France’s National Assembly has adopted an End-of-Life Bill legalizing assisted dying under strict conditions for adults with incurable illness, pending Senate approval.

Key Provisions of the French End-of-Life Bill

• Assisted Dying: It is defined as allowing a person to take lethal medication themselves.
  • In cases where patients cannot self-administer, medical professionals may assist.
• Eligibility Criteria
  • Only adults (18+) who are French citizens or residents.
  • Must suffer from an incurable illness in an advanced or terminal stage.
  • Must experience intolerable and untreatable physical pain.
• Excludes patients with severe psychiatric conditions and neurodegenerative diseases like Alzheimer’s.
• Procedure and Safeguards
  • The request must be initiated voluntarily by the patient.
  • A mandatory reflection period is included.
  • A team of medical professionals must confirm eligibility.
  • Lethal medication can be taken at home, in a nursing home, or in a healthcare facility.
• Complementary Palliative Care Bill
  • A separate bill was passed to enhance palliative care.
  • It aims to relieve pain and preserve patient dignity.
    

Comparison between Euthanasia and Assisted Dying

Ethical and Legal Concerns Regarding Ending Life

• Respect for Autonomy and Human Dignity: Legalizing euthanasia supports an individual’s right to make autonomous decisions about their body and life.
  • It recognizes the principle of dignity in death, especially for terminally ill patients facing unbearable suffering.
  • However, ethical debates question whether full autonomy is always possible in conditions of emotional, physical, or psychological vulnerability.
• Risk of Coercion and Exploitation: A major concern is that vulnerable populations — such as the elderly, disabled, or chronically ill may feel pressured to choose death to avoid being a burden.
  • Coercion can be subtle, rooted in social, financial, or emotional dynamics, making truly voluntary consent questionable.
• Impact on Palliative Care: Critics argue that legalizing euthanasia may undermine investments and advancements in palliative care.
  • It might reduce societal and institutional commitment to improving long-term care options for patients in pain.
• Slippery Slope Argument: Legalizing euthanasia for limited, severe cases could gradually expand to include non-terminal conditions, or even non-voluntary euthanasia.
  • Some nations have faced criticism for allegedly broadening eligibility criteria over time, raising alarms about moral boundaries.
• Legal Safeguards: Supporters highlight that a regulated euthanasia framework introduces transparent legal and medical safeguards, protecting both patients and doctors.
  • Protocols such as multiple physician reviews, consent verification, and time-bound reflection periods aim to prevent misuse.
• Ethical and Religious Opposition: Most major religions (Christianity, Islam, Judaism, Hinduism) consider euthanasia morally wrong, as it contravenes the sanctity of life.
  • These traditions believe that life and death are not for humans to decide, and that suffering may have spiritual meaning or value.
  • However,  some religious practices like Santhara are aligned with the concept of voluntary End of life.
• United Nations: The UN Human Rights Council has not explicitly endorsed euthanasia but promotes a rights-based approach to healthcare, emphasizing dignity, autonomy, and access to quality palliative care.

India’s Stance on Euthanasia or Assisted Dying

Legal Framework

• Passive euthanasia (withholding or withdrawing life-sustaining treatment) is legal in India under defined safeguards. This legality stems from the Supreme Court’s 2018 judgment in Common Cause v. Union of India and is regulated under Article 21 (Right to Life) of the Constitution.
• The Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill, 2006 was a draft attempt to provide legislative clarity, though it has not yet become law.
• Active euthanasia, which involves the intentional administration of lethal substances to end a person’s life, remains illegal in India.
  • It is punishable under Section 101 or 106 of the Bharatiya Nyaya Sanhita, 2023, depending on whether the act qualifies as murder or culpable homicide not amounting to murder.

Judicial Precedents

• Aruna Shanbaug Case (2011): The Supreme Court allowed passive euthanasia with prior approval from a High Court bench, based on the principle of parens patriae (state as guardian).
• Common Cause v. Union of India (2018): Landmark judgment declared the right to die with dignity as part of Article 21.
  • Legalized passive euthanasia
  • Validated living wills/Advance Directives, allowing terminally ill patients to refuse medical treatment.
  • Emphasized autonomy, dignity, and privacy of individuals in end-of-life care decisions.
• Recent Progress: Ministry of Health and Family Welfare released a  draft Guidelines for the Withdrawal of Life Support in Terminally Ill Patients to operationalise the Supreme Court’s Orders.

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