Understanding the Right to Die Through Recent Euthanasia Cases in India

Euthanasia… is simply to be able to die with dignity at a moment when life is devoid of it.” – Marya Mannes

The concept surrounding the right to die has gained significant popularity all around the world, as well as in India. We can see that through recent euthanasia cases in India, which is a huge step towards individual rights. This right allows individuals, especially those who are suffering from long-term terminal illness and have no hope for recovery, they can refuse life-sustaining treatment in India. This concept wasn’t easy to bring up in India, as we have a diverse society with people following their own moral or religious beliefs. This concept evolved through key rulings addressing moral, legal, and ethical disruptions surrounding euthanasia. 

As we know about the Right to Die, we also have the Right to Life, which is a fundamental right under Article 21 of the Constitution, which states, “No person shall be deprived of his life or personal liberty except according to procedure established by law.” This fundamental right focuses on the preservation of the life of an individual, and it has been recognized by the judiciary. However, the question arises whether this right continues to the right to end one’s life. 

There are conflicts surrounding the concept of voluntary death through euthanasia as it collides with societal, cultural, religious, and legal norms. India has recognized the unlawful act of suicide and has penalized it under Section 309 of the India Penal Code (IPC). But as medical systems have advanced legal debates have pushed the law to recognize euthanasia, or the right to die, to be allowed under special circumstances.

Recent Euthanasia Cases in India: What is Euthanasia?

Euthanasia, also known as “mercy killing,” is the practice of voluntarily ending the life of individuals to relieve them from suffering, usually when the individual is suffering from terminal illness and has no hope of getting cured. Essentially, it means hastening the death of a patient to prevent further suffering. 

Passive euthanasia is generally accepted worldwide. Active euthanasia is illegal to perform. Passive euthanasia means withholding or withdrawing treatment that is necessary to sustain an individual’s life. Active euthanasia means when a physician deliberately administers lethal drugs to end a terminally ill or incurable patient’s life. 

Active euthanasia remains illegal in India, as it means that a physician will have to end a patient’s life by direct intervention. Passive euthanasia is legalized, as we see in recent euthanasia cases in India, and has been confirmed by the judgement in Common Cause v. Union of India(2018). The court agreed to withdraw life support for terminally ill patients. The concept of living will was introduced as well, which allows individuals to give instructions about their end-of-life care. This grants that people who are suffering from terminal illnesses or are in a vegetative state can choose a dignified way of death according to their wishes.

Recent Euthanasia Cases in India: Common Cause v. Union of India 2018

This petition was brought in by Common Cause, a registered society that believed that the right to die with dignity was a part of the right to live with dignity under Article 21 of the Constitution and wanted to make it a legal right. They wanted the State to opt for appropriate measures and procedures to allow a person who is terminally ill or has an incurable disease to execute living wills or Advanced Medical Directives.

“Continuing treatment against the wishes of a patient is not only a violation of the principle of informed consent but also of bodily privacy and bodily integrity that have been recognized as a facet of privacy by this Court.”

The common arguments in this case were that keeping an individual or a patient in a vegetative state and in prolonged pain and suffering directly affects a person’s autonomy and dignity. The Petitioner claimed that the right to die with dignity was linked to the right to live with dignity. It pleaded that if an individual does not want or refuses unwanted medical treatment, it should be considered a common law, and the person should not be forced to take medical treatment without their consent.

The Respondent State, in the counter-affidavit, submitted that the State had considered regulating euthanasia, but the Ministry of Health and Family Welfare found it unfavorable. The Respondent further argued that the right to live with dignity under Article 21 guaranteed food, health, and shelter, which did not include the right to die with dignity.

An intervention application filed by “Society for the Right to Die with Dignity” was allowed. The affidavit sided with the concept of euthanasia and the importance of a peaceful exit from life and the freedom of choice not to continue living in an incurable state. It also sided with the concept of living wills and gave a “living will” sample. The court accepted this plea and safeguarded a person’s interest in choosing whether or not to live or die with dignity in terms of special circumstances.

Recent Euthanasia Cases in India: SC Rejects Parents’ Plea for Euthanasia for 30-year-old Son

Parents of a 30-year-old man requested the Supreme Court to constitute a medical board to examine the withdrawal of the Ryles tube through which their son has been fed and to free their son from suffering more through passive euthanasia. Ryle’s tube, which is inserted through his nose into the stomach. It is used to deliver food and medicine to the stomach.

