Euthanasia in India: Is right to die with dignity legal?

In layman's terms, the right to die implies a person’s right to end his/her life. In contrast, in a legal sense, it means a doctor, when allowed by law, to end a person’s life by painless means, as long as the person and their family agree. It is also called aid in dying law, death with dignity law, or assisted suicide. On the other hand, the constitution of India provides article 21, which is known as the heart of the constitution. It is a fundamental right that protects life and personal liberty and states that a human being is entitled to make any decision relating to their life. This article will focus on major judgments and arguments on whether the right to die is discrepant from the right to life or it is included under the article 21 itself. 

Is attempt to suicide legal in India?

First of all, Section 309 of IPC deals with a suicide attempt, stating that whoever attempts to commit suicide and does any act towards the commission of such offense shall be punished with simple imprisonment for a term which may extend to one year 1[or with fine, or with both].So, India has only one law related to suicide under Section 309, which criminalizes attempts to commit suicide 

• In 1994, in the landmark case of P. Rathinam v. Union of India, the Supreme Court decriminalized the attempt to suicide; it understood the undertone behind every law; say, for example, freedom of movement also includes freedom not to move

• But in 1996, in the landmark case of Gian Kaur, the five-judge constitutional bench overruled P. Rathinam's judgment and criminalized attempt to suicide and said the right to life does not include the right to die or the right to be killed. So, Section 309 of IPC didn't violate article 21 of the Indian Constitution and upheld the section.

• The law commission in 2014 argued that a person trying to suicide needs care and counselling and not imprisonment; considering the point, the supreme court called states for input, and 18 states and 4 UTs were in favour of deletion of article 309, and finally under Mental Healthcare Act 2017 decriminalized suicide.   

• In 2018, in the case of Common Cause v. Union of India, a five-judge bench of the Supreme Court overturned the Gian Kaur case and unanimously held that the right to die with dignity is a fundamental right. But this case did not strike down any section of IPC regarding the same, that is, section 309 IPC.

What is Euthanasia?

Euthanasia comes from a Greek word meaning ‘pleasant death.’ It is different from suicide. It means mercy killing assisted by a physician; it is normally asked for a bedridden person, like in the case of a coma where it is said death would be a better place than a painful life. Euthanasia is of two types; Active euthanasia, where death is caused by external intervention, most likely through a drug or lethal injection; passive euthanasia, which occurs when living aids or assistance are removed like oxygen. A person is allowed to die of a natural cause.  

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Arguments against Euthanasia 

1. Hampering the situation – there is a possibility that if the government legalized euthanasia, a disadvantage could be taken out of the situation to get a hand on property or inheritance.

2. Contradictory to a fundamental right- fundamental rights are the most rigid thing in the constitution of India, especially article 21, which talks about the right to life, and euthanasia promotes unnatural termination of life, therefore, violating the right to life

3. Increased malpractice at health care centers- already, many poor are denied adequate health treatment after euthanasia is legalized; this malpractice will be done openly.

4. Suffering should be alleviated by better care- the need behind euthanasia is to eliminate the suffering; many argue that it should be done through better treatment and medical facilities.

5. Diminishing the last hope of survival

Arguments supporting euthanasia 

1. Right to die with dignity- a certain incurable disease that causes slow death horrifies people, and every person deserves a dignified death.

2. Takes off the burden of care- people who do not have family or family to help take off the burden of managing bills and care.

3. Encouraging organ transplant- a systematic death prevents rusting of organs that can be used for needy 

Types of Euthanasia

Euthanasia is of two types- Active and Passive. In India, passive euthanasia is legal and not active euthanasia. Passive euthanasia has been recognized in the landmark judgment of Aruna Ramachandra Shanbaug v. Union of India; Thus, in India, too, euthanasia has been recognized