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Published: Sun, March 11, 2018
Medical | By Garry George

Supreme Court permits passive euthanasia in India

Supreme Court permits passive euthanasia in India

The Supreme Court emphasised that the right to die with dignity is a fundamental right.

The five-judge Constitution Bench, headed by Chief Justice Dipak Misra, said the living will can authorise the withdrawal of life-support system if the individual reached an irreversible stage of terminal illness in the medical view. "After this verdict, euthanasia and living will can not be misused as there will be strict guidelines", he said.

Euthanasia has multiple and complex legal, ethical, and emotional ramifications. Medical ethics demand doctors educate patients and relatives about the implications and effectiveness of life support systems like ventilators, but commercial imperatives of hospitals triumph all too often.

Justices A K Sikri, D Y Chandrachud and Ashok Bhushan also wrote their own separate and concurring judgements.

Delivering the judgement, Justice Chandrachud said, "Life and death are inseparable. For some, even their death could be a moment of celebration".

He said the only constant is change, the slow process of dying as we live.

The judgment led to a flurry of reactions across India.

Father Paul Thelakkat, editor of the church-run Sathyadeepam magazine, said the church apprehends that the verdict could be misused as a right of dignified killing of terminally ill patients. In 2016, the Centre drafted the Medical Treatment of Terminally-ill Patients Bill, but was silent on the matter of a living will, says Jha.

In active euthanasia, a specific overt act is performed to end the patient's life whereas in passive euthanasia, something is not done that would be necessary to preserve a patient's life, the panel noted. During the assault, she was tied with a dog chain around her neck, which cut off oxygen supply to her brain and left her in a permanently vegetative state.From that day Aruna could survive only on mashed food. In the absence of a living will, it would be the discretion of family and doctors to decide if they want the patient to be taken off life support.

As a safeguard measure, the court further stated that if a person is not of sound mind and not competent to make a living will, a medical board would decide for the individual.

The Press Trust of India news agency said that in each living will, a court-appointed medical panel will review the instructions before they can be carried out.

"The question that arises is should he not be allowed to cross the doors of life and enter painlessly and with dignity, into the dark tunnel of death whereafter it is said that there is resplendence". Thus, this decision by the SC needs to be applauded.

Aruna Shanbaug remained in vegetative state for 37 years after being strangled and sodomised by a sweeper.

Bhushan had filed a petition to the Supreme Court on behalf of a registered society, Common Cause, seeking recognition of the right to establish a living will.

Also termed as "advance medical directive", it is a direction issued by an individual that "he or she shall or shall not be given medical treatment in future when or he she becomes terminally ill". Meantime, a non-government organisation approached the top court with a plea to also legalise the right to a living will.

The passing of the 2018 verdict gains precedence for the Supreme Court has postulated a mechanism for passive euthanasia by allowing people to have a living will.

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