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[op-ed snap] Is active euthanasia the next step?


Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: Not mcuh

Mains level: The newscard talks against the APD. It supports the argument that there is no point of not allowing active euthanasia. As the passive euthanasia is legally and morally not much different from active euthanasia.



  1. If passive euthanasia is a guaranteed fundamental right, a rigid “active” versus “passive” euthanasia distinction (APD) is analytically unsustainable

Basis of the Common Cause v. Union of India decision

  1. The SC expounded the basis of its 2011 ruling in Aruna Shanbaug v. Union of India ,
  2. which permitted “passive” euthanasia, including “involuntary” passive euthanasia for mentally incompetent patients, in certain terminal cases
  3. Ruling that Article 21 of the Constitution guaranteed the “right to die with dignity”, the court also issued interim guidelines to enforce individuals’ living wills in case of future incompetence
  4. Aruna and Common Cause have incorporated the judicial APD evolved primarily by U.K. courts

There is not much difference between active and passive euthanasia

  1. There is no articulable reason why “withdrawal” (as opposed to “withholding”) of current treatment isn’t an illegal “active” decision that hastens death from the underlying cause
  2. It is much like a lethal injection that also accelerates imminent death
  3. More importantly, it may unjustly deny a recognised fundamental right to those who need assistance to access it

Points on which ‘passive’ euthanasia was constructed

  1. APD is an elaborate and flawed judicial construct arguably necessitated by overarching policy concerns, namely,
    (1) potential for abuse by unscrupulous individuals;
    (2) the spectre of criminal prosecution of benign doctors and families, etc.

The way forward

  1. Common Cause signals that APD’s days are numbered
  2. Whether couched as “dignified death” or “bodily autonomy”, there is no reasonable basis for negating the right vis-à-vis a patient whose circumstances warrant assistance to exercise it

[op-ed snap] Under a humane Constitution: Euthanasia



[op-ed snap] Death with dignity


Mains Paper 2: Polity | Structure, organization and functioning of the Executive and the Judiciary

From UPSC perspective, the following things are important:

Prelims level: Read the attached story

Mains level: Reasoning behind the decision, new framework regarding passive euthanasia and advance directive.


Reasoning behind the Supreme Court’s decision on passive euthanasia

  1. The core philosophy underlying the Supreme Court’s verdict allowing passive euthanasia and giving legal status to ‘advance directives’ is that the right to a dignified life extends up to the point of having a dignified death
  2. The court’s reasoning is unexceptionable when it says burdening a dying patient with life-prolonging treatment and equipment merely because medical technology has advanced would be destructive of her dignity
  3. In such a situation, “individual interest has to be given priority over the state interest”
  4. The court has invoked its inherent power under Article 142 of the Constitution to grant legal status to advance directives, and its directives will hold good until Parliament enacts legislation on the matter

Laying down of new framework

  1. Court lays down a broad legal framework for protecting the dignity of a terminally ill patient or one in a persistent vegetative state (PVS) with no hope of cure or recovery
  2. For, in such circumstances, “accelerating the process of death for reducing the period of suffering constitutes a right to live with dignity”
  3. The core message is that all adults with the capacity to give consent “have the right of self determination and autonomy”, and the right to refuse medical treatment is also encompassed in in it

Recognition of the Passive Euthanasia and ‘Living Will’

  1. Passive euthanasia was recognised by a two-judge Bench in Aruna Shanbaug in 2011
  2. Passive euthanasia essentially involves withdrawal of life support or discontinuation of life-preserving medical treatment so that a person with a terminal illness is allowed to die in the natural course
  3. Now the Constitution Bench has expanded the jurisprudence on the subject by adding to it the principle of a ‘living will’, or an advance directive
  4. The will is a practice whereby a person, while in a competent state of mind, leaves written instructions on the sort of medical treatment that may or may not be administered in the event of her reaching a stage of terminal illness

Government is going to make a new law

  1. The government submitted that it was in the process of introducing a law to regulate passive euthanasia, but opposed the concept of advance directive on the ground that it was liable to be misused
  2. The stringent conditions imposed by the court regarding advance directives are intended to serve as a set of robust safeguards and allay any apprehensions about misuse

The way forward

  1. The court is justified in concluding that advance directives will strengthen the will of the treating doctors by assuring them that they are acting lawfully in respecting the patient’s wishes
  2. An advance directive, after all, only reflects the patient’s autonomy and does not amount to a recognition of a wish to die

Passive euthanasia verdict: It will be the doctors’ call

Image source


Mains Paper 2: Governance | mechanisms, laws, institutions & Bodies constituted for the protection & betterment of vulnerable sections.

