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Introduction

The interpretation of the Article 21 of the Constitution of India has expanded the scope of the right to life to include dignity in death. The Common Cause v. Union of India (2018) judgment recognised withdrawal of life support under strict safeguards, raising important ethical and legal debates on end-of-life decisions.

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Ethical Complexities Surrounding Passive Euthanasia in India

• Life Preservation vs Dignity in Death: Ethical dilemma between prolonging life at all costs and respecting a patient’s dignity when treatment is futile.
  Eg: The Supreme Court allowed withdrawal of life support for Harish Rana after 13 years in a vegetative state.
• Autonomy of the Patient vs Family Decision-making: Many patients cannot express consent, raising ethical concerns about who should decide on withdrawal of treatment.
• Risk of Misuse or Coercion: Concerns exist that euthanasia decisions could be influenced by financial or social pressures on families.
  Eg: The Supreme Court mandated medical board scrutiny before withdrawal of life support.
• Moral Responsibility of Medical Professionals: Doctors face ethical dilemmas between prolonging life and avoiding futile treatment that only extends suffering.
  Eg: Continued non-beneficial treatment may violate a patient’s dignity.
• Cultural and Religious Sensitivities: Indian society traditionally values preservation of life, creating ethical hesitation toward end-of-life decisions.
  Eg: The Court stressed euthanasia as a compassionate medical decision, not abandonment of care.

Legal Complexities Surrounding Passive Euthanasia in India

• Constitutional Interpretation: Courts must balance the right to life with dignity against the prohibition of actively ending life.
• Distinction between Active and Passive Euthanasia: Indian law allows withdrawal of futile treatment but prohibits active measures causing death.
  Eg: Active euthanasia through lethal injection remains illegal.
• Procedural Safeguards: Legal procedures require verification by medical experts to prevent misuse of euthanasia decisions.
• Absence of Comprehensive Legislation: India currently relies mainly on judicial guidelines rather than a dedicated statute on euthanasia.
  Eg: The Supreme Court directed to enact a specific law regulating withdrawal of life support.
• Judicial Oversight and Administrative Processes: Hospitals must inform Judicial Magistrates of First Class when medical boards recommend withdrawal of treatment.

Role of Palliative Care in Addressing Prolonged Suffering

• Pain Management: Palliative care reduces physical suffering through specialised medical treatment and pain management.
  Eg: The Supreme Court linked withdrawal of treatment with structured palliative care plans.
• Patient Dignity and Comfort: End-of-life care ensures dignity and emotional support during the final stages of illness.
• Holistic Support: Palliative care includes psychological and emotional counselling for patients and caregivers.
• Preventing Futile Medical Interventions: Palliative care discourages unnecessary life-prolonging treatments that do not improve quality of life.
  Eg: The court held that continuing non-therapeutic treatment merely prolongs suffering.
• Strengthening End-of-Life Care in Public Health: Integrating palliative services into hospitals improves accessibility and humane care.
  Eg: The Supreme Court emphasised the right to receive quality palliative and end-of-life care.

Conclusion

Balancing compassion, dignity, and legal safeguards remains central to India’s evolving euthanasia framework. Expanding palliative care infrastructure, strengthening ethical oversight, and enacting clear legislation can ensure humane end-of-life care while protecting vulnerable patients, aligning healthcare practices with the constitutional promise of dignity under Article 21.

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