Euthanasia in India – Legal and Social aspect

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Contents 

  1. Introduction
  2. Definition and concept of Euthanasia
  3. Opinions on Euthanasia
  4. Types of euthanasia
  5. International perspective on Euthanasia
  6. India and Euthanasia
  7. Conclusion

Abstract

Euthanasia is not completely accepted by Indian society. Each one of them have distinct opinions on mercy killing or Euthanasia. Some are more practical and consider euthanasia as a viable and realistic option, but some are more adherent to tradition and customs and are rigid towards change. Euthanasia is not suicide but an act of ending one’s own life with help of another. Euthanasia can be classified into active, passive, voluntary, nonvoluntary. Even though there are several judicial interpretations that the right to die is under the ambit of article 21 of the constitution, there is no explicit recognition of the right to die under the constitution or in any other legislation by the Parliament. After the legalizing the practice of euthanasia, there are several issues such as corruption at unethical hospitals, organ trafficking and many more would arise, which need to be addressed effectively. Proper legislation to regulate the practice of euthanasia is very much essential in India. Euthanasia is based on the idea that all individuals must be given the right to self-determination and autonomy, where they have the option to choose or refuse treatment. 

  1. Introduction 

According to World Health Organization (WHO), “Health is a state of complete physical, mental, and social wellbeing and not merely the absence of disease”[1]. Under the Article 21 of the Indian Constitution, the fundamental right to life and personal liberty is guaranteed. And life is not mere animal existence or simple survival but a life with human dignity. Despite, India being one of the founding members of United Nations and a part of several international conventions has promised to secure health care right of individuals in society. Ironically Indian Constitution does not expressly grant the fundamental right to health.

Mercy killing is a deliberate act of taking the life of a person in a painless and effective manner because it is not worth living. It is an act that relieves the individual from an irreversible state of agony and pain. When all other life-saving measures fail to provide a better quality of life for a terminally sick or vegetative patient, euthanasia is considered the sole realistic alternative.

  • Definition and concept of Euthanasia 

In the early 17th century, English philosopher and statesman Sir Francis Bacon coined the term “euthanasia”. The term “euthanasia” is derived from a combination of the two Greek words “eu” and “thantos,” which signify “good” and “death“. It illustrates the practice of taking one’s life without causing any pain or sorrow.

According to the House of Lords Select Committee on Medical Ethics, the definition of euthanasia is “a deliberate interference undertaken with the express intention of ending a life, to relieve intractable pains and agonies”[2]. Euthanasia is the suspension of medical facilities or injection of a lethal drug to end an individual’s life of agony and misery caused by a condition that is beyond repair or a terminal illness, in order to relieve the person from the terrible sorrow.

Euthanasia and suicide are completely two different topics. In the well-known case of Maruti Shripati Dubal vs State of Maharashtra,1986,[3] the honourable Bombay High Court attempted to distinguish between the two conceptions of suicide and euthanasia. According to the court, suicide occurs when an individual wish to end his life through an act performed only by himself without the involvement of others, whereas euthanasia necessitates the involvement of other humans.

  • Opinions on Euthanasia

Euthanasia is commonly referred to as “mercy killing“, or the intentional taking of a person’s life in a painless method when that person is tired of living a life of misery and pain. However, in terms of its legal status and public opinion, euthanasia has been a source of disagreement. Some are for it and some are against it. 

People against euthanasia make a clear-cut opinion that the concept of ending an individual’s life is not only against the laws of the land but against the laws of the nature and various religions. All religions condemn the unnatural termination of life and suggest that all humans should face the challenges that life throws at them rather than succumb to them. They believe that life is a precious gift from God that should not be squandered. The concept of family encourages us to help one another and to maintain the principle of unity in all circumstances. Governments are tasked with the responsibility of working for the common good of all citizens. In every case, the sanctity of life should be respected. In addition, the law does not allow anyone the right to kill another person. Regardless of the scenario, neither humanitarian, constitutional, legal, or religious principles allow a person to kill.

India is a country that values its culture and tradition, and Indians adhere to their traditions, whether cultural or religious, with zeal. Since most of the religions practiced here do not acknowledge euthanasia, believing that life and death are in God’s control and humans cannot intervene, implementing a provision like Euthanasia that would offend the religious emotions of the majority of religions.[4] In Hinduism, it is believed that a soul is eternal, immortal, and never dies. And assumes death is merely a means of altering one’s physical appearance. The Muslim religion likewise believes that life should end only when ALLAH wishes it to. The same is the case with Christianity. So, all three religions condemn the unnatural death of a person.

People who are in support of euthanasia are of an opinion that everyone has the right to self-determination and autonomy, as well as the freedom to choose his own way of life. Everyone should have the right to end their lives if their lives have become so stressful that it is easier and better to die than to live. Choosing death over pain and suffering. As a result, death will provide him with peace and relief from an incurable illness and a horrible life. It puts an end to a life that isn’t worth living.