From UPSC perspective, the following things are important:

Prelims level: Passive euthanasia, SC guidelines

Mains level: Debate over the ethical need of euthanasia


Supreme Court guidelines on passive euthanasia

  1. Guidelines prescribed by the Supreme Court while upholding passive euthanasia and ‘Living Will’, place a huge burden on the treating physician and hospital
  2. The responsibility is on the treating doctor to ascertain the “genuineness and authenticity” of a Living Will of a terminally ill patient
  3. The living will would be placed in the custody of the Judicial Magistrate

Doctor’s call

  1. The court gives the treating doctor even a right to move the High Court, along with the dying person’s relatives or guardian, in case the Medical Board revokes permission for passive euthanasia
  2. The court also gives an individual the right to withdraw or alter his Living Will, but only in writing

SC Constitution Bench holds passive euthanasia, living wills permissible


Mains Paper 2: Polity | Structure, organization & functioning of the Executive & the Judiciary

From UPSC perspective, the following things are important:

Prelims level: Passive euthanasia, fundamental right to life and dignity

Mains level: SC judgments and laws related to euthanasia


Passive euthanasia permissible

  1. In a historic decision, the Supreme Court declared passive euthanasia and the right of persons, including the terminally-ill, to give advance directives to refuse medical treatment permissible
  2. A Constitution Bench led by Chief Justice of India upheld that the fundamental right to life and dignity includes right to refuse treatment and die with dignity
  3. The fundamental right to a “meaningful existence” includes a person’s choice to die without suffering

Guidelines given

  1. The judgment includes specific guidelines to test the validity of a living will, by whom it should be certified, when and how it should come into effect, etc
  2. The guidelines also cover a situation where there is no living will and how to approach a plea for passive euthanasia
  3. A person need not give any reasons nor is he answerable to any authority on why he should write an advanced directive

Australian state allows voluntary euthanasia in 2019


Mains Paper2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

The following things are important from UPSC perspective:

Prelims: Euthanasia

Mains level: Australia has legalized voluntary euthanasia 20 years after it repealed its mercy killing law. Euthanasia has been in news for quite some time now and it becomes important for mains.



  1. An Australian state parliament has legalised voluntary euthanasia 20 years after the country repealed the world’s first mercy-killing law for the terminally ill. 
  2. The final vote in the Victorian parliament on Wednesday means that doctor-assisted suicide will be allowed in Australia’s second-most populous state from mid-2019.

First Jurisdiction in the world to legalise doctor-assisted suicide

  1. Australia’s sparsely populated Northern Territory in 1995 became the first jurisdiction in the world to legalise doctor-assisted suicide for terminally ill patients.
  2. But the Australian Parliament overturned that law in 1997 after four people had been helped to die.



  1. Generally, the word euthanasia is defined as the, act or practice of painlessly putting to death or withdrawing treatment from a person suffering an incurable disease.
  2. Euthanasia is intentionally killing another person to relieve his or her suffering. 
  3. There are 2 types of euthanasia: Passive euthanasia and Active euthanasia.
  4. Active euthanasia is defined as taking an immediate action such as using lethal injection to painlessly put a terminally-ill patient to death.
  5. Passive euthanasia is withdrawing treatment while the life of the patient is still dependent on it and when it is believed that treatment is more burdensome than beneficial.
  6. Passive euthanasia allows the patient to die naturally and is often considered more acceptable. 




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

Image Source


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

Image source


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

Decriminalising suicide- background & foreground

  1. Background: Earlier, in August 2014,Govt had said that it would decriminalise suicide
  2. The Law Commission of India in its 210 report on ‘Humanization and Decriminalization of Attempt to Suicide’ had recommended the removal of Section 309 from IPC
  3. What next? Home Ministry is in the process of effacing the section as recommended by the Law Commission along with amendment of certain other sections of the CrPC and IPC in consultation with all stake holders
  4. Loophole: There are suicide bombers who fail in their attempt to blow themselves up and other terrorists who consume cyanide pills with the intention to wipe out evidence

RS passes Bill decriminalising suicide

  1. The Mental Health Care Bill, 2013: Decriminalise suicide and provide better healthcare for people with mental illness
  2. Provision: Any person who attempts suicide shall be presumed, unless proved otherwise, to have mental illness and shall not be liable to punishment under Section 309 of the Indian Penal Code
  3. Section 309 IPC: Whoever attempts to commit suicide and does any act towards the commission of such offence, shall he punished with simple imprisonment for a term which may extend to one year 1 [or with fine, or with both]

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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