Right to die with dignity: SC allows passive euthanasia with guidelines

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The court held that the right to live with dignity included smoothening of the process of dying in case of a terminally ill patient or a person in the persistent vegetative state with no hope of recovery.

Guidelines issued by the five-judge bench will be in place until the federal government enacts a law on mercy killing or passive euthanasia.

It is now legal in India for terminally ill patients to refuse medical treatment. "After this verdict, euthanasia and living will can not be misused as there will be strict guidelines", he said. Bhavna Kapadia, Chief Operating Officer of Dignity Foundation, too said that there was a need to be cautious as there could be hidden reasons why a person wanted to end his/her life.

On the other hand, Anamika Mishra, a patient of Muscular Dystrophy, is happy with the apex court's decision.

This last wish can be executed only by an adult in sound state of mind and who is in a position to communicate and comprehend the consequences of executing such a direction.

It "must be voluntarily executed" and "without any coercion or inducement or compulsion and after having full knowledge or information".

Her plight prompted the Supreme Court to decide in 2011 that life support can be removed for some terminally ill patients in certain circumstances. The document should be signed along with a witness before a judicial magistrate. A five-bench judge also defined the rule to implement the procedure in case there would be no living wills.

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Ms Virani approached the SC in 2009 as the "next friend" of Shanbaug seeking euthanasia for her. Shanbaug, who had suffered brain damage from a sexual assault and strangling by a ward boy-cum-sweeper at KEM Hospital in 1973, became the face of the euthanasia debate in the country.

"This decision shall be regarded as a preliminary opinion".

The court specified that family members of terminally ill patients can seek passive euthanasia for a patient by petitioning the court, which would then appoint a committee of doctors to evaluate the necessity of the petition.

"In the event the executor is incapable of taking a decision or develops impaired decision-making capacity, the consent of the guardian nominated by the executor in the advance directive should be obtained regarding refusal or withdrawal of medical treatment to the executor to the extent of and consistent with the clear instructions given in the advance directive", it said.

The judges pronounced four separate but concurring judgements. Every moment of our lives, our bodies are involved in a process of continuous change. "The ultimate aim of medical science is to save life from death. Both constitute essential elements in the inexorable cycle of existence". The Centre, through its draft "Management of patients with terminal illness-withdrawal of medical life support Bill', tabled in Parliament in 2016, had proposed that patients with terminal illnesses with no chance of revival be allowed passive euthanasia".

Advocate Prashant Bhushan, appearing for the NGO, said since a patient in a coma can not express his or her wishes, the law should allow him or her to put down in writing in advance that he or she should not be tortured.

"Making a decision like this is extremely hard for the family, especially when the patient is not conscious, because they have to consider what the patient would want".