AUTHOR: TANNU MANOJ MISHRA, GOPALDAS JHAMATMAL ADVANI LAW COLLEGE, MUMBAI 

This article examines how India is recognizing passive euthanasia through Article 21 of the Constitution, which ensures the right to life and personal freedom. It studies landmark judgements, including the Aruna Shanbaug and Common Cause cases, to assess how ideas like dignity, autonomy, and privacy are linked to life and, by extension, to death. The article highlights the change from denying the right to die to accepting that Article 21 of the Constitution includes the right to seek death. It also discusses the moral and religious aspects of euthanasia, pointing out the compassionate reasons for it as well as concerns about ethics. While society holds mixed views, the article suggests that respecting end-of-life choices shows growth in how the law relates to human suffering. This legal discussion encourages a new understanding of dignity not just as a right during life, but as a principle that guides a humane death.

KEYWORDS

Euthanasia, Dignity, Autonomy, Privacy, Right to Die, Article 21.

“Life sans dignity is an unacceptable defeat, and life that meets death with dignity is a value to be aspired for.” - Dipak Misra Chief Justice of India

The haunting reflection of Chief Justice Dipak Misra’s above quote hits at the core of this young woman's plea. Her physical life, supported by machines, is no longer a life in the sense that matters; it is a sustained survival devoid of agency, awareness, and hope. Her plea is grounded in unwavering conviction which is to regain the dignity her condition has stripped her of. This case puts in perspective the very constitutional question that Indian law has struggled with whether the right to life under Article 21 also encompasses the right to a dignified death. This woman's desire is a restatement of the judicial acknowledgement in Common Cause v. Union of India (2018), in which the Supreme Court opined that the right to die with dignity is essential to the right to life. Her request, albeit individualized, is an expression of a constitutional principle based on progressive interpretations of Article 21.

Based on this judicial precedent, the discussion logically shifts to the medical and ethical area of euthanasia. Euthanasia is defined as the alleviation of allowing a relatively painless death for terminally ill or seriously injured persons. This article is written with an aim to probe this very crossroad by analyzing the legal and ethical aspects of euthanasia in India, focusing on the landmark judgments delivered by the Honorable Indian Supreme Court.

Euthanasia is the deliberate taking of a life in order to end one’s suffering and pain. Euthanasia, word has its origins in the Ancient Greek language. It is derived from the words "well" (eu) and "death" (thanatos). The term "mercy killing" refers to the practice of euthanasia, which is the act of attempting to give a person a decent death when they might otherwise face a much more unpleasant one. There are different forms of euthanasia and it can be categorized into four prominent types. Those are as follows:

1. Voluntary Euthanasia: When a person decides on their own to end their life in order to prevent further suffering.

2. Non-Voluntary Euthanasia: When someone else decides on an early and compassionate death because the person who will be euthanized is incapable of making the decision for themselves. 

3. Active Euthanasia: If a person is actively euthanized, it indicates that an outside force likely a lethal injection or the willful ingestion of a lethal combination of drugs caused their death as opposed to natural causes.

4. Passive Euthanasia: When someone is permitted to pass away because of the intentional discontinuation of any treatment that could save their lives. This type of euthanasia is allowed in India as ruled in the Common Causes case though there is lack of legislation with this aspect in the Indian Legal System. 

Article 21 of the Indian Constitution guarantees every citizen of India as well non-citizens the right to protection of life and personal liberty. It states that “no person shall be deprived of his life or personal liberty except according to procedure established by law”. Over time, Indian courts have interpreted Article 21 to cover a wide range of entitlements necessary for meaningful living. Among the many facets of the right to life are the rights to a healthy environment, livelihood, and the ability to live with dignity. Article 21 also includes freedoms such as the right to move freely, choose one’s residence, and pursue any lawful occupation all of which can only be curtailed in accordance with lawful procedures.

