Euthanasia Mercy Killing

Euthanasia Mercy Killing

What is a Living Will?


From UPSC perspective, the following things are important :

Prelims level: Living Will

Mains level: Passive Euthanasia in India

A five-judge Bench of the Supreme Court headed by Justice K M Joseph agreed to significantly ease the procedure for passive euthanasia in the country by altering the existing guidelines for ‘living wills’.

What is Living Will?

  • A living will is a legal document detailing the type and level of medical care one wants to receive if they are unable to make decisions or communicate their wishes when care is needed.
  • A living will addresses many life-threatening treatments and procedures, such as resuscitation, ventilation, and dialysis.
  • A person can appoint a healthcare proxy to make decisions regarding care when they are unable to do so.
  • A living trust is a legal document that addresses how the assets of the incapacitated person should be managed.
  • People can enlist the services of an estate planner or an attorney to help draft or review a living will.

Living Will in India

  • It was first laid down in its 2018 judgment in Common Cause vs. Union of India & Anr, which allowed passive euthanasia.
  • It was in response to the Aruna Shanbaug Case where protagonists were arguing in favor of mercy killing to Aruna.
  • The guidelines pertained to questions such as who would execute the living will, and the process by which approval could be granted by the medical board.
  • It declared that an adult human being having mental capacity to take an informed decision has right to refuse medical treatment including withdrawal from life-saving devices.

What is Euthanasia?

  • Euthanasia refers to the practice of an individual deliberately ending their life, oftentimes to get relief from an incurable condition, or intolerable pain and suffering.
  • Euthanasia, which can be administered only by a physician, can be either ‘active’ or ‘passive’.
  • Active euthanasia involves an active intervention to end a person’s life with substances or external force, such as administering a lethal injection.
  • Passive euthanasia refers to withdrawing life support or treatment that is essential to keep a terminally ill person alive.

What is the legal history of this matter?

  • Passive euthanasia was legalized in India by the Supreme Court in 2018, contingent upon the person having a ‘living will’.
  • It must be a written document that specifies what actions should be taken if the person is unable to make their own medical decisions in the future.
  • In case a person does not have a living will, members of their family can make a plea before the High Court to seek permission for passive euthanasia.

What did the SC rule in 2018?

  • The Supreme Court allowed passive euthanasia while recognising the living wills of terminally-ill patients who could go into a permanent vegetative state.
  • It was required to be signed by an executor (the individual seeking euthanasia) in the presence of two attesting witnesses and to be further countersigned by a Judicial Magistrate of First Class (JMFC).
  • The court issued guidelines regulating this procedure until Parliament passed legislation on this.
  • However, this has not happened, and the absence of a law on this subject has rendered the 2018 judgment the last conclusive set of directions on euthanasia.

What was the situation before 2018?

  • P Rathinam vs Union Of India, 1994: In a case challenging the constitutional validity of Section 309 of the IPC — which mandates up to one year in prison for attempt to suicide the Supreme Court deemed the section to be a “cruel and irrational provision”.
  • Gian Kaur vs The State Of Punjab, 1996: Two years later, a five-judge Bench of the court overturned the decision in P Rathinam, saying that the right to life under Article 21 did not include the right to die, and only legislation could permit euthanasia.
  • Aruna Ramchandra Shanbaug vs Union Of India & Ors, 2011: SC allowed passive euthanasia for Aruna Shanbaug, a nurse who had been sexually assaulted in Mumbai in 1973, and had been in a vegetative state since then. The court made a distinction between ‘active’ and ‘passive’, and allowed the latter in “certain situations”.

Key observations by Law Commission

  • Earlier, in 2006, the Law Commission of India in its 196th Report’ had said that a doctor who obeys the instructions of a competent patient to withhold or withdraw medical treatment does not commit a breach of professional duty and the omission to treat will not be an offence.
  • It had also recognised the patient’s decision to not receive medical treatment, and said it did not constitute an attempt to commit suicide under Section 309 IPC.
  • Again, in 2008, the Law Commission’s ‘241st Report On Passive Euthanasia: A Relook’ proposed legislation on ‘passive euthanasia’, and also prepared a draft Bill.

What was the old cumbersome process?

  • The treating physician was required to constitute a board comprising three expert medical practitioners from specific but varied fields of medicine, with at least 20 years of experience.
  • They would decide whether to carry out the living will or not.
  • If the medical board granted permission, the will had to be forwarded to the District Collector for his approval.
  • The Collector was to then form another medical board of three expert doctors, including the Chief District Medical Officer.
  • Only if this second board agreed with the hospital board’s findings would the decision be forwarded to the JMFC, who would then visit the patient and examine whether to accord approval.
  • This cumbersome process will now become easier.

