When Mercy Meets Law
Euthanasia, also known as ‘mercy killing’, is an act or practice of painlessly putting to death persons suffering from painful and incurable disease or allowing them to die by withholding treatment or withdrawing artificial life-support measures.
The word itself is derived from the Greek words ‘eu’, meaning ‘good’, and ‘thanatos’, meaning ‘death’ — together signifying a ‘good death’.
Countries Where Euthanasia Is Legal
Euthanasia is legally recognised in countries such as the Netherlands, Belgium, Luxembourg, Spain, Colombia, New Zealand, and Canada (including the province of Quebec).
In Australia, it is permitted in certain states such as Victoria, but not nationally.
| Country | Legal Status of Euthanasia |
|---|---|
| Netherlands | Legal |
| Belgium | Legal |
| Luxembourg | Legal |
| Spain | Legal |
| Colombia | Legal |
| New Zealand | Legal |
| Canada | Legal (Including Quebec) |
| Australia | Permitted in Certain States Such as Victoria |
Types Of Euthanasia
It can be of two broad types: active and passive.
Active Euthanasia
Active euthanasia involves the use of a hazardous substance or lethal method to end a person’s life.
Passive Euthanasia
Passive euthanasia involves stopping medical treatment, in the absence of which a person is likely to die.
| Type | Description |
|---|---|
| Active Euthanasia | Use of hazardous substances or lethal methods to end life. |
| Passive Euthanasia | Withdrawal or withholding of medical treatment or life support. |
Voluntary And Involuntary Euthanasia
Both active and passive euthanasia can be voluntary or involuntary.
- Voluntary Euthanasia: When the consent of the patient is taken.
- Involuntary Euthanasia: When the patient is not in a condition to give consent and the decision is taken by another person on their behalf.
Constitutional Framework and the Right to Die
The Constitution of India explicitly provides for the right to life for all its subjects. It is a fundamental right guaranteed under Article 21, and there are no doubts when it comes to the right to life itself. However, questions have persistently arisen whenever the right to die is discussed — it has always been a matter of contention for lawmakers and courts alike. The courts, in various judgements, have interpreted this right differently and based their opinions accordingly.
The Bombay High Court, in State of Maharashtra v. Maruti Sripati Dubal (1987 Cr LJ 743), held that the right to life under Article 21 also includes the right to die. It was contended that Section 309 of the Indian Penal Code, which criminalised attempting to commit suicide, was unconstitutional as it violated Article 21. The court clearly stated in this judgement that the right to die is just uncommon, not unnatural.
Subsequently, in P. Rathinam v. Union of India (1994) 3 SCC 394, the Supreme Court of India also accepted that the right to live under Article 21 includes the right not to live. It is pertinent to note that this case dealt primarily with suicide and Section 309 IPC, not with euthanasia directly. However, its observations on personal autonomy laid the groundwork for future euthanasia jurisprudence.
This position was reversed in Gian Kaur v. State of Punjab (AIR 1996 SC 1257), in which the Supreme Court overruled the P. Rathinam judgement and held that the Right to Life under Article 21 does not include the Right to Die.
At the same time, the Court made a crucial distinction: while a person has no right to die, the right to life includes the right to live with human dignity — and therefore, the right to die with dignity.
The Court held that the right to die with dignity must be distinguished from the right to die. The right to die is an unnatural death that cuts short a person’s natural lifespan; the right to die with dignity, on the other hand, is a humane provision for a person in a condition such as a Permanent Vegetative State (PVS) to be relieved of prolonged suffering. Hence, both rights are altogether different and must not be misconstrued.
Key Constitutional Cases on Right to Die
| Case Name | Year | Key Observation |
|---|---|---|
| State of Maharashtra v. Maruti Sripati Dubal | 1987 | Recognised Right to Die under Article 21. |
| P. Rathinam v. Union of India | 1994 | Held that the right to live includes the right not to live. |
| Gian Kaur v. State of Punjab | 1996 | Held that the right to die is not part of Article 21 but recognised the right to die with dignity. |
The Aruna Shanbaug Case
In Aruna Ramchandra Shanbaug v. Union of India (2011) 4 SCC 454, the Supreme Court laid down guidelines for passive euthanasia in India. These guidelines provided for the withdrawal of life support systems which could ultimately lead to a patient’s death. This verdict made passive euthanasia legally permissible in India under certain conditions, to be decided by the High Court on a case-by-case basis.
In the specific facts of the case, however, the Court declined to permit euthanasia for Aruna Shanbaug. The Court declared that Aruna was not brain dead, relying on the doctor’s report and the definition of brain death under the Transplantation of Human Organs Act, 1994.
She was able to breathe on her own, had feelings, and showed some symptoms. Though she was in a PVS, her condition was stable, and the grounds presented were not sufficient for terminating her life.
The Court further held that the next of kin of the patient, for the purpose of this case, was the staff of KEM Hospital — not Pinki Virani, who had filed the petition. The right to make decisions on Aruna’s behalf was therefore vested in the hospital staff.
The court also recommended the repeal of Section 309 IPC.
