Euthanasia law in India has changed following a landmark Supreme Court ruling earlier this month which said patients have the ‘right to die.’
The country’s apex court has ruled that passive euthanasia is permissible in the case of terminally ill patients whose condition has deteriorated irreversibly. To this end, the living will has been legalised in the country. This allows terminally ill patients to put into writing their wish to have life support withdrawn, with the full force of law.
Euthanasia has been a topic of debate in India for several decades. Much of the controversy centres around the case of Aruna Shanbaug.
The case of Aruna Shanbaug
In 1973, Shanbaug was strangled and sexually assaulted by a ward boy at the King Edward Memorial Hospital in Mumbai, where she worked as a junior nurse. The attack left Shanbaug in a permanent vegetative state until her death in 2015. In this time, a legal petition was filed by her friend Pinki Virani, arguing for Shanbaug’s ‘right to die.’
The case ultimately led to the Supreme Court legalising passive euthanasia in exceptional circumstances in 2011. The ruling, however, did not lead to Shanbaug being taken off life support, as the Court did not recognise Virani as Shanbaug’s ‘next friend’ (a substitute for next of kin). As such, she could not make the decision on Shanbaug’s behalf. Shanbaug ultimately died of pneumonia on May 18, 2015.
In 2014, the SC argued that the Court’s earlier reasoning was inconsistent. It took umbrage with the notion of living wills, expressing doubt that a patient’s next of kin should exercise sole discretion in choosing whether the patient has their life support withdrawn. The Court was also critical of living wills, which they said may not represent an informed choice by the patient.
The Court last year reserved judgement. They opined that the right to die is inseparable from the right to life as guaranteed under Article 21 of the Indian Constitution. Previous cases on the matter, such as Gian Kaur vs. State of Punjab, have held that both passive euthanasia and assisted suicide are at odds with the right to life. However, they also reasoned that the preservation of life should not entail the prolongation of suffering.
SC: ‘The core value of life’
In March of this year, a five-judge Constitution bench unanimously ruled in favour of passive euthanasia. Chief Justice Dipak Misra said the judgement ‘fosters the cherished value of dignity of an individual’, which he termed ‘the core value of life.’ Misra said the ruling ‘saves a helpless person from uncalled for and unnecessary treatment.’
Justice Arjan Kumar Sikri concurred. On the subject of the living will, Sikri said ‘autonomy of the individual gives him right to choose his destiny…therefore, he may decide beforehand, in the form of advance directive, at what stage of his physical condition he would not like to have medical treatment.’
Sikri acknowledged that a doctor’s obligation is to provide treatment for their patient. However, he argued this does not apply ‘in the case where a person has already expressed his desire of not being subjected to any kind of treatment.’
The Court says legislation will be implemented to reflect the ruling. Until that time, the existing guidelines will remain in place.
Some have welcomed the decision. India’s medical community backs the ruling, with many doctors asserting patients have a right to a dignified death. Lawyer Prashant Bushnan, who filed a petition with the SC to allow for living wills, called the ruling ‘an important, historic decision.’
Virani said she was ‘deeply grateful’ for the SC’s decision. She paid tribute to Shanbaug, whom she said ‘suffered for 42 years. We must thank her.’
The ruling has not been without controversy, however. Reaction on Twitter was polarised. Whilst some welcomed the ruling and congratulated the SC, others were critical. One user said ‘from now on no miracles will happen.’ Activist Rahul Easwar wrote ‘there is nothing progressive about “Right to Die”’ and said ‘accepting euthanasia is against the divinity of life, and growth of science.’
‘The right of life is in the hands of God,’ said Archbishop Soosa Paikam. He called the ruling ‘unfortunate and condemnable.’ Father Paul Thelakkat concurred, asserting ‘no one has the right to put an end to human life. The ultimate aim of the medical science is to save life from death. If we move away from this principle, there would be far-reaching repercussions in our society.’