Every person aspires to live a good, meaningful life, and they strive tirelessly to do so. They aspire to live extraordinary lives and pass away honourably and peacefully. Nobody wants to live in a world where being alive is worse than dying. Euthanasia, also known as mercy killing, occurs when a person’s life is terminated by another with that person’s consent. The only distinction that sets it apart from suicide is that suicide is when a person intentionally ends their own life.

In countries like Switzerland (1942), Australia (1996), the Netherlands (2001), Belgium (2002), and Luxembourg (2009) euthanasia has been legalized. Additionally, three federal states in the United States (including Oregon, Vermont, and Washington), as well as Switzerland have laws permitting Physician-Assisted Suicide (PAS). However, in India, neither the laws nor the legislation makes any unique provisions for euthanasia[1]. There have been, nonetheless, some medical cases that necessitated the need for Euthanasia to be applicable in India.

This prevailing legal position on euthanasia has been established by a series of three cases – Gian Kaur v. State of Punjab in 1996, Aruna Shanbaug v. Union of India in 2011, and finally Common Cause v. Union of India in 2018. The distinction between active and passive euthanasia is a theme that recurs frequently across these cases. Active euthanasia refers to the use of specific proactive measures to end a patient’s life, such as injecting a patient with a fatal drug dose, which directly causes the patient’s death. In contrast, passive euthanasia involves turning off life-sustaining mechanisms, leading to the patient’s death due to the underlying condition itself. The Supreme Court further elaborated on this distinction in the Common Cause case.

In the landmark judgment of Common Cause v. Union of India[2], the Supreme Court elaborated on four key issues i.e., (1) Whether the constitutional guarantee of the Right to Life includes the Right to Die. (2) Whether euthanasia can be made lawful only by legislation. (3) Whether there is a difference between passive and active euthanasia. (4)

[1] Arjun Kolhi, Euthanasia: Right To Die With Dignity, LEGAL SERVICES INDIA (20 July, 2023, 11:40AM), https://www.legalserviceindia.com/legal/article-3563-euthanasia-right-to-die-with-dignity.html.

[2] Common Cause (A Regd. Society) vs Union Of India (2018) 5 SCC 1.

Whether individuals can give ‘advance directives’ on medical treatment if they lose the ability to communicate in the future.

The story began in 2002 when Common Cause, a registered society, wrote to the Ministries of Law & Justice, Health & Family Welfare, and Company Affairs as well as State Governments, regarding the issue of the right to die with dignity. Subsequently, in 2005, Common Cause filed a petition under Article 32 seeking a declaration that the right to a dignified death is a fundamental right under Article 21 of the Constitution of India.

On February 25th, 2014, a three-Judge Bench of the Supreme Court referred the matter to a larger bench, to settle the issue in light of inconsistent opinions in Aruna Ramchandra Shanbaug v Union of India (2011)[1] and Gian Kaur v State of Punjab (1996)[2]. Later, on March 9th, 2018, a five-judge Bench comprising of the then Hon’ble Chief Justice of India Mr. Dipak Misra, Hon’ble Mr. Justice A.M. Khanvilkar (Retired) (Majority opinion), Hon’ble Chief Justice of India Mr. D Y Chandrachud (concurring opinion), and Hon’ble Mr. Justice Ashok Bhushan (Retired), Hon’ble Mr. Justice A K Sikri (Retired) held that the right to die with dignity is a fundamental right. An individual’s right to execute advance medical directives is an assertion of the right to bodily integrity and self-determination and does not depend on any recognition or legislation by a State.[3] According to the Supreme Court’s ruling, Article 21 of the Indian Constitution’s right to life intrinsically includes the right to die with dignity. Since Article 21 views dignity as its fundamental tenet, every person must have the freedom to choose whether or not to accept medical help in the event of a fatal illness. The freedom to choose not to experience pain or suffering when dying is a part of the right to live with dignity. A decent life is defined in Article 1 of the UDHR, and the concepts of the right to a dignified life are expanded in Articles 6, 7, and 18 of the ICCPR, which support this view.[4] Further, as it was a matter of constitutional interpretation, in response to the apprehensions of misuse of advance directives (or living wills), such as those expressed by the Law Commission of India in its 241st Report, the court also issued comprehensive

[1] Aruna Shanbaug v. Union of India (2011) 4 SCC 454.

[2] Gian Kaur v State of Punjab 1996 (2) SCC 648.

[3] SUPREME COURT OBSERVER, https://www.scobserver.in/cases/common-cause-euthanasia-and-the-right-to-die-with-dignity-case-background/ (last visited 20th July).

[4] Devina Srivastava, “The Right to Die with Dignity: The Indian Supreme Court Allows Passive Euthanasia and Living Wills” (OxHRH Blog, 11 April 2018), https://ohrh.law.ox.ac.uk/right-to-die-with-dignity-a-fundamental-right-indian-supreme-court-allows-passive-euthanasia-and-living-wills/.

guidelines on the procedure for execution of an advance directive as well as for giving effect to passive euthanasia.

Finally, on January 24, 2023, a five-judge Constitution Bench chaired by Justice K.M. Joseph issued a significant judgment altering the guidelines for terminally ill patients to discontinue treatment. The court’s decision aimed to simplify the processes and lessen the suffering of individuals who are terminally ill yet unable to express their preferences. The changes apply to both cases when the patient has provided instructions in an “Advance Medical Directive” (AMD) and situations where there have been no instructions provided. [1]

Thus conclusively, we can say that India’s euthanasia law has evolved through landmark judgments, affirming the right to die with dignity under Article 21 of the Constitution of India. Therefore, by recognizing individual autonomy and compassion, India’s legal framework now acknowledges the delicate balance between preserving life and respecting end-of-life decisions. As the nation continues to navigate this complex topic, the journey reflects India’s commitment to human rights and the pursuit of a dignified existence for every citizen until the end of life.

[1] SUPREME COURT OBSERVER, https://www.scobserver.in/reports/streamlining-the-process-for-passive-euthanasia-judgement-summary/ (last visited 20th July).

Author – Shantanu Garg (Associate)

Co-Author – Ananya Singh (Intern)