Important Observations in the Aruna Shanbaug Case
- Passive euthanasia was recognised under limited circumstances.
- Withdrawal of life support required judicial scrutiny.
- High courts were empowered to decide such cases.
- Medical opinion became essential before permitting euthanasia.
- The Court stressed the importance of acting in the patient’s best interests.
Common Cause v. Union of India (2018) — Legalising Passive Euthanasia
In Common Cause (A Regd. Society) v. Union of India (2018) 5 SCC 1, the Supreme Court took a landmark step by proclaiming the right to die with dignity to be a fundamental right, thereby legalising passive euthanasia across the country.
The court also introduced the concept of a living will — a document that allows a person to make decisions in advance regarding what course of treatment they wish to receive in case they become seriously ill and unable to make decisions in the future.
Essential Conditions for Passive Euthanasia
The Court held that passive euthanasia requires the satisfaction of three essential conditions:
- Life-prolonging treatment is being discontinued or withheld.
- The primary goal of discontinuation or withholding of treatment is to avoid prolonging inevitable death.
- The justification for hastening death is that the action is taken in the patient’s best interests, given that death is imminent and certain.
Guidelines Issued by the Supreme Court
The guidelines laid down by the Court included the following:
- Parents, spouses, or other close relatives are responsible for the decision to discontinue life support. In their absence, any person or group acting as a friend, or the patient’s doctor, may make the decision.
- The decision must be in the patient’s best interests and must not be arbitrary.
- Although the decision to withdraw life support can be made by relatives or doctors, the High Court must still approve it.
- Upon receiving such an application, the chief justice must convene a bench of at least two judges to decide the matter.
- A panel of three reputed doctors nominated by the bench will report on the patient’s condition.
- The state and close family members must be notified before a verdict is given.
Living Will and Advance Directive
- A person of sound mental health alone can execute an advance directive.
- It must be voluntary and non-coercive.
- Two attesting witnesses must be present when the executor signs the document.
- The Jurisdictional Judicial Magistrate of First Class (JMFC) must countersign it.
- The treating physician must verify the authenticity of the advance directive from the JMFC if the executor becomes terminally ill with no hope for recovery.
Medical Board Procedure
Medical boards shall be formed by the hospital to decide whether to withdraw medical treatment.
- If the board certifies that the instructions should be followed, the hospital must inform the collector.
- An additional medical board formed by the collector shall examine the patient.
- If the board agrees, it shall notify the JMFC.
- The JMFC visits the patient and may permit implementation.
Conclusion
The evolution of the Right to Die jurisprudence in India reflects the judiciary’s attempt to balance the sanctity of life with human dignity and personal autonomy. While the Supreme Court has consistently rejected the notion of an unrestricted right to die, it has gradually recognised the constitutional importance of dying with dignity in exceptional medical circumstances.
From Maruti Sripati Dubal to Common Cause v. Union of India, Indian constitutional law has evolved significantly in recognising passive euthanasia and advance medical directives. The recognition of living wills and passive euthanasia marks a major development in Indian legal and medical ethics, ensuring that terminally ill patients are treated with dignity, compassion, and respect for their autonomy.
Recent Developments — Simplifying the Process
In recognition of the cumbersome nature of the 2018 guidelines, a five-judge bench of the Supreme Court headed by Justice K.M. Joseph subsequently revised the procedure to make it more accessible. :contentReference[oaicite:0]{index=0}
Key Changes Introduced
| Aspect | Earlier Position | Revised Position |
|---|---|---|
| Primary Medical Board | Four doctors with twenty years of experience | Three doctors — the treating physician and two doctors with at least five years of experience in the concerned specialty |
| Custody of Living Will | District Court | National Health Digital Record accessible across India |
| Timeline for Decision | No definite timeline | Decision preferably within 48 hours |
- The primary medical board was reduced from four doctors with twenty years of experience to a team of three doctors — the treating physician and two doctors with at least five years of experience in the concerned speciality.
- The living will is no longer to be kept in the custody of the district court. Instead, it will form part of the national health digital record, accessible by hospitals and doctors from any part of the country.
- The primary board must preferably decide within 48 hours on the withdrawal of further treatment — a definite timeline absent in the 2018 judgement.
Harish Rana v. Union of India (2026) — Passive Euthanasia Becomes Reality
The most significant and recent development in this area of law is Harish Rana v. Union of India (2026 INSC 222), decided on 11 March 2026 by a bench of Justice J.B. Pardiwala and Justice K.V. Viswanathan. :contentReference[oaicite:1]{index=1}
Harish Rana was a 19-year-old student in Chandigarh when he fell from the fourth floor of a building in August 2013, sustaining catastrophic brain injuries that left him in a permanent vegetative state with 100% quadriplegia for over thirteen years.
Supreme Court Ruling
courtThe Supreme Court permitted the withdrawal of Clinically Assisted Nutrition and Hydration (CANH) being administered through a PEG tube. The Court unequivocally held that CANH administered through a feeding tube constitutes medical treatment — not merely basic care — and can therefore be lawfully withdrawn when its continuation no longer serves the patient’s best interests.
