[op-ed snap] The will to die — on ‘living wills’

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Mains Paper 2: Governance | Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes; mechanisms, laws, institutions and Bodies constituted for the protection and betterment of these vulnerable sections.

From the UPSC perspective following things are important:

Prelims Level: Vegetative state, Living will.

Mains Level: Much debated topic. The SCs cognizance on the issue has made it more important for the Mains paper.



  1. The article talks about the recent case came before the Constitution Bench of the Supreme Court
  2. The case is on allowing euthanasia as a means to protect the dignity of patients in a vegetative state

What is a vegetative state?

  1. A vegetative state is absence of responsiveness and awareness due to overwhelming dysfunction of the cerebral hemispheres(a part of brain), with sufficient sparing of the diencephalon and brain stem to preserve autonomic and motor reflexes and sleep-wake cycles

What is a living will?

  1. A written statement detailing a person’s desires regarding future medical treatment in circumstances in which they are no longer able to express informed consent, especially an advance directive

Should the law allow ‘living wills’?

  1. The court will have to resolve the question whether the right to life under Article 21 of the Constitution(while taking decision on euthanasia and living will)
  2. And according to an earlier verdict, Article 21 does not include the right to die
  3. And a living will may relieve the close family members and caregivers of a terminally ill patient of the moral burden of making a life-ending decision

Courts reaction on this

  1. While reserving its verdict, the court has indicated that it may lay down comprehensive guidelines on operationalising the idea of living wills

Government’s stance on the issue

  1. The government has opposed the concept of an advance directive, arguing that it would be against public policy and the right to life
  2. The government is rightly concerned that the idea may be misused and result in the neglect of the elderly

Earlier judgement of SC on Euthanasia

  1. The Supreme Court, in a landmark verdict in 2011, ruled out any support for active euthanasia
  2. But laid down a broad legal framework for passive euthanasia, or the withdrawal of life support subject to safeguards and a fair procedure

The way forward

  1. In the present case, the court may have to draw up stringent safeguards for certifying living wills, preferably by a judicial officer
  2. And lay down the exact stage at which the advance directive becomes applicable
  3. The court’s observation that it would initiate only after a medical board rules that a person’s condition is incurable
  4. So, Living wills, if sanctified in law, should come with robust safeguards

Passive euthanasia Bill ready, but ‘living will’ may be misused: Govt tells SC

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Mains Paper 2: Governance | Government policies & interventions for development in various sectors & issues arising out of their design & implementation.

From UPSC perspective, the following things are important:

Prelims level: Active and passive euthanasia, persistent vegetative state (PVS)

Mains level: All aspects related to euthanasia


Draft law for euthanasia

  1. The Centre told the Supreme Court that it was vetting a draft law allowing passive euthanasia
  2. But was opposed to permitting people to make a ‘living will’ — that they should not be put on life support in case of terminal illness — as it could be misused

The draft bill

  1. The ‘Management of Patients With Terminal Illness — Withdrawal of Medical Life Support Bill’ has been drawn up in keeping with the recommendations of the Law Commission

Passive euthanasia and its status in India

  1. Passive euthanasia is the law of the land
  2. Court findings in the Aruna Shanbaug case have allowed it
  3. The Law Commission, under the chairmanship of Justice (retired) P V Reddy, had in its 241st report come out in favour of allowing withdrawal of life support for certain categories of people — like those in persistent vegetative state (PVS), in irreversible coma, or of unsound mind, who lack the mental faculties to take decisions

Social and philosophical aspects

  1. Forcing a person to take medical treatment against their will is also a social issue
  2. On one hand, country is short of medical facilities etc, and on other hand, we force those who are in a hopeless situation to take treatment
  3. This also raises a “philosophical question” on whether a person can refuse treatment
  4. An individual who refuses to undergo treatment may become a burden on the resources of the state

Way forward

  1. As laid down in the Shanbaug case, the way ahead was to allow medical boards to decide whether to allow passive euthanasia or not

Let ‘people’s court’ decide on euthanasia: SC

  1. Context: Question of legalizing passive euthanasia and living will in India
  2. News: SC said that the Parliament should be the final judge to decide the legality of passive euthanasia and living will
  3. Passive Euthanasia: An act of withdrawing medical treatment with the deliberate intention of causing the death of a terminally-ill patient
  4. Living Will: An advance directive by a person to physicians for end-of-life medical care

Supreme Court asks Centre to clear stand on euthanasia

  1. A 5-judge Constitution Bench asked the govt. to make it’s stand clear on euthanasia.
  2. The law officer pointed out a bill for allowing passive euthanasia was pending.
  3. Medical Treatment of Terminally ill Patient (Protection of Patients and Medical Practioners) Bill, 2006, is pending in Parliament, which deals with the issue.
  4. There is a report of Law Commission which says that passive euthanasia should be allowed with certain safeguards.
  5. A regulation under Medical Council of India Act says that practising euthanasia would constitute unethical conduct.

:( We are working on most probable questions. Do check back this section.

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