The Supreme Court has interpreted Article 21 liberally, reading various rights to give "life" greater purpose and meaning. The Supreme Court in the landmark case of Maneka Gandhi v. Union of India (1978) upheld that the right to life and personal liberty under Article 21 encompasses the right to live with dignity. In a further significant ruling, the Supreme Court acknowledged the right to privacy as a fundamental right safeguarded by Article 21 in K.S. Puttaswamy v. Union of India (2017). Following the earlier perspective of the Supreme Court in Maneka Gandhi’s case the Honorable Court in Francis Coralie v. Union Territory of Delhi (1981), held that the right to live is not restricted to mere animal existence but it also includes the right to live with human dignity encompassing all the bare necessities of life. 

This ongoing change is a powerful validation of human flourishing, which it is able to do because it validates living not just as biological life, but as a life of meaning and self-realization. The right to privacy is relevant to this discourse. This right clarifies the relationship one has with their own selves to personal autonomy that mastery over the self as independence over one's own life, space, information and choice is essential to living a respectable and dignified life. Now, the right to privacy allows the person to make "personal choices free from unwarranted state interference" and includes matters of identity and relations, and the right to determine the limits and boundaries especially related to personal autonomy to individual life. The journey of this shift could not have occurred, without the timeliness of the Honorable Court's interpretation of meaning regarding upholding the essence of human dignity in a world that is constantly evolving. The Honorable Court has expressed in several landmark judgments what Article 21 meant as a "guarantor" of a life worth living, the right to govern themselves and to the extent how they want to live their respective lives according to their values and objectives.

In the 1997 case of State of Maharashtra v. Maruty Sripati Dubal (1997), the Bombay High Court declared that section 309 of the Indian Penal Code, 1860, which punished someone for attempting suicide, was unconstitutional and upheld that Article 21 includes the right to die. This case marked the beginning of the debate over whether Article 21 includes the right to die. The discussion surrounding the scope of Article 21 has been lively ever since, with a range of judicial interpretations and ethical criticisms of the "right to die."

In P. Rathinam v. Union of India (1994) The Supreme Court supported the stance taken by the Bombay High Court in the earlier mentioned case that a person has a right to die and likewise section 309 of IPC, 1860 is unconstitutional. The Apex Court recognized that Article 21 which guarantees right to life does include the right not to live along with the right to live. The Court explained this is precisely why section 309 of IPC is unconstitutional and also opined that a person should not be forced to enjoy their right to life against their wish. In this case the Apex Court also rejected the plea that euthanasia should be permitted by the law. However, the Supreme Court overruled its earlier decision in the case of Gian Kaur. In Gian Kaur v. State of Punjab (1996) The Supreme Court held that the “right to life” guaranteed by article 21 of the constitution does not include “right to die” or the “right to be killed”. The Court was of the opinion that the expression the right to die is inconsistent with the right to life as any aspect of life which shall make it dignified would naturally be read under Article 21 but not that which will extinguish it.

Although the above-mentioned cases may have mentioned the "right to die" they mainly addressed the constitutionality of Section 309 IPC and did not specifically address the complex medical and ethical issues surrounding euthanasia, particularly passive euthanasia for patients in a persistent vegetative state. The case of Aruna Ramchandra Shanbaug v. Union of India (2011), which was decided by the Supreme Court was the first case in India which addressed and acknowledged the legitimacy of passive euthanasia. The Apex Court drew the distinction between active and passive euthanasia. From this judgement onwards passive euthanasia was legalized in India. This is a landmark case because the Court, using its parens patriae authority, acknowledged passive euthanasia for the first time and established rules for it in India for future situations in which a person is incapable of giving consent and in an irreversible vegetative state. Following this doctrine, the Supreme Court, in this case, established that passive euthanasia is permissible only in exceptional and rarest of rare cases. Such a decision requires the explicit approval and consent of the patient's family members and doctors. The Court emphasized that this power should be used sparingly to prevent it from undermining the right to life under Article 21. A strict procedure was mandated: a written petition must be filed in the High Court (under Article 226), which would then appoint a three-doctor committee to assess the patient's condition. Based on their medical report, the High Court would make the final decision to permit the withdrawal of life support.

