A good and meaningful life is the goal of every person and they constantly
thrive to achieve it. Along with leading a good life, they also hope to die with
dignity and not while waiting for some illness to torture and kill them slowly.
People hope for their death to be easy and peaceful. No one desires for a life
where staying alive is worse than death itself. When a person takes his own
life, then it is called suicide
, whereas when the life of a person is
taken by some other person with the consent of that person, it is called
The term Euthanasia is a combination of two Greek words, eu
means good and thanatos
which means death, referred to as 'Euthanasia'
in English. The term 'Euthanasia' implies intentional killing of a person, by
another person, at the explicit request of that person who wishes to die and for
solely for the benefit of that person which is to relieve that person from pain
and suffering arising out of an illness or some injury.
Thus, Euthanasia is
related with those persons who because of some terminal illness or who have
become incapacitated and do not desire to live the rest of their life in
suffering and pain. A terminally ill or a handicapped person should have a right
to decide to live or to die. The concept of Euthanasia is very controversial and
is related with the morals, values and ethics of a society.
The concept of euthanasia has been narrowed to the killing of patients by
doctors at the request of the patient in order to free him from excruciating
pain or from terminal illness globally. Thus the basic intention behind
euthanasia is to ensure a less painful death to a person who is not showing any
sign of improvement and his condition will eventually lead to his death after a
long period of pain and suffering.
Euthanasia can be of following types:
Active or Positive: Active euthanasia involves painlessly putting individuals to death for
merciful reasons. When a doctor administer lethal dose of medication to a
patient, it is called active euthanasia.
Passive or negative: Euthanasia is passive when death is caused because a treatment that is
sustaining the life of the patient is held off and the patient dies as a
result thereof. For example, withdrawing life supporting devices from a
serious patient, removing which, the patient dies. In "passive euthanasia"
the doctors are not actively killing anyone; they are simply not saving him.
Voluntary: it is voluntary when the euthanasia is practiced with the express desire and
consent of the patient. Voluntary euthanasia is primarily concerned with the
right of choice of the terminally ill patient who decides to end his or her
life, choice which serves his/her best interest and also that of everyone
Involuntary: when the patient is killed without an express wish to this effect, it is a
form of involuntary euthanasia. It refers to cases wherein a competent
patient's life is brought to an end against the wishes of that patient who
oppose euthanasia; and would clearly amount to murder.
Non-Voluntary: it refers to ending the life of a person who is not mentally competent to
make an informed request to die, such as a comatose patient. In
Non-Voluntary euthanasia the patient has left no such living will or given
any advance directives, as he may not have had an opportunity to do so, or
may not have anticipated any such accident or eventuality. In cases of
non-voluntary euthanasia, it is often the family members, who make the
According to the British House of Lords Select Committee on Medical Ethics, it
is defined as:
a deliberate intervention undertaken with the express intention of ending a
life, to relieve intractable suffering.
Euthanasia has been
legalized in Switzerland (1942), Australia (1996), the Netherlands (2001), Belgium (2002), and Luxembourg (2009). The legislation allowing physician-assisted suicide (PAS) exists in Switzerland as well as outside of
Europe, in three federal states in the United States:
Oregon, Vermont, and
In India, there is no special provision for Euthanasia, neither in legislation
nor in law. But there have been some medical cases which necessitated the need
of Euthanasia been applicable in India. Like for example, the Supreme Court in
the Aruna Shanbaug case allowed passive Euthanasia in India and also laid
down the guidelines regarding processing of pleas of passive Euthanasia.
The Concept Of Euthanasia Vis-�-Vis Constitution Of India
Chapter III of the Constitution of India guarantees Fundamental rights. Article
21 provides one of these rights and it reads as follows:
Article 21 Protection of Life and Personal Liberty: No person shall be deprived
of his life or personal liberty except according to procedure established by
While understanding the meaning of this Article it is observed that the
phraseology of this article is such that it starts with a negative word which is
, however, this word No
has been used in this article in relation with the
Article 21 is construed to prevent the encroachment upon the
personal liberty of a person and depravation of life of a person except
according the procedure established by law. Construing the meaning of Article
21, it is clear that the right guarantees protection against the state only and
if any act is done by any private individual violating this article, such
violation will not meet the parameters of Article 21.
