'Living will is autonomy over life or death'

SC permits 'living will' of terminally ill patients What does 'passive euthanasia' mean

Passive euthanasia will apply only to a terminally ill person with no hope of recovery, a panel of five judges said. Just as the Indian Constitution provides people the right to live with dignity, on Friday, in a landmark judgment, the Supreme Court has allowed people to die with dignity too.

Parliamentarian Baijayant Jay Panda, who moved a Private Members Bill regarding passive euthanasia in 2016, told YourStory, "I've long supported the right of terminally ill patients to die with dignity, should they wish to, instead of lingering on in pain".

A five-judge constitution bench headed by Chief Justice Dipak Misra observed that the failure to legally recognise advance medical directives may amount to "non-facilitation" of the right to smoothen the dying process and the dignity in that process was also a part of the right to life under Article 21 of the Constitution. In passive euthanasia, the life support system of a terminally ill patient who is in a vegetative state is withdrawn.

Advocate Prashant Bhushan, appearing for petitioner NGO Common Cause, had argued that safeguards were needed while taking a decision by medical boards to withdraw life support of a patient.

Even though passive euthanasia has been legal since 2011 in India, the government is yet to pass the law.

Says Common Cause India on whose plea the SC delivered its verdict on passive euthanasia and living will yesterday. Integrity and ethical conduct of the medical and legal professions need supplementary fortification, on matters beyond passive euthanasia as well. "The safeguards that the court has built in should allay fears that some people may have", he said. In Australia, there is a system of "advance directive" to allow citizens to decide how they would like to be treated in future, if they are incompetent to make a decision at that point.

On when and by whom the living will may be put into effect, the bench, in its 538-page judgement, said in such a case the treating physician, when made aware of the advance directive, shall ascertain the genuineness and authenticity thereof from the jurisdictional JMFC before acting upon it. The plea had stated that a person, who is afflicted with a terminal disease, should be given relief from agony by withdrawing artificial medical support provided to him which is medically referred to as passive euthanasia. The British House of Lords Select Committee on Medical Ethics defines euthanasia as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering".

Stating that active euthanasia - when death is brought about by an act - was not allowed in the country, Ms Virani said, "Passive euthanasia is allowed when a patient is in a persistent vegetative state (PVS) like the case of Shanbaug".

Thus the Constitution Bench held that an adult human being having mental capacity to take an informed decision has right to refuse medical treatment including withdrawal from life saving devices. During the discussion, the family members shall be apprised of the pros and cons of withdrawal or refusal of further medical treatment to the patient and if they give consent in writing, then the hospital medical may certify the course of action to be taken.

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