Recent changes after the SC’s order this week

  • Medical board: Instead of the hospital and Collector forming the two medical boards, both boards will now be formed by the hospital.
  • 5 year experienced doctor: The requirement of 20 years of experience for the doctors has been relaxed to five years.
  • Magistrate approval not required: The requirement for the Magistrate’s approval has been replaced by an intimation to the Magistrate.
  • No witness required: The 2018 guidelines required two witnesses and a signature by the Magistrate; now a notary or gazetted officer can sign the living will in the presence of two witnesses instead of the Magistrate’s countersign.
  • HC for appeal: In case the medical boards set up by the hospital refuses permission, it will now be open to the kin to approach the High Court which will form a fresh medical team.

Different countries, different laws

  • NETHERLANDS, LUXEMBOURG, BELGIUM allow both euthanasia and assisted suicide for anyone who faces “unbearable suffering” that has no chance of improvement.
  • SWITZERLAND bans euthanasia but allows assisted dying in the presence of a doctor or physician.
  • CANADA had announced that euthanasia and assisted dying would be allowed for mentally ill patients by March 2023; however, the decision has been widely criticised, and the move may be delayed.
  • UNITED STATES has different laws in different states. Euthanasia is allowed in some states like Washington, Oregon, and Montana.
  • UNITED KINGDOM considers it illegal and equivalent to manslaughter.

Justification for Euthanasia/Assisted Suicide

  • It provides a way to relieve extreme pain.
  • Euthanasia can save life of many other people by donation of vital organs.


  • India officially recognizes that- “every single citizen is entitled to and reserves the right to die with dignity.”
  • Hon’ble Supreme Courts’ recent updated guidelines are a major move in this direction.


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Euthanasia Mercy Killing

Complex issue of Assisted Suicide


From UPSC perspective, the following things are important :

Prelims level: Assisted Suicide

Mains level: Assisted Suicide and issues involved


A renowned French filmmaker died earlier this week by assisted suicide at the age of 91.

What is Assisted Suicide?

  • Assisted suicide and euthanasia are practices under which a person intentionally ends their life with active assistance from others.
  • These have long been contentious topics of debate as they involve a complex set of moral, ethical and in some cases, religious questions.
  • Several European nations, some states in Australia and Colombia in South America allow assisted suicide and euthanasia under certain circumstances.

Difference between assisted suicide and euthanasia

  • Euthanasia is the act of intentionally ending a life to relieve suffering – for example a lethal injection administered by a doctor.
  • Intentionally helping another person to kill themselves is known as assisted suicide.
  • This can include providing someone with strong sedatives with which to end their life or buying them a ticket to Switzerland (where assisted suicide is legal) to end their life
  • Euthanasia can further be divided into active and passive.
  • The practice of passive euthanasia involves simply stopping lifesaving treatment or medical intervention with the consent of the patient or a family member or a close friend representing the patient.
  • Active euthanasia, which is legal in only a few countries, entails the use of substances to end the life of the patient.

India and Assisted suicide/ Euthanasia

  • In a landmark judgment, the Supreme Court of India legalised passive euthanasia in 2018, stating that it was a matter of ‘living will’.
  • According to the judgment, an adult in his conscious mind is permitted to refuse medical treatment or voluntarily decide not to take medical treatment to embrace death in a natural way, under certain conditions.

Consideration for ‘living will’

  • In the 538-page judgment, the court laid down a set of guidelines for ‘living will’ and defined passive euthanasia and euthanasia as well.
  • It also laid down guidelines for ‘living will’ made by terminally ill patients who beforehand know about their chances of slipping into a permanent vegetative state.
  • The court specifically stated that the rights of a patient, in such cases, would not fall out of the purview of Article 21 (right to life and liberty) of the Indian Constitution.
  • The SC’s judgment was in accordance with its verdict in March 2011 on a separate plea.
  • While ruling on a petition on behalf of Aruna Shanbaug Case, the court had allowed passive euthanasia for the nurse who had spent decades in a vegetative state.

Who was Aruna Shanbaug?

  • Shanbaug had become central to debates on the legality of right to die and euthanasia in India.
  • Shanbaug died of pneumonia in March 2015 at the age of 66, 42 years of which she had spent in a room at KEM Hospital in Mumbai, after a brutal rape left her in a permanent vegetative state.

Recent cases in India

  • In 2018, an old couple from Mumbai wrote to then President Kovind, seeking permission for active euthanasia or assisted suicide.
  • Neither of them suffered from a life-threatening ailment.
  • The couple stated in their plea that they had lived a happy life and didn’t want to depend on hospitals for old age ailments.

Justification for Euthanasia/Assisted Suicide

  • It provides a way to relieve extreme pain.
  • Euthanasia can save  life  of  many  other  people  by  donation  of  vital organs.

Issues with such killings

  • Euthanasia can be misused. Many psychiatrists are of the opinion that a terminally ill person or someone who is old and suffering from an incurable disease is often not in the right frame of mind to take a call.
  • Family members deciding on behalf of the patient can also lead to abuse of the law legalizing euthanasia as it can be due to some personal interest.


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