The UK Parliament has recently approved the Assisted Dying Bill, marking a historic shift in the end-of-life rights debate.

• The Bill is now being reviewed by the House of Lords and is widely expected to become law in England and Wales.
• It reflects a shift from moral absolutism to legal and ethical pragmatism.

Background

• Evolution of Debate: Earlier debates on assisted dying often focused on religious doctrines, the sanctity of life, and moral absolutism , however recent debates centered on safety, legal safeguards, and individual autonomy.
  • Eg. Most MPs in Britain parliament supported the principle of assisted dying, while opposition MPs largely raised concern about implementation risks, such as coercion and diagnostic errors. 

Key Features of the Bill

• The Bill allows mentally competent adults to seek assisted dying if:
  • They have a terminal illness, expected to cause death within six months.
  • Their request is voluntary and informed.
• Safeguards introduced:
  • Two independent doctors must confirm the patient’s eligibility and absence of coercion.
  • A multidisciplinary panel must approve the application.
  • New criminal offences:
    • Inducing someone to seek assisted dying through coercion: up to 14 years in prison.
    • Administering the drug unlawfully: life imprisonment.
• Comparative Legal Insight:
  • UK law already permits refusal of life-saving treatment, including in cases with high recovery chances.
  • Example: Jehovah’s Witnesses refusing blood transfusions have had their right upheld.
• Ethical Basis:
  • Focuses on patient autonomy, informed consent, and protection from harm.
  • The Bill covers a narrower scope than existing end-of-life rights, applying only to those who are already terminally ill.

Concerns

• Misdiagnosis and Prognostic Errors:
  • Terminal illness predictions can be uncertain.
  • Risk mitigated by restricting eligibility to patients already nearing end of life.
• Coercion:
  • Risk of external pressure from family, caregivers, or society.
  • Addressed through independent assessments and strict penalties.
• Self-Coercion:
  • Fear that patients may choose death to avoid being a burden.
  • Rejected amendment: Assisted dying only if for the person’s “own sake.”
• Legal principle: Competent adults are not required to justify their reasons if mentally capable.

Ethical Debate on Assisted Dying

India’s Legal Position: Does the Right to Live under Article 21 of the Indian Constitution include the Right to Die too?

• In India, the “Right to Life” is a fundamental right enshrined in Article 21 of the Constitution, primarily focuses on the preservation of life, it has also been interpreted by the judiciary to include the right to live with dignity.
• Historical Position: The concept of death, especially voluntary death through euthanasia or assisted suicide, often conflicts with societal, cultural, and legal norms. 
  • Section 309 of the Indian Penal Code (IPC) which has been penalized suicide, however, this section has been repealed and replaced in the Bharatiya Nyaya Sanhita (BNS), which decriminalized attempted suicide.

The legal framework regarding the right to die in India has been shaped by several landmark judgments

• State v. Sanjay Kumar Bhatia (1994): In this case, the Delhi High Court criticized Section 309 of the IPC, which criminalizes attempted suicide, as “anachronistic” and a “paradox.” 
  • The court recognized the distressing nature of a suicide attempt and called for a more humane approach, but it did not provide a conclusive ruling on euthanasia
• P Rathinam Vs Union of India(1994): The judiciary debated whether the punishment for attempting to commit suicide (section 309 of IPC) was right or wrong.
  • In this case, the SC upheld that the liberty to die comes under the liberty to live. Thus, section 309 of the IPC was observed to be constitutionally invalid.
• Gian Kaur Vs State of Punjab (1996): The Supreme Court (SC) stated that the right to life enshrined in the Constitution does not mandate the right to die because suicide or someone choosing to die is an unnatural way of putting an end to one’s life. 
  • SC brought the validity of section 309 back and made an attempt to suicide an offence again.
• Naresh Marotrao Sakhre v. Union of India (1996):  In this case, the court drew a distinction between suicide and euthanasia. Suicide is considered self-destruction, while euthanasia involves the active participation of a third party. 
  • The court pointed out that euthanasia was not addressed under Section 309 of the IPC.

Right to Die with Dignity & Passive Euthanasia

• Aruna Shanbaug v. Union of India (2011): Recognized passive euthanasia under strict conditions.
  • Allowed withdrawal of life support for patients in permanent vegetative state (with High Court approval).
• Common Cause v. Union of India (2018): In a landmark judgment, a five-judge bench, led by unanimously recognized the “right to die with dignity” as a fundamental right under Article 21 of the Constitution. 
  • The Court also legalized passive euthanasia and permitted the creation of a “living will” or an advance directive, allowing terminally ill patients to express their wishes regarding end-of-life decisions. 
• In 2023 the Supreme Court modified the guidelines to make the right to die with dignity more accessible, however active euthanasia remains illegal due to concerns over misuse (refer Infographics).

Way forward: Lesson for India

• Need for Broader Discussion:
  • India must address assisted dying within the frameworks of healthcare ethics, legal oversight, and cultural sensitivity.
  • Strengthening Palliative Care: The ensure that terminally ill patients have access to comprehensive support services, irrespective of their choice to balance personal autonomy with the ethical responsibility of care.
• Takeaways from the UK Model:
  • Robust procedural safeguards can reduce risk and build public trust.
  • A rights-based approach reinforces patient dignity and autonomy.
  • Clear legal penalties deter abuse and coercion.
  • Acknowledging the difference between voluntary death and unregulated withdrawal of care.
• Global examples: 
  • Netherlands, Luxembourg, Belgium: These Countries allow both euthanasia and assisted suicide for anyone who faces “unbearable suffering” that has no chance of improvement.
  • Switzerland:  Switzerland has banned euthanasia but allows assisted dying in the presence of a doctor or physician.
  • Canada: Canada had announced that euthanasia and assisted dying would be allowed for mentally ill patients by March 2023; however, the decision has been widely criticized, and the move may be delayed.
  • United States: USA has different laws in different states. Euthanasia is allowed in some states like Washington, Oregon, and Montana.
  • France: It has recently approved a similar bill in its National Assembly (May 2025).

Conclusion

• While no law can eliminate all risk, the Bill presents a model that is more controlled and compassionate than existing unregulated end-of-life decisions.
• For India, the debate opens up space for a mature, safety-focused, and rights-oriented policy discourse, in line with evolving global human rights perspectives.

DOWNLOAD PDF