In a landmark ruling, the Supreme Court has allowed passive euthanasia, stating that human beings have the right to die with dignity.  The apex court has permitted an individual to draft a ‘living will’ specifying that they not be put on life support if they slip into an incurable coma. However, it has also set out strict guidelines that will govern when and how it is permitted.

The order was passed by a five-judge Constitution bench including the Chief Justice of India.  Though the judges gave four separate opinions, all of them were unanimous that a 'Living Will' should be allowed. This is because an individual should not be allowed to continue suffering in a vegetative stage when they have given an advanced will that if their condition is such that chances of revival are nil their will should be respected.

Speaking about this, Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “Just as every person has the right to life, he/she also has the right to die with dignity. It is inhuman to force them to live on life support: not only is it a torture for the person and the family but also increases the cost of stay at the hospital. Thus, this decision by the SC needs to be applauded. There are some other facts to be considered. Advance directives (ADs) talk about whether the documents a person completes while still in possession of decisional capacity. It is important to remember that ADs are only acted upon when the patient has lost the ability to make decisions for himself and can be revoked orally or in writing by the patient at any time. Second is the Durable Power of Attorney for Health Care (DPAHC) or Health Care Proxy and third is the Living Will (LW). LW is a document summarizing a person’s preferences for future medical care.”

A typical LW takes effect when the person is terminally ill without chance of recovery and outlines the desire to withhold heroic measures. It addresses resuscitation and life support and gives a general sense of the patient’s wishes. LW can be modified by the patient to include specific interventions such as cardiopulmonary resuscitation, ventilatory support, or enteral feeding.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “In passive euthanasia, the life support system of a terminally ill patient who is in a vegetative state is withdrawn. In active euthanasia, a patient is put to death through a lethal injection. Active Euthanasia has more likelihood of being misused by unscrupulous individuals to attain their ulterior motives and therefore, may not be approved.”

There are different euthanasia laws in each country. The British House of Lords Select Committee on Medical Ethics defines euthanasia as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering". In the Netherlands and Flanders, euthanasia is understood as "termination of life by a doctor at the request of a patient". Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary. Voluntary euthanasia is legal in some countries. Non-voluntary euthanasia (patient's consent unavailable) is illegal in all countries. Involuntary euthanasia (without asking consent or against the patient's will) is also illegal in all countries and is usually considered murder. As of 2006, euthanasia is the most active area of research in contemporary bioethics.