FROM PRECEDENT TO PRACTICE: INDIA’S EUTHANASIA LAW IN ACTION

PRADAKSHINA SARMAH

Euthanasia, derived from the Greek words ‘eu’(good) and ‘thanatos’(death), means “good death” or the intentional act of ending a life to relieve unbearable suffering caused by incurable or terminal illness.

It often refers to a painless, deliberate intervention to end life with the primary aim of alleviating physical, emotional, or spiritual distress.

Classification of Euthanasia

Active euthanasia– Active euthanasia refers to the physician’s deliberate act, usually the administration of lethal drugs, to end an incurably or terminally ill patient’s life.

There are three types of active euthanasia in relation to giving consent, namely

Voluntary euthanasia- at patient’s request,

Non voluntary euthanasia- without patient’s consent,

Involuntary euthanasia-the patient is not in a position to give consent.

Active euthanasia is not legalized in India.

Passive euthanasia- Passive euthanasia refers to withholding or withdrawing treatment which is necessary for maintaining life.

Common conditions which make patients seek euthanasia are terminally ill cancer patients, acquired immune deficiency syndrome (AIDS), and other terminally ill conditions where there is no active treatment.

Legality of Passive Euthanasia in India:

◦ A five-judge bench of the Supreme court in Common Cause vs. Union of India (2018) recognised a person’s right to die with dignity.

◦ It said that a terminally ill person can opt for passive euthanasia and execute a living will to refuse medical treatment.

◦ The Court permitted an individual to draft a living will specifying that she or he will not be put on life support if they slip into an incurable coma.

◦ The Court recognised the right to die with dignity as a fundamental right and an aspect of Article 21(Right to Life)

Landmark Judgementson Euthanasia:

The journey of euthanasia law in India can be divided into three distinct phases:

Phase 1: The Prohibition Era (1996-2010)

Initially, Indian courts took a strict stand against any form of right to die.

Gian Kaur v. State of Punjab(1996):A Constitution Bench held that the “right to life” under Article 21 does not include the “right to die.”

The court declared that suicide represents an unnatural extinction of life, and thus the right to life could not be interpreted to mean the right to end it.

Phase 2: Legal Recognition of Passive Euthanasia (2011-2017)

This phase saw a shift towards recognizing the agony of prolonged existence in a vegetative state.

◦ Aruna Shanbaug v. Union of India (2011):While denying the plea to terminate the life of Aruna Shanbaug (arguing she was not brain dead and receiving care), the Supreme Court laid the foundation for passive euthanasia in India. It legalized the withholding or withdrawal of life-sustaining treatment (passive euthanasia) in exceptional circumstances under strict guidelines involving High Court supervision.

Phase 3: Legalization of Living Wills and Streamlining (2018─ Present)

The law shifted towards strengthening patient autonomy and simplifying the process.

◦Common Cause v. Union of India(2018): A five-judge Constitution Bench recognized that the “right to die with dignity” is a fundamental right under Article 21.It authorized “Living Wills” or Advance Medical Directives, allowing individuals to outline their medical treatment preferences in advance if they become incapable of making decisions.

◦ Modified Guidelines (2023): The SC modified the 2018 judgment to make the process of passive euthanasia less cumbersome, removing the requirement for a Judicial Magistrate’s approval, replacing it with attestation by a notary or gazetted officer.

◦ Harish Rana v. Union of India (2026): In a historic 2026 ruling, the Supreme Court permitted the first direct application of these guidelines, authorizing the withdrawal of life-sustaining treatment, including nutrition and hydration, for a patient in a vegetative state for 13 years.

Key Reforms in the Euthanasia Framework are as follows:

Simplification of Advance Directives (Living Wills): The 2023 and 2026 Supreme court rulings removed the need for judicial magistrate’s attestation, allowing for easier, faster notarization.
Digitalization: Implementation of a National Euthanasia Portal linked to Aadhaar for registering and accessing advance directives by doctors.
Decentralized Decision-Making: Shifting authority from district authorities to hospital-level ethics committees (comprising doctors, palliative care specialists) to speed up decisions within 48-72 hours.
Clarification of Procedures: Defining that “Passive Euthanasia” can include the withdrawal of Clinically Assisted Nutrition and Hydration (CANH), particularly highlighted in the 2026 Harish Rana case.
Mandatory Safeguards: Retaining a cooling-off period and expert evaluation to prevent misuse and protect vulnerable patients from coercion.

India has moved from a largely theoretical right to die towards a practical, court-supervised framework: the Supreme Court’s 2018 Common Cause ruling recognised Advance Medical Directives and Passive Euthanasia, and the 2026 Harish Rana Decision applied those principles to permit withdrawal of life support in a long-term vegetative case – signaling a push to make passive euthanasia more accessible while stressing strict safeguards.

India’s evolving euthanasia framework balances individual dignity and societal safeguards. The jurisprudence now recognises the right to refuse life-prolonging treatment and provides a pathway to operationalise it, but implementation gaps ─ especially in accessibility and institutional capacity – remain the central policy challenge.

Pradakshina Sarmah: She is an emerging legal professional passionate about writing contents on diverse topics.

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