However, in case of such a
violation, the aggrieved person can sought remedy under Article 226 of the
Constitution of India or under general law of the land. But in case the
violation done by an act of a private individual is supported by the State, then
that act will clearly attract the violation done under Article 21 of the Indian
Article 21 is a basic as well as a fundamental right.
It recognizes the sanctity
of human life. The question as to whether 'Right to life' conferred under
Article 21 of the Constitution of India includes 'Right to die or Right not to
live' as well has been a topic of debate in several cases. Death in simple words
means termination of life or the end of life and it can occur either naturally
on unnaturally. A man can die unnaturally either by commit an act on himself
that will cause his death which is called suicide or either by some other
individual with immoral and bad intention causing his death which is termed as
Euthanasia is concept which can be said is similar to suicide, yet it is
completely different from it. It is a completely different act from suicide.
Therefore, it is necessary to understand the difference between 'euthanasia' and
suicide'. According to Oxford Dictionary, suicide means an acting of killing
For a better understanding, suicide can be termed as an
act in which a person intentionally takes his own life by his own means. The
reasons for suicide can be losing job, financial crisis, depression, stress,
failing in examinations, troubles in love life, etc. The basic difference is
that in suicide it is voluntary taking of one's own life and in euthanasia, some
other person ends the life of the person with the consent of that person.
other person may either actively or passively involved in the killing of the
person who gave the consent to get killed by way of either providing means to
end the life for example, a doctor on the consent of his patient deliberately
provides a lethal dose of a medicine and the patient himself consumes that
medicine and ends his life or by way of abetting the person to end his life. In
this context, it has also become necessary to understand the difference between
Assisted suicide means an act by which a
person intentionally aids another person and helps him to commit suicide by
providing him with the means to commit suicide like the example mentioned above
when a doctor giving lethal dose of a patient on his consent so that he could
commit suicide is physician assisted suicide
Other cases of assisted suicide
can be providing means to take own life like arranging and giving a gun to a
person and simply helping him so that he could commit suicide by shooting
himself. On the other euthanasia can be active or passive. If is by a doctor
administering a lethal dose or injection to a patient on his consent to end his
life it is called passive euthanasia and if it is by way of withdrawal of the
services or medical support system which was keeping the patient alive, then it
is called passive euthanasia.
In the case of Maruti Shripati Dubal v. State of Maharastra
, the Bombay High
Court distinguished between suicide and euthanasia by stating that suicide is an
in act of self-killing without assistance from any other person but in
euthanasia, intervention of some other person is required to end the life. Mercy
killing or euthanasia cannot be said similar to suicide. The court in this case
further held that:
Euthanasia or mercy
-killing is nothing but homicide, whatever the circumstances
in which it is effected. Unless it is specifically excepted it cannot but be an
offence. Our Penal Code further punishes not only abetment of homicide but also
abetment of suicide.
The law related to assisted suicide is clearly stated in India and suicide is
punishable under the India Penal Code, 1860 under sections 305, 306 and 309
which are of abetment of suicide of child or insane person, Abetment of suicide
and Attempt to commit suicide respectively. The constitutional validity of
section 309 of the Indian Penal Code, 1860 has been challenged in the Supreme
Court of India.