Supreme Court, however, said, “Removal of the Ryles tube is not part of passive euthanasia. If the Ryles tube is removed, the patient will starve and die”. It also asked the government to find an institution that can take care of this person. 

The parents are aged 62 and 55, who fought to save their son from a head injury which happened from falling through a building’s fourth floor, which caused 100% disability. The family is living on a meager pension that the father gets, and the soaring hospital bills have given them mental stress, as well as they had to sell off their house to pay those bills. 

The bench said the Delhi High Court dismissed their permission for Passive euthanasia as it was permitted by the Supreme Court in 2018. The bench said, “Removal of the Ryles tube is not part of passive euthanasia. If the Ryles tube is removed, the patient will starve and die. Passive euthanasia is very different. Ryles tube is not a life support system.” The bench requested the government to find a permanent solution to this, as the parents have suffered long enough and have exhausted all their life savings. 

Recent Euthanasia Cases in India: Aruna Ramchandra Shanbaug vs Union of India

Aruna Ramchandra Shanbaug was a nurse employed in King Edward Memorial Hospital, located in Mumbai. One of the sweepers of the hospital attacked her on 27th November 1973. He choked and strangled her with a dog chain to restrain any movement from her end in an attempt to rape her. The strangulation via the dog chain lessened the supply of oxygen to her brain, causing severe damage to the cortex of the brain. She sustained a brain stem contusion, along with cervical cord injury.

A petition for the case was filed under Article 32 of the Indian Constitution by a friend of Ms. Aruna in the year 2009, after 36 years of the incident. For so many years, Ms. Shanbaug has been in a “Permanent Vegetative State”.

The dean of the Hospital said that Ms. Shanbaug was being fed and taken care of by the nurse and hospital staff for 36 years. The staff had the utmost responsibility and willingness to take care of her. Therefore, they oppose the idea of Ms. Shanbaug being euthanised. Now that the patient has crossed as many as 60 years of age, she might naturally die. Euthanising Ms. Shanbaug would be immoral and inhuman since she has a right to live.

A petition was filed by Ms. Shanbaug’s friend under Article 32 of the Indian Constitution. The counsel for the petitioner claimed that the right to life guaranteed under Article 21 includes the right to life with utmost dignity. Therefore, it must also include the right to die with dignity. Any person or an individual suffering from any terminal illness or is in a permanent vegetative state must be allowed under the ambit of the “right to die” to end the unending suffering and pain. She has no awareness of her surroundings, has lost the ability to chew her food, can’t express anything on her own, and has been bedridden for the past 36 years with no scope of improvement.

The court distinguished active and passive euthanasia. Active euthanasia can be seen as the positive and deliberate termination of one’s life by injecting and administering lethal substances.  In India, active euthanasia is a direct threat to sections 302 and 304 of the IPC. Even physician-assisted suicide is an offense under section 309 of the IPC. Moreover, Passive euthanasia is the withdrawal of life-supporting systems or medical treatment. 

The main distinction between active and passive euthanasia is that in “active”, something direct is done deliberately to end someone’s life, whereas in “passive”, something direct is not done, like injecting a lethal injection is not done. A proper procedure is followed and laid out by the apex court for granting passive euthanasia in the “rarest of rare circumstances,” while rejecting the plea made by the petitioner. 

The High Court, under article 226, would be entitled to make decisions regarding the withdrawal of the life support system. A bench must be constituted by the Chief Justice of the High Court when an application is received, before which a committee of three reputed doctors must be referred. There should be a thorough examination of the patient, and the state and family members are provided with a notice issued by the bench. The High Court must give a speedy decision.

Conclusion

The journey of the right to die with dignity in India highlighted the landmark judgements, such as the Aruna Shanbaug case, as well as the Common Cause v. Union of India verdict, which shows how India has evolved in terms of the legal and ethical landscape. Active euthanasia still remains illegal, but the judiciary has made way for passive euthanasia, recognizing that it’s an individual’s right to refuse life-sustaining treatment and write living wills. 

The importance of individuality and recent euthanasia cases in India shows how much of a progressive society we have become, which focuses on personal autonomy and dignity in end-of-life care. Even though we are a diverse society and are very much religion-centric, we have adapted to modern ways, focusing on individual rights. The ongoing discourse around this needs a compassionate as well as a regulated approach, such that this power isn’t misused but also empowers individuals.

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