What Does Supreme Court Permitting Passive Euthanasia Mean?

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Dr Anupam Sibal, the group medical director and senior pediatric gastroenterologist and hepatologist in Apollo Hospitals Group, said "living will" or advanced directive (as it is called in some countries) allows a citizen the ability to exercise a fundamental right - to decide in advance what should be done to his or her body when he or she is not in a position to make that decision.

The Supreme Court has given legal sanction to passive euthanasia in a landmark verdict, permitting ' living will' by patients on withdrawing medical support if they slip into irreversible coma.

The bench said its guidelines and directives should remain in force until Parliament makes legislation on this issue.

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The decision, given by the Bench of Chief Justice Dipak Misra, Justices AK Sikri, AM Khanwilkar, DY Chandrachud and Ashok Bhushan, said, "The right to live with dignity (a component of right to life and liberty under Article 21) also includes the smoothening of the process of dying in case of a terminally-ill patient or a person in PVS with no hope of recovery". "Following the Supreme Court ruling, the Centre will now have to frame guidelines on the matters around the issue, like who can carry out the process, what is the role of caregivers and such", says Jha. "We don't want to be in a situation where one of us is left alone or taking care of the other". "This means that now if I prepare a document expressing my wish not to be subjected to aggressive life-prolonging interventions in the face of an incurable terminal illness, I have a chance of having my final hours or days with loved ones..." "But before passive euthanasia comes the question of the living will". "Hence, the Constitution protects the legitimate expectation of every person to lead a life of dignity until death occurs", he said.

Advocate Prashant Bhushan, appearing for the NGO, said since a patient in a coma can not express his or her wishes, the law should allow him or her to put down in writing in advance that he or she should not be tortured. A five-bench judge also defined the rule to implement the procedure in case there would be no living wills.

The top court also held that when passive euthanasia as a "situational palliative measure becomes applicable", the best interest of the patient shall override the state interest.

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The petitioner, NGO "Common Cause", had approached the court seeking a direction for recognition of "living will". Choosing death, giving birth, abortion, making love, eating food, wearing clothes, and turning religious are extremely personal choices people make.

Passive euthanasia involves withholding or discontinuing treatment for a terminally ill person where as active euthanasia involves injecting a lethal dose to a terminally ill person.

Mar 7, 2011: SC, on a separate plea on behalf of Aruna Shanbaug, allows passive euthanasia for the nurse lying in vegetative state at a hospital in Mumbai. He further clarified that while active euthanasia is a crime, same is not the case with passive euthanasia as the element of good faith and objective assessment of the caregiver of the patient will protect doctors performing this task.

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