In Gian Kaur v. State of Punjab
, the Supreme Court held
Section 309 of Indian Penal Code to be constitutionally valid but as per current
scenario, even though this section is constitutional yet it is the time for the
parliament of India to delete it as it has become out dated. For example if A
person attempts to commit suicide because of depression, then it would not be
correct him to punish him, rather he is in acute need of help to come of that
The Delhi High Court in the case of State v. Sanjay Kumar Bhatia
that section 309 of I.P.C. has no justification to continue remain on the
statute book. The Bombay High Court in Maruti Shripati Dubal v. State of
Maharashtra held section 309 to be violative of Article 14 and Article 21 of
the Indian Constitution. In this case, section 309 was held to be of
discriminatory nature and also to be arbitrary and it violated the right to
equality guaranteed under Article 14 of the Indian Constitution.
The court also in this case interpreted Article 21 of the Indian Constitution
and help that the the right to live
under this article also includes right to die
held section 309 of the Indian Penal Code to be violative of Article 21 as well.
The Supreme Court for the first time decided on whether right to life under
Article 21 also includes right to die
in the case of P. Rathinam v. Union of
The court in this case held that right to life would include in it the
right to die as well and thus, held Section 309 of the Indian Penal code to be
unconstitutional. However, in the case of Gian Kaur v. State of Punjab
constitutional validity of Section 309 of the Indian Penal Code was challenged.
The Supreme Court upheld the constitutional validity of Section 309 and set
aside the judgment in P. Rathinam Case and held that right to life guaranteed
under Article 21 of the Constitution does not include right to die.
Later, in the case of Aruna Ramchandra Shanbaug v. Union of India
Supreme Court of India permitted passive euthanasia in India. In 2018, Common
cause (a regd. society) vs. Union of India & anr, the Supreme Court held
'right to die with dignity' a fundamental right and recognised the 'living will'
of terminally ill patients.
Analysis Of The Case - Aruna Ramchandra Shanbaug V. Union Of India
The landmark judgment of the Supreme Court in the case of Aruna Ramchandra
Shanbaug v. Union of India has made passive euthanasia legal in India after
getting approval from the concerned High Court for withdrawal of life support
and the High Courts can approve the withdrawal of life support and permit
passive euthanasia under the power of the High Courts under Article 226 of the
Constitution of India.
Aruna was a nurse in the King Edward Memorial Hospital (KEM), Parel, Mumbai. She
was attacked by a sweeper of the hospital on the evening of 27th November, 1973.
That sweeper pulled her by wrapping a dog chain around her neck. The sweeper in
order to rape her twisted that dog chain around her neck to stop her from
moving. When he found that Aruna was menstruating, he sodomized her. The chain
cut off the oxygen supply to her brain rendering her completely unconscious and
causing brain damage. The incident sent her into coma from which she never came
out. Even the doctors had said that there was no sign for her condition to ever
On 24th January 2011, Ms. Pinky Virani, who claimed to be a friend of Aruna
Shaunbaug filed a petition to the Honourable Supreme Court of India. In the
petition, Ms. Pinki Virani described the condition of Aruna Shaunbaug. She is
featherweight, and her brittle bones could break if her hand or leg are
awkwardly caught, even accidentally, under her lighter body. She has stopped
menstruating and her skin is now like papier mache' stretched over a skeleton.
She is prone to bed sores.
Her wrists are twisted inwards. Her teeth had decayed
causing her immense pain. She can only be given mashed food, on which she
survives. It is alleged that Aruna Ramachandra Shanbaug is in a persistent
negetative state (P.V.S) and virtually a dead person and has no state of
awareness, and her brain is virtually dead. She can neither see, nor hear
anything nor can she express herself or communicate, in any manner
whatsoever. Ms. Pinki Virani prayed to the Supreme Court of India to direct
the KEM hospital to stop feeding her and let her die peacefully.
The Supreme court of India directed to set up a committee to know the details
about the condition of Aruna Shaunbaug as there were certain variations between
the allegations made by Ms. Pinki Virani and the counter affidavit submitted by
Dr. Pazare, who was the head of KEM hospital where Aruna Shaunbaug was admitted.
