Supreme Court Allows Passive Euthanasia in First Such Order

In its first order allowing passive euthanasia, the Supreme Court has permitted the removal of artificial life support of a 32 year old man who has been in a coma for more than 12 years.

• Passive euthanasia is an act in which a patient is intentionally allowed to die by stopping or removing life support or the necessary treatment required to keep him alive.
• Harish Rana, a resident of Ghaziabad, who was a student of Punjab University, suffered head injuries after falling from the fourth floor of his paying guest accommodation in the year 2013 and has been in a coma for more than a decade.
• A bench of Justices J. B. Pardiwala and K. V. Viswanathan directed AIIMS-Delhi to admit Rana into palliative care so that medical treatment could be withdrawn.
• The bench said that it should be ensured that it is withdrawn with a specific plan so that dignity is maintained.
• While hearing the writ petition of Rana’s family, the top court had earlier expressed the desire to meet the parents of the 32 year old man. It had seen a report on Rana’s medical history filed by a secondary medical board of doctors at AIIMS-Delhi and said that it was a “sad” report.
• The primary medical board, after examining the condition of the patient, had emphasized the very low chances of his recovery. The top court had said on December 11 that according to the report of the primary medical board, the man’s condition is “very bad”.

About the Common Cause judgment, 2018 related to passive euthanasia

• The order allowing passive euthanasia is in accordance with its year 2018 Common Cause judgment. In the year 2018 judgment, a constitution bench had recognized passive euthanasia and the right to die with dignity as a fundamental right under Article 21.
• The court had held that passive euthanasia can be carried out by using “Advance Medical Directives”.
• On January 24, 2023, a five judge constitution bench amended the year 2018 euthanasia guidelines to simplify the process of granting passive euthanasia to terminally ill patients.
• In the Aruna Shanbaug vs Union of India (2011) case, the Supreme Court accepted that life sustaining treatment can legally be withheld or withdrawn. This also applies to individuals who have lost the capacity to make decisions.

Supreme Court guidelines on euthanasia:

• The Supreme Court amended the year 2018 euthanasia guidelines in the year 2023 to simplify the process of granting passive euthanasia.
• Living will/Advance directive: Adult persons of sound mind can make a living will. It should be signed by the executor of the will in the presence of two witnesses. The signature can be verified by a notary or a gazetted officer.
• Approval of medical board: The hospital forms two medical boards. The medical boards must communicate their decision within 48 hours.
• Supervision of the High Court: If the hospital boards refuse to grant permission, the relatives of the patient can approach the High Court, which constitutes a new medical board to review the case.

Global examples related to passive euthanasia

• Passive euthanasia is acceptable in many countries. The Netherlands is the first country in the world to legally recognize euthanasia.
• In April, 2002 the first national law legalizing euthanasia and physician assisted suicide came into effect here, under which patients suffering from serious and incurable diseases were given the right to die with dignity.

About euthanasia

• Euthanasia or “mercy killing” means intentionally ensuring the premature death of a person so that he can be saved from extreme suffering caused by an incurable or fatal disease.

Types of euthanasia:

• Active euthanasia: It involves directly taking steps for the death of the patient, such as giving a lethal injection.
• Passive euthanasia: It refers to the situation when the patient is incurably ill and there is no real possibility of recovery, then stopping or withdrawing life supporting equipment or medical treatment, leading to death occurring naturally.
• Non voluntary: A decision taken by another person for an incapable or helpless patient.

Involuntary: Death carried out without the consent of the patient.