Context

• The Supreme Court of India for the first time permitted passive euthanasia and recognized the fundamental right to die with dignity.

Background :

• Harish Rana, a resident of Ghaziabad, suffered severe head injuries in August 2013 after falling from the fourth floor of a paying guest (PG) hostel in Chandigarh.
• Accident: On the day of Raksha Bandhan in 2013, the 20-year-old engineering student fell from the fourth floor of his PG accommodation in Chandigarh.
• Injury: Due to severe head trauma and prolonged coma, he developed quadriplegia (paralysis of all four limbs).
• Life condition: For the past 13 years, he remained on ventilator support, feeding tubes, and other life-support systems with no possibility of recovery.

Supreme Court Verdict :

• The bench comprising Justice J. B. Pardiwala and Justice K. V. Viswanathan delivered the judgment.
• Approval of euthanasia: After reviewing medical reports, the Court allowed passive euthanasia under the principle of “Right to Die with Dignity.”
• Basis of the decision: The Court observed that there was no possibility of recovery and that continuing life in such a painful condition was not justified.
• Special direction: The Court directed All India Institute of Medical Sciences to place Harish Rana under palliative care (pain management) before withdrawing life-support treatment.

Constitutional Basis :

• Article 21: The Court clarified that the right to life guaranteed under Article 21 of the Constitution of India also includes the right to die with dignity.
• Inseparable right: According to the Court, the right to die with dignity is inseparable from the right to receive quality palliative care.

Euthanasia :

• Euthanasia refers to intentionally ending the life of a person suffering from an incurable illness or unbearable pain in order to relieve suffering.

Types of Euthanasia :

• Active Euthanasia: Deliberately causing death through injections or drugs. This form is illegal in India.
• Passive Euthanasia:Withdrawal or withholding of life-support systems such as ventilators or medication, allowing natural death to occur.
• Voluntary Euthanasia:Carried out with the explicit consent of the patient.
• Non-Voluntary Euthanasia: Occurs when the patient is unable to make a decision, such as in cases of coma or severe cognitive impairment.

Legal and Constitutional Position of Euthanasia in India

• The legal framework in India attempts to balance the right to life with the ethical debate surrounding the right to die.

Active vs Passive Euthanasia: Legal Distinction :

• Active Euthanasia:This is completely illegal and punishable in India. Under the Bharatiya Nyaya Sanhita, 2023, any intentional act causing a person’s death is treated as a criminal offense.

Depending on the circumstances, it may fall under:

• • Section 101 (Murder) or
  • Section 100 (Culpable Homicide Not Amounting to Murder).
• Passive Euthanasia: The Supreme Court has recognized passive euthanasia in specific circumstances, particularly where a patient suffers from an incurable illness and recovery is medically impossible.

In such cases, life-support systems like ventilators may be withdrawn following strict legal and medical procedures.

Article 21 and the Principle of Dignified Death

• Article 21 of the Constitution guarantees not only the protection of life but also the right to live with human dignity.
• Judicial interpretation has clarified that:
  • The right to life does not normally include the right to die.
  • However, when a person’s existence becomes one of extreme suffering due to terminal illness, the concept of “death with dignity” may be recognized as an extension of the right to life.

Law Commission’s Perspective :

The Law Commission of India in its 241st Report (2012) contributed significantly to the legal debate.

• Patient autonomy:A mentally competent patient has the right to refuse life-sustaining medical treatment.
• Protection for doctors: If doctors act according to the patient’s informed consent and discontinue treatment, they should not be held guilty of abetment of suicide or homicide.

Landmark Judicial Pronouncements on Euthanasia

• Maruti Shripati Dubal vs State of Maharashtra (1987)
• The Bombay High Court adopted a progressive approach and held that the right to die could be interpreted as part of the right to life under Article 21.
• The Court reasoned that individuals suffering from incurable illnesses or unbearable pain should have the freedom to choose death.

Gian Kaur vs State of Punjab (1996) :

• The Supreme Court of India overturned the Bombay High Court’s view.
• It ruled that the right to life does not include the right to end one’s life, emphasizing that life is a natural right that must be protected.

Aruna Shanbaug vs Union of India (2011) :

• This case became a landmark in Indian legal history.
• The Supreme Court recognized passive euthanasia for the first time, allowing withdrawal of life support in cases where patients are in a permanent vegetative state, subject to strict medical safeguards.

Common Cause vs Union of India (2018) :

• In this historic judgment, the Supreme Court clearly distinguished between active and passive euthanasia.
• The Court held that:
  • A person suffering from a terminal illness has the fundamental right to die with dignity.
  • Individuals can issue advance medical directives, commonly known as Living Wills, specifying that they should not be kept alive through artificial life-support if they become incapable of making decisions.

Countries Where Active Euthanasia is Legal :

• Netherlands (2002): First country in the world to legalize euthanasia; also allows “duo euthanasia” (partners choosing death together).
• Belgium (2002): Permits euthanasia even for minors in cases of terminal illness.
• Canada (2016): Allows euthanasia under the MAID (Medical Assistance in Dying) law.
• Other countries: Colombia, Luxembourg, Spain (2021), New Zealand (2021), and Ecuador (2024).
• Australia: Legal across all six states, including Victoria and New South Wales.

Countries Allowing Assisted Suicide :

• Switzerland: Legal since the 1940s; uniquely allows foreign nationals to access assisted suicide services through organizations such as Dignitas.
• United States: Around 10–11 states, including Oregon, Washington, California, and Vermont, allow assisted suicide. The law also came into effect in Delaware on 1 January 2026.
• Other countries: Austria, Germany, and Italy permit it under specific conditions.