A team of three doctors was appointed for examining her and the gave a report to
the Supreme Count regarding the mental and physical condition of Aruna
The opinion of the committee in their report was:
� There is irreversible damage on the brain of Aruna which is the effect
� Her condition meets most of the criteria required for a person to be
in a permanent vegetative state (PVS)
� Despite having intact auditory, visual, somatic and motor primary
neural pathways, there was no conclusive proof of stimuli.
The Supreme Court on 7th March, 2011 gave the landmark judgment in this case
legalizing passive euthanasia in India. The Court in this connection has laid
down the guidelines which will continue to be the law until Parliament makes a
law on this point.
- A bona fine decision has to be taken to discontinue life support either
by the parents or the spouse or other close relatives, or in the absence of
any of them, such a decision can be taken even by a person or a body of
persons acting as a next friend. It can also be taken by the doctors
attending the patient.
- A decision is taken by the near relatives or doctors or next friend to
withdraw life support, such a decision requires approval from the High Court
concerned as laid down in Airedale's case.
However, it rejected the plea of Ms. Pinki Virani and Aruna Shaunbaug died on
18th May 2015 because of pneumonia after being in persistent vegetative state
for a period of 42 years.
Analysis Of The Case - Common Cause (A Regd. Society) Vs. Union Of India &
Though passive euthanasia was legalized by the Supreme Court in the case
Aruna Ramchandra Shanbaug v. Union of India
 yet the court didn't give
guidelines regarding the procedure a terminally ill patient should follow in
order to execute his right to die with dignity. However, the Supreme Court again
got the opportunity to address the issue of right to die with dignity in another
petition filed before it.
In March, 2011, the Supreme Court of India again gave a landmark judgment in the
favour of passive euthanasia in the case Common Cause (A Regd. Society) vs.
Union of India & Anr
 and recognised the living will of terminally ill
patients permitting withdrawal of medical support held right to die with
dignity a fundamental right.
It was not the first the time that the Supreme Court of India came across with
the issue of euthanasia before itself. Earlier also in the case of Aruna
Ramchandra Shanbaug v. Union of India
 and the honourable court decided
in favour of passive euthanasia and legalized it in India giving certain broad
However, the decision in this case by the division bench of Supreme court of
India was not entirely satisfactory for the three judge bench to decide upon the
current case and therefore the case was referred to the constitutional bench
considering the important question of law involved which needs to be reflected
in the light of social, legal, medical and constitutional perspectives, it
becomes extremely important to have a clear enunciation of law" and which in the
words of the reference order was for the benefit of humanity as a whole.
The landmark judgment in this case was delivered by the constitutional bench of
Supreme Court which comprised of 5 Judges and the Chief Justice delivered the
landmark decision along with A M Khanwilkar, J. The other 3 judges of the
constitutional bench shared the opinion with the Chief Justice in his findings
but they passed their separate judgments on the issue.
In the year 2005, common cause, a registered society filed a writ petition under
in the Supreme Court of India under Article 32 of the Constitution of India and
in their petition they prayed the Supreme Court to declare right to die with
dignity a fundamental right and also prayed the court the issue directions for
the central government to execution of the living will made by the terminally
ill patients for the withdrawal of their medical support.
The common cause
society also as an alternative relief prayed the court for the appointment of an
expert committee consisting of doctors, lawyers and social scientists for the
purpose of determining the various aspects related to the execution of the
living will. The society argued that the terminally ill individuals who are
suffering from chronic diseases and are admitted in hospitals should be
subjected to cruel treatments that will only prolong their sufferings.
them uncontrollable pain and sufferings with no sign of improvement will amount
to denying them their right to a dignified death. Hence, such terminally ill
patients should be allowed to make a decision about their lives through a living
will which should be executed in such a time secure them their right to a
On 9th March 2018, the Five Judge constitutional bench of the Supreme Court
comprising of Chief Justice Dipak Misra and Justices A K Sikri, A. M. Khanvilkar,
D Y Chandrachud and Ashok Bhushan held right to die with dignity
fundamental right and held that an individual's right to execute advance medical
directives is an assertion of the right to bodily integrity and
self-determination and does not depend on any recognition or legislation by a
State. As it was a matter of constitutional interpretation, the court also laid
down several guidelines and safeguards for its proper implementation and to
avoid the abuse of the process of euthanasia.
