Context
The article discusses the evolving debate on passive euthanasia in India, comparing it with developments in the UK’s End of Life Bill (2025). While India legally recognises passive euthanasia (since Aruna Shanbaug v. Union of India, 2011; reaffirmed in Common Cause v. Union of India, 2018), implementation remains limited and complex due to procedural, moral, and regulatory hurdles.
What is Passive Euthanasia?
Passive euthanasia refers to withholding or withdrawing life-sustaining treatment (like ventilators or feeding tubes) for a terminally ill or permanently unconscious patient, allowing death to occur naturally. It contrasts with active euthanasia, which involves direct action to end life and remains illegal in India.
Legal and Constitutional Framework
- Article 21 (Right to Life) has been interpreted by the Supreme Court to include the Right to Die with Dignity.
- The 2018 Common Cause judgment allowed living wills and advance medical directives under strict supervision.
- However, procedural requirements — such as multiple medical boards, district magistrate approval, and judicial oversight — have made the process impractically slow.
Challenges in Implementation
- Practical Inaccessibility:
- Current legal safeguards are complex and delay decision-making, even in hopeless cases.
- Lack of clarity and fear of prosecution discourage doctors and families from invoking euthanasia provisions.
- Institutional Weaknesses:
- India lacks a uniform, reliable healthcare regulatory framework.
- Fragmented healthcare, inadequate palliative care, and social stigma hinder dignified end-of-life options.
- Moral and Religious Constraints:
- Cultural and religious beliefs often view withdrawal of life support as morally unacceptable, even when medically justified.
- Jurisdictional Dilemmas:
- Ambiguity persists between judicial interpretation and executive policy.
- Supreme Court’s caution reflects fear of misuse, but it also prevents genuine cases from timely relief.
India’s Constitutional Promise
Justice Kannan argues that “dignity in life must extend to dignity in dying.”
The Constitution’s commitment to human dignity must encompass end-of-life care that is compassionate, accessible, and ethically consistent.
Suggested Reforms and the Way Forward
- Simplify and Decentralise Procedures:
- Empower local medical boards and hospitals to review and approve passive euthanasia cases within 48 hours.
- Use digital dashboards and state-level ombudsmen for transparency and accountability.
- Strengthen Palliative and Hospice Care:
- Integrate palliative care into primary health services and insurance frameworks.
- Train healthcare workers and doctors in end-of-life ethics and counselling.
- Public Awareness and Legal Literacy:
- Encourage citizens to make advance directives (living wills) through Aadhaar-linked online registration systems.
- Promote societal dialogue about the right to die with dignity.
- Ethical Oversight:
- Establish decentralised ethical review bodies, independent of bureaucratic delay.
- Develop a compassionate, Indian-contextual framework — not a replica of Western laws.
Comparative Note – The UK Model
The UK’s End of Life Bill (2025) permits physician-assisted dying for terminally ill adults under strict safeguards. While India is unlikely to allow active euthanasia soon, its passive form can be improved through humane, efficient, and ethically sensitive procedures.