The mandatory thirty-day reconsideration period prescribed by earlier guidelines was waived in view of the patient’s prolonged suffering.
Why This Judgment Is Historic
- First court-approved practical implementation of passive euthanasia in India.
- Recognised the right to die with dignity as an enforceable constitutional reality.
- Clarified that CANH through a PEG tube constitutes medical treatment.
- Called upon Parliament to enact comprehensive standalone legislation on euthanasia and end-of-life care.
This judgement is historically significant as the first court-approved practical implementation of passive euthanasia in India, converting the right to die with dignity from a theoretical constitutional principle into an enforceable reality.
The Court also called upon Parliament to enact comprehensive standalone legislation on euthanasia and end-of-life care — a legislative gap that continues to persist.
Impact of Bharatiya Nyaya Sanhita, 2023
It is also pertinent to note that Section 309 IPC, which criminalised attempting to commit suicide, has now been omitted under the Bharatiya Nyaya Sanhita, 2023.
This legislative development reflects a significant shift in the state’s approach towards personal autonomy and bodily self-determination — a shift that is directly relevant to the broader euthanasia debate.
My Opinion
Life is the most precious gift bestowed upon humankind. One has the obligation to protect and preserve it with kindness and dignity.
On the question of euthanasia, morality and religion often stand in opposition. Passive euthanasia can, in many cases, be morally unacceptable to certain people. Many argue that allowing individuals to decide how their life ends weakens the sanctity of life.
- Several religious groups and faith organisations remain opposed to euthanasia.
- Theistic traditions have largely resisted unnatural endings to life.
- Medical practitioners traditionally take an oath to preserve life, not end it.
Though life and death are companions of each other, theistic traditions have largely resisted unnatural endings to life, and caretakers and medical practitioners take an oath to preserve life, not to end it.
And yet, I find myself unable to speak of ethics in the abstract when I try to imagine the pain of a person who has been suffering for years — unable to move, unable to think, unable to communicate.
When we fall ill with even a minor ailment, we want nothing but rest. We cannot properly function.
We can only begin to imagine, then, the suffering of those who have lived in a vegetative state for over a decade, dependent entirely on machines and tubes for survival.
Who are we, as a majority, to speak of sanctity and ethics in the face of that suffering?
Personal View on Passive Euthanasia
I believe that passive euthanasia must remain a deeply personal decision.
- Every individual is different.
- Terminally ill patients should have autonomy over their own bodies.
- The right to live with dignity includes the right to die with dignity.
- Compassion should guide end-of-life decisions.
Every individual is different, and people suffering from incurable and terminal conditions must have the right to decide what happens to their own bodies.
The right to live with dignity and the right to die with dignity are two sides of the same coin.
Respecting a person’s decision to choose death over prolonged, medically futile suffering is not cruelty — it is the highest form of compassion.
This is what the Greeks called euthanasia: a good death.
Conclusion
The journey of passive euthanasia in Indian law—from the Bombay High Court’s 1987 observation in Maruti Sripati Dubal to the Supreme Court’s historic 2026 ruling in Harish Rana—reflects India’s slow but steady march towards recognising that dignity in death is as fundamental as dignity in life.
The law has evolved from treating the right to die as inconceivable to acknowledging it as a constitutional right under Article 21.
Continuing Challenges
- The procedural framework remains complex for ordinary citizens.
- Living wills are poorly understood and rarely executed.
- India still lacks comprehensive euthanasia legislation.
- The field continues to rely heavily on judicial guidelines.
Yet, significant challenges remain. The procedural framework, even after simplification, is complex and inaccessible to most ordinary citizens.
Living wills remain poorly understood and rarely executed.
Parliament has not yet enacted a comprehensive euthanasia statute, leaving the field entirely to judicial legislation.
The call made by the Supreme Court in Harish Rana for legislative action must be heeded.
Until that day, the Common Cause guidelines — as refined by subsequent benches — remain the law of the land.
And Harish Rana’s case will stand as a reminder that behind every legal principle is a human story: a young man of nineteen, a fall, thirteen years of silence, and a family’s long wait for the law to catch up with compassion.
Bibliography
Cases:
- State of Maharashtra v. Maruti Sripati Dubal (1987 Cr LJ 743)
- P. Rathinam v. Union of India (1994) 3 SCC 394
- Gian Kaur v. State of Punjab (AIR 1996 SC 1257)
- Aruna Ramchandra Shanbaug v. Union of India (2011) 4 SCC 454
- Common Cause (A Regd. Society) v. Union of India (2018) 5 SCC 1
- Harish Rana v. Union of India (2026 INSC 222)
Legislation:
- Constitution of India, 1950 — Article 21
- Indian Penal Code, 1860 — Section 309 (now omitted)
- Bharatiya Nyaya Sanhita, 2023
- Transplantation of Human Organs Act, 1994
Online Sources:
- Supreme Court of India — sci.gov.in
- SCC Online — scconline.com
- Live Law — livelaw.in
- Vidhi Centre for Legal Policy — vidhilegalpolicy.in