The court laid that only an adult with a sound mind and capable of communication
and who is completely aware of executing a living will may voluntarily execute
it. The will must clearly reflect the consent of the person wanting to end his
life by withdrawal of medical support and also it should contain the
instructions as to when the medical support be withdrawn and no further medical
service be provided. The document should also contain the name of the guardian
of the patient who would give his consent allowing or refusing withdrawal of
medical support. There should also be a provision in the living will to allow
the revocation of the will by the executor
Mercy killing i.e., Euthanasia though seems to be morally justified and is
practiced in many countries on the ground that the sufferings and pain of a
patient because of some illness is given priority over the life of the patient
but no law can provide a guarantee over the abuse concerning the lives of
critically ill patients who do not desire to end their lives. Euthanasia does
not mean to kill a person but it means allowing the critically ill patient to
end his life on his own wish to get free from the pain and sufferings.
Suicide has become illegal after the judgment in the Gian Kaur's case
Passive Euthanasia was legalized after the judgment of the Supreme Court in the
case of Aruna Ramchandra Shanbaug v. Union of India
.It paved the way
for patients in coma with no sign of recovery to exercise their right to die
with dignity by permitting passive euthanasia. After the landmark decision in
the Common Cause (A Regd. Society) vs. Union of India & Anr
, the Supreme
Court has held right to with dignity as a fundamental right and right to life
under Article 21 of the Constitution of India is akin to right to die with
dignity. In this case, the court created a balance between two aspects of the
right to life under Article 21. One creates a duty on the state to preserve
human life and other is ensuring individual autonomy related to decisions
regarding their own life and body.
However, right to die with dignity being of similar character as that of right
to live, the Supreme Court highlighted that the Euthanasia can be used by the
unscrupulous relatives of the patients and can be abused and the right to die
cannot be made absolute and is subject to regulatory mechanisms. It is the duty
of the courts to protect the abuse of law relating to Euthanasia. To prevent the
abuse of Euthanasia the legislature is required to make a special law dealing
with all the aspects of euthanasia. Nevertheless, it is a step in the right
direction and one must embrace it with the hope that the Courts and law makers
would one day realise that the word "Euthanasia" when translated from Greek
means "good death".
- Aruna Shanbaug v. Union of India (2011) 4 SCC 454
- Oxford Advanced Learner's Dictionary of Current English. (2000). Sixth
Edition. Oxford University Press.
- 1987 Cri.L.J 743 (Bomb.
- 1996 (2) SCC 648 : AIR 1996 SC 946
- 1985 Cri.L.J 931 (Del.).
- 1987 Cri.L.J 743 (Bom.)
- AIR 1994 SC 1844
- See Supra note 5.
- (2011) 4 SCC 454.
- (2018) 5 SCC.
- See Supra note 10
- Common Cause (A Regd. Society) vs Union Of India (2018) 5 SCC 1
- Harish, Dasari & Singh, Amandeep & Kumar, Ajay & Sane, Mandar. (2018).
The Current Status of Euthanasia in India. Journal of Indian Academy of
Forensic Medicine. 40. 134-139. 10.5958/0974-0848.2018.00023.4.
- Airedale NHS Trust v Bland  1 All ER 821 (HL.)
- See Supra note 11
- See Supra note 10
- See Supra note 11
- See Supra note 10
- Gian Kaur v State of Punjab 1996 (2) SCC 648 : AIR 1996 SC 946
- See Supra note 10
Award Winning Article is Written By:�Arjun Kohli
Authentication No: SP024675320234-2-920
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