A latest Constitution bench judgment of the apex Court has authoritatively held that “meaningful existence of a human being” includes his choice to die without suffering.
The Court enunciated a broader legal framework protecting the dignity of terminally ill patients or patients in persistent vegetative state (PVS) with perceived less scope of recovery.
The jurisprudence laid down in Aruna Shanbaug (2011) has been expanded by according primacy to the constitutional values of liberty, dignity, autonomy and privacy of a person.
It is significant, since it empowers an individual to decide his fate in case of acute and painful diseases with poor chances of recovery.
In the aftermath of this verdict, an individual can draft a “living will” and his relatives and doctors will be obliged to execute his option for death rather than enduring prolonged suffering.
It offers great relief for hundreds of Indian families who spend so much time, money and mental agony on medical treatment of their near and dear ones who are terminally ill.
It has been held that advance medical directive or living will in case of passive euthanasia is in accordance with the constitutional precept though such instances of “acceptance” of euthanasia in ancient times have been largely rejected by physicians, philosophers, and ethicists especially in the past two millennia.
The interest in hastened death by choice regained support from some sections of the medical and scientific communities in the late 19th century though it was short lived. The modern interest in assisted suicide began to resurface in public debates since 1980s.
At present, euthanasia is legal in the Netherlands, Belgium, Colombia, Luxembourg, Canada and medically assisted suicide is legal in Switzerland, Germany, Japan, South Korea and in some states of the US.
Based on both philosophical ideas and religious beliefs, human life is sacred and should be protected whenever possible. There is no “right to die” enshrined in the Constitution, nor is there any moral claim to end one’s life.
According to religious tenets, life is a gift given by God and should only be taken by God or his naturally ordained process of death. Hinduism does not support mercy killing. Christianity, Judaism and Islam also emphasise on the “sanctity of human life”.
Our moral tradition and our laws have uniformly condemned these practices; it is simply inaccurate to say that the right to assist in ending human life is a personal right inherent in an individual. Our history prohibits such dangerous conduct, though the latest judgment goes contrary to this position.
The duty of the state
The Constitution recognises inalienable right to life that the government has a topmost duty to protect.
The state places highest importance to protect lives of all its citizens. Yet, these claims fail to recognise that life is already measured, and society often ends lives prematurely under specific state sanction.
However, the pro-good death lobby believes that end-of-life decisions are personal matters that should not involve government interference for three reasons:
(1) End-of-life matters typically fall within the realm of personal freedom;
(2) End-of-life decisions are private medical matters that should be protected as private, and
(3) Prolonging a patient’s life against his or her wishes wastes resources that the patient may not want to drain from his or her family or society.
Judicial Journey
Although early laws in the west were rigid in dealing with such cases, more recent developments have gradually expanded the boundaries and defined the conditions under which hastened death can occur.
In the United States, this process began with the Quinlan Case (1976), which upheld the right to terminate life-sustaining interventions.
Subsequent Supreme Court cases such as Cruzan (1990), Glucksberg (1997), and Quill(1997) have further established parameters of interventions to hasten death.
Indian Courts have responded differently from case to case by putting the sanctity of life at a higher pedestal. In P.Rathinam case(1994), the Apex Court held that Section 309 of the IPC was irrational and sought to humanise penal laws though it was overruled in Gian Kaur’s Case(1996).
In this case, a five judge Constitutional Bench held that the “right to life” is inherently inconsistent with the “right to die.” In Samira Kohli case (2008), the Supreme Court laid down certain path-breaking guidelines to be followed to obtain the patient’s consent which should be real and valid.
This may include information regarding the nature of treatment, alternatives if any, risks associated with a particular treatment etc. These guidelines are, by all means well-founded because they indeed enable an individual, to harmoniously exercise his Right to Life as guaranteed in Article 21.
The latest Common Cause judgment has expanded the jurisprudence of Aruna Ram Chandra Shanbaug case (2011) wherein the apex Court held it illegal to allow active mercy killing but allowed passive euthanasia (with guidelines).
“The death with dignity,” or “physician-assisted suicide” creates a huge obligation on doctors in reaching a conclusion taking into account factors leading to the treatability of the diseases vis a vis the wishes of the patients, social value system etc.
It is still a controversial subject which is much talked about but actually affects very few people. However, the issue cries for a strong legislative backing with enlightened public discourse.
In Common Cause Case (2018), the apex Court has interpreted that the right to die peacefully without suffering comes under the right to life (Art.21).
However, the liberty associated with ending one’s life is riddled with so many complicated questions given the cultural, religious and legal systems in India.
On the other hand, liberty of a person is also equally important in relation to his choice to die when faced with a condition of unending suffering.
The latest judgment has tried to strike a balance by evolving some objective standards to discourage any devious idea to end somebody’s life who is terminally ill.
In order to strike a fine balance between right to life and the liberty to die, it is imperative that legalising the right to die be allowed sparingly in some of the rarest of rare cases as per the guidelines framed by the Apex Court.
The founding fathers of the Constitution recognised and established primacy of liberty over the very fundamental right to life as Patrick Henry states “Give me liberty or give me death.”
The writer is an advocate of the Supreme Court