After this landmark judgement the 241st Report of the Law Commission of India on Passive Euthanasia has also recognized passive euthanasia, but no law has been enacted. The Common Cause (A Regd. Society) v. Union of India (2018) The case, which also made significant advancement in the legal position on passive euthanasia, is the next landmark decision in India's euthanasia jurisprudence. The right to die with dignity was declared as a fundamental right as per the verdict in this case under Article 21 based on the principles established in Justice K.S. Puttaswamy v. Union of India and the privacy-autonomy-dignity matrix created in this landmark case. The major emphasis of the judgement was based on the fact that prolonging suffering through artificial means is going against constitutional liberty and that life without dignity is not worth preserving. The Court legalized passive euthanasia and also acknowledged the legitimacy of advance directives, also known as living wills, and attorney authorizations for patients who are terminally ill or in a permanently vegetative, state. As a direct result of the broad interpretation of Article 21, the Court ultimately established the right to die with dignity as an inherent aspect of life.

The first argument in support of euthanasia is about the quality of life an individual is left with which maintains that there are several instances where death may be more humane than living for a person who is terminally ill or any vegetative patient experiencing ongoing suffering or someone who has lost their consciousness completely. The second point with respect to supporting euthanasia is about the resource management and its use argument, which highlights the moral distribution of scarce medical resources. This viewpoint examines whether extending life in situations such as permanent vegetative state (PVS) is justified when those resources could better help others, rather than concentrating solely on that one particular patient's suffering whose end is not in sight. The third argument supporting the right to die concerns itself with the idea of personal autonomy of the person on the basis that people should have the right to choose how and when they wish to end their respective lives. This perspective, which is rooted in John Stuart Mill's harm principle, asserts that individual choices should never be influenced unless doing so would injure other people. It may accordingly be against the concerned person’s autonomy to deny terminally ill patients who voluntarily request euthanasia, particularly if their choice does not cause bodily harm to others.

The rationale behind not supporting euthanasia revolves around several contentions. The first contention among people not in favor of euthanasia is about the sanctity of life. This argument, which is frequently based on religious convictions Christianity, for example holds that human life is sacred because it reflects the presence of God. Therefore, it is morally wrong to perform any kind of euthanasia. In Hinduism it is believed that killing oneself in unnatural ways could have a detrimental effect on karma and it also interferes with the soul-body's natural separation. On the other hand, some believe that euthanasia would be a compassionate act particularly when it relieves extreme suffering. Thus, there are two main schools of thought in Hinduism: one that emphasizes karmic responsibility and spiritual continuity, while the other supports compassionate release.

The second argument opposing euthanasia is related to the slippery slope objection which argues that legalizing euthanasia, even in limited sense and morally defensible cases, may gradually erode ethical boundaries. While not denying that euthanasia can be justified in certain isolated instances, critics warn that it could lead to broader, dangerous applications such as involuntary euthanasia or misuse in cases of mental illness. The third contention is that modern treatment argues that because of continuous medical progress, euthanasia is no longer necessary. This view asserts that premature death deprives patients of the opportunity to gain from better treatments or future cures. Accordingly, this perspective implies that euthanasia may not always be warranted, even in situations involving terminal illness or vegetative states, as it may be possible to alleviate suffering without hastening death. 

The arguments for and against euthanasia shows that this debate stresses upon the basic issues regarding the worth of life, suffering, and the boundaries of human choice, and that it transcends the fields of medicine and law.

There are two groups of people in the ongoing debate about whether the right to die should be recognized as a fundamental right: those who support it and those who oppose it. This divide makes the issue specifically concerning in a society that values individual freedom. Supporters of legalization argue that in some cases, patients' medical conditions worsen to such a degree that living becomes unbearably painful. For these individuals, seeking ways to end their suffering may seem like the relief they want. On the other side, opponents of euthanasia, strongly resist its legalization. Their view comes from a belief in the value of human life. From their ethical and moral perspective, taking active steps to end a life is deeply wrong.

In the legal context of Article 21, the "right to life" has always protected liberty and dignity. However, modern legal thought is starting to explore whether this right should include not just living, but also a dignified death. This questions for reflection, empathy, and clarity in our legal framework. When suffering takes away the meaning of life, should the law remain unchanged, or should it grow with society’s values? Amidst these changes, one truth stands out: “Death is not the greatest loss in life. The greatest loss is what dies inside us while we live.” written by Norman Cousins. Perhaps the right to die is the start of a philosophical discussion. It encourages us to redefine dignity, as life’s most sacred companion.

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