Laws on Euthanasia in India
Euthanasia, or the practice of intentionally ending a life to relieve pain and suffering, is a highly debated and sensitive topic worldwide. In India, the legal stance on euthanasia has evolved over time, balancing ethical considerations, medical ethics, and individual rights. Here’s a comprehensive overview of the current legal framework and the significant milestones in the evolution of euthanasia laws in India.
Types of Euthanasia
1. Active Euthanasia: This involves directly causing the death of a patient, such as through the administration of lethal substances. Active euthanasia is illegal in India.
2. Passive Euthanasia: This involves withholding or withdrawing medical treatments that prolong life, allowing the patient to die naturally. This form of euthanasia has been recognized under specific circumstances in India.
Legal Milestones
1. The Aruna Shanbaug Case (2011): The landmark judgment in the Aruna Shanbaug case by the Supreme Court of India set the precedent for passive euthanasia. Aruna Shanbaug was a nurse who had been in a persistent vegetative state (PVS) for decades following a brutal assault. In response to a plea for euthanasia filed by journalist Pinki Virani, the Supreme Court in 2011 recognized the legality of passive euthanasia under strict guidelines. The court allowed withdrawal of life support for patients in a PVS under the supervision of a medical board and with the approval of the high court.
2. The Common Cause Case (2018): In 2018, the Supreme Court delivered another landmark judgment in the case of Common Cause v. Union of India. This judgment legalized passive euthanasia and recognized the right to die with dignity as a fundamental right under Article 21 of the Indian Constitution. The court laid down detailed guidelines for the implementation of passive euthanasia and also recognized the validity of living wills or advance directives.
Guidelines for Passive Euthanasia
1. Living Will or Advance Directive: A living will is a document in which a person states their wishes regarding end-of-life medical treatment in the event that they become incapable of expressing informed consent. The Supreme Court’s guidelines include:
The living will must be executed by an adult who is of sound mind and in a clear state of mind.
It should be specific about the circumstances under which withdrawal or withholding of medical treatment is desired.
The will must be signed by the executor in the presence of two attesting witnesses and a Judicial Magistrate of First Class (JMFC).
2. Implementation Process:
When the patient is terminally ill and the circumstances mentioned in the living will arise, the treating physician must inform the hospital’s medical board.
The hospital’s medical board, after confirming the authenticity and applicability of the living will, must inform the jurisdictional Collector.
A medical board constituted by the Collector must visit the patient, review the case, and provide its opinion.
If the board confirms that passive euthanasia is applicable, the JMFC must visit the patient to ensure there is no coercion or undue influence.
Finally, the decision is reviewed by the high court before implementation.
3. In Absence of a Living Will: If there is no living will, close relatives or friends can approach the high court seeking passive euthanasia for a patient. The court, with the help of a medical board, will review and decide the case.
Ethical and Moral Considerations
Euthanasia, even passive, raises numerous ethical, moral, and religious questions. The Supreme Court has emphasized the need to balance the right to die with dignity and the sanctity of life. The guidelines are designed to prevent misuse and ensure that the decision for passive euthanasia is taken with utmost care and responsibility.
Conclusion
The legal stance on euthanasia in India is clear: active euthanasia remains illegal, while passive euthanasia, under strict conditions and guidelines, is permitted. The recognition of living wills and advance directives marks a significant step towards respecting patient autonomy and ensuring that individuals can make informed decisions about their end-of-life care. These laws aim to provide a humane and ethical approach to dealing with terminally ill patients, balancing the right to die with dignity with the need to protect vulnerable individuals from abuse.