  • Types of euthanasia

Physician-Assisted Suicide (PAS) is when a doctor intentionally provides medical assistance to someone who is suffering from unbearable misery and anguish to terminate their life. The doctor conducts a thorough examination of the patient’s medical state and selects the most painless and effective manner of death.

Voluntary Euthanasia is when a person (patient) makes a conscious decision to end his/her life with the assistance of another. It necessitates complete agreement, consent, and understanding of the concept and procedure adopted.

Non-Voluntary Euthanasia occurs when someone else, such as a family member or a partner, makes the decision to end someone’s (patient) life.

Active Euthanasia: The doctor can immediately end an individual’s life. The doctor may intervene directly and suggest a painless manner of ending a person’s life. This is a faster way to die by taking a lethal dose of a drug or injecting a lethal drug. Consent is the most important factor.

Passive Euthanasia is defined as intentionally causing a person’s death by withholding or depriving the necessary and essential care (like ventilator), food, or water. It’s a deliberate termination that also involves the removal of artificial life support systems. It is only used when the person is no longer cognitively or physiologically alert. Passive euthanasia is most practiced in the case of brain failure. 

There are four types of euthanasia proposed by the Senate Selection of Bills Committee. These are the following:[5]

• Active voluntary euthanasia: when medical intervention is used to end a patient’s life at the patient’s request.

• Passive voluntary euthanasia: when a patient’s medical care is withdrawn or withheld at the patient’s request to end the patient’s life.

• Passive in non-voluntary euthanasia: when a patient’s medical care or life support is withheld or discontinued without the patient’s consent in order to end the patient’s life.

• Active in non-voluntary euthanasia: when medical intervention is used to end a patient’s life without the patient’s consent.

  • International perspective on Euthanasia

Only four countries, the Netherlands, Belgium, Luxembourg, and Canada have allowed euthanasia out of the 193 members of the United Nations. In both China and Hong Kong, euthanasia is illegal. It contradicts Chinese traditional and moral values. According to Chinese law, euthanasia is considered as an act equivalent to murder. Even in the United Kingdom, euthanasia is indeed not legal. Active euthanasia is permitted in Germany, but this is not the case with passive euthanasia. Active euthanasia is expressly forbidden in the United States of America. Only a few states, such as Oregon, Washington, and Montana, have approved physician-assisted suicide in some manner.

  • India and Euthanasia

In India, there is no specific law or statute that enables or determines mercy killing to be legal or legitimate. It was suggested to create a legislation on the topic of passive euthanasia in India’s 241st Law Commission Report, titled “Passive Euthanasia – A Relook”[6]. Later “The Medical Treatment of Treatment of Terminally Patients (Protection of Patients and Medical Practitioners) Bill” was drafted with an intention to formulate a legislation on passive euthanasia.

In India due to the various miserable scenarios, euthanasia has been still a legal and societal issue for a long time. Numerous times, the right to die has been argued to fall under the ambit of Article 21 of the Indian Constitution’s right to life with dignity. It is stated that if a patient’s dying process causes significant delays and excruciating agony for both the patient and his loved ones, then the patient should be permitted to die so that he might be free of pain and misery. It is asserted that the right to die is closely intertwined and inseparable from the right to life with human dignity. 

Even though the Indian Parliament has not enacted any legislation specific to euthanasia, the Apex court has interpreted the idea of euthanasia on several occasions. In 1994, P. Rathinam N. Patnaik v. Union of India, a two-judge bench of the Supreme Court held that “a person has a right not to live a forced life and attempt to suicide is not illegal”.[7]

However, the above decision of the Supreme Court was overruled in 1996 by the Constitutional Bench of the Supreme Court in the case of Gian Kaur v. State of Punjab. “Gian Kaur and her husband Harbans Singh were convicted by a trial court under section 306 of the Indian Penal Code. They were sentenced to six years imprisonment and a fine of Rs. 2,000/- for abetting the suicide by Kulwant Kaur”.In this case, the validity of sections 306 and 309 of the Indian Penal Code was challenged on the grounds that it was violative of Article 21 of the Constitution. Section 306 punishes anyone who abets the commission of suicide, while section 309 punishes anyone who attempts to commit suicide. The court stated that the right to life guaranteed under article 21 of the Constitution does not include the right to die under its ambit and declared sections 306 and 309 of IPC as Constitutional. The Constitutional bench emphasized that dying properly and with dignity at the end of life cannot be combined or interwoven with dying unnaturally. Therefore, the Apex Court held that in India, euthanasia and assisted suicide are both illegal, and should only be implemented through a specific law.[8] 

After this case, the Law Commission’s 210th report recommended that the attempt to suicide, under section 309 of the IPC, be decriminalized on humanitarian grounds. But this recommendation was not implemented at the time. 

In 2017, The Mental Healthcare Act was enacted by the parliament, which de-criminalized the “attempt to suicide”. Section 115 of the Act states that “Notwithstanding anything contained in Section 309 of the IPC, any person who attempts to commit suicide shall be presumed to have severe stress and shall not be tried and punished under this Code; and the government is duty-bound to provide care, treatment and rehabilitation to such a person in order to reduce the risk of recurrence of attempt to commit suicide.”[9]

Aruna Ramachandra Shanbaug v. Union of India, 2011, was a writ petition filed by the person in the interest of the victim (nurse) who was raped by a ward boy thirty-six years back in 1973. She was not in awareness and her brain was unconscious. She was on the bed the entire time and was looked after by the medical staff. The petitioner advocated that the respondent (hospital) to stop feeding the victim. The court appointed a team of three doctors to submit a report on her health condition. Although the court did not order the withdrawal of medical treatment to Ms. Shanbaug, it discussed the issue of euthanasia at a length and considered that preventing the feeding of a person in coma is considered as passive euthanasia.[10] 

In the judgement Justice D.Y. Chandrachud expressed his thoughts on euthanasia as “Life and death are inseparable. Every moment our bodies undergo change… life is not disconnected from death. Dying is a part of the process of living”[11]. The court concluded that when all other life-saving measures fail or fall short to provide a better life for a terminally ill patient or one who is in a vegetative state, euthanasia is considered the only feasible choice.

On March 9, 2018, as part of the decision in the case of Aruna Shanbaug, the Supreme Court of India legalized passive euthanasia by withdrawing life support from patients in a persistent vegetative state. 

The landmark case of Common Cause (A Regd. Society) v. Union of India, 2018, was a writ petition that was filed requesting a strong system for Passive euthanasia and recognition of the ‘living will’ of a person. The Supreme Court recognized the concept of living will in India. The court also recognized the ‘Right to Die with Dignity’, Right to Self-determination, and Right to Autonomy as fundamental rights.[12] 

In India, the provision of Euthanasia can be misused. Corruption is an uncontrolled evil in India, and there are chances where hospital authorities accept bribes from cold-blooded relatives and kill a patient, not eligible for mercy killing and play the card of euthanasia. Euthanasia would also affect the legal functioning of organ selling and encourages the expansion of the market of organ trafficking (organs black market). In India, there are numerous heinous crimes, one of which is “dowry death,” in which the option of euthanasia can be exploited once again. These incidents usually occur in those hospitals that values money and wealth over human life. Hence, euthanasia in India must be constantly monitored and supervised by a regulating authority. Thus, in this aspect, proper guidelines and laws should be formulated and a regulating authority should be established by the Government of India to avoid the misuse of the concept of euthanasia.[13]

  • Conclusion

The Supreme Court has authorized the practice of euthanasia considering the patient’s suffering from pain and the importance of his peaceful death in life. Making the right to die with dignity a reality is a positive enhancement of the right to live under article 21 of the Constitution. It is now up to Parliament to draft a legislation and suggest recommendations on this matter, with the goal of putting them into effect as quickly as possible. It would lead to a better understanding of the situation.

Humans are the precious creation of God in our cosmos and hence, the sacredness of life must be protected.The government is bound with a duty to provide a secure life to all of its citizens. But the complex urban life has given rise to several complications. Scientific advancements in the field of medical science have affected the lives of people. People benefit not only from the employment of newly developed medical treatments as their lives are saved at various times, but at sometimes their lives are prolonged since they are equipped with life-saving medicines and medicinal equipment’s and the patient will have to die every minute waiting for natural death. And to give a relief from this kind of situation euthanasia is practiced.

Life’s most valuable jewel is good health without which life cannot be. A person is given the right to live a dignified life, which includes the right to self-determination, the right to choose, and the right to refuse.


[1] Constitution of World Health Organization (WHO), Basic Documents, Forty-fifth edition, Supplement, October 2006, https://www.who.int/governance/eb/who_constitution_en.pdf.

[2] House of Lords, Report of the Select Committee on Medical Ethics, 1994.

[3] Maruti Shripati Dubal vs State of Maharashtra (1986) 88 BOMLR 589.

[4] Ayush Verma, Euthanasia in India: Legal aspect, iPleaders (May 16, 2020), https://blog.ipleaders.in/euthanasia-india-legal-aspect/

[5] House of Lords, Report of the Select Committee on Medical Ethics, 1994.

[6] Law Commission of India, 241st Report on Passive Euthanasia – A Relook. Report. No.241 (Aug 2012).

[7] P. Rathinam N. Patnaik v. Union of India, AIR 1994 SC 1844 at 1868.

[8] Gian Kaur v. State, AIR 1996 SC 946.

[9] The Mental Health Care Act, 2017 (Act 10 of 2017)

[10] Aruna Ramachandra Shanbaug v. Union of India (2011) 4 SCC 454.

[11] Ibid

[12] Common Cause Society v. Union of India (2018) 5 SCC 1.

[13] Ayush Verma, Euthanasia in India: Legal aspect, iPleaders (May 16, 2020), https://blog.ipleaders.in/euthanasia-india-legal-aspect/

Author: Pranav N, School of Law Christ University

Editor: Kanishka VaishSenior Editor, LexLife India.

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