (JMFC).

Aruna Shanbaug Case (2011)

This landmark case permitted passive euthanasia for Aruna Shanbaug, a nurse who remained in a vegetative state for decades following a violent assault.

• The Supreme Court differentiated between active and passive euthanasia, allowing the latter under specific conditions.

Law Commission Reports

• 196th Report (2006): The Commission clarified that withdrawing or withholding medical treatment per a patient’s request does not constitute medical negligence or an offence.
• 241st Report (2008): It proposed legislation on passive euthanasia and drafted a bill to provide legal clarity on the matter.

Harish Rana Case (2024)

The Supreme Court ruled that a Ryles tube does not constitute a life-support system and, therefore, denied its removal in a patient in a vegetative state.

Recent Legal Simplifications

• Medical Boards: Now formed at the hospital level to ensure efficiency and impartiality, reducing procedural delays.
• Reduced Experience Requirement: Doctors on the medical board now require a minimum of five years of experience, down from 20 years.
• Judicial Simplification: Instead of seeking approval from a magistrate, only an official intimation is now necessary.
• Signatory Requirements: The magistrate’s countersignature can be substituted with signatures from witnesses and a notary or gazetted officer.

Arguments Supporting Euthanasia

• Dignity in Death: Allows individuals to avoid prolonged suffering, as seen in countries like the Netherlands, where euthanasia is legal for terminal patients.
• Avoidance of Futile Treatment: Prevents the continuation of medical procedures that offer no hope of recovery.
• Potential for Organ Donation: In Belgium, euthanasia patients can consent to organ donation, potentially saving other lives.
• Financial Considerations: Reduces financial strain on families by avoiding prolonged medical expenses.
• Legal Recognition: The right to die with dignity has been upheld under Article 21 of the Indian Constitution (Aruna Shanbaug case).

Arguments Against Euthanasia

• Moral and Religious Concerns: Many faiths, including Christianity and Islam, oppose euthanasia, viewing life as a divine gift.
• Risk of Misuse: There is a possibility of non-voluntary euthanasia, where the patient’s consent is ambiguous or absent.
• Slippery Slope Concern: Legalizing euthanasia may lead to its acceptance in less severe medical conditions.
• Medical Ethics: The World Medical Association (WMA) opposes euthanasia, stating it contradicts the fundamental principles of medical practice.

Way Forward

Strict Regulations: Establishing a robust legal framework to prevent the misuse of passive euthanasia, similar to the Netherlands’ strict multi-doctor approval process.
Awareness Campaigns: Educating the public on euthanasia’s ethical and legal aspects, along with alternatives such as Advance Care Planning.
Judicial Oversight: Ensuring legal and medical reviews for euthanasia requests through a multi-tier system involving medical boards and High Court judges.
Palliative Care Focus: Expanding palliative care programs to provide compassionate end-of-life care, as seen in Kerala’s palliative care initiative, which has improved the quality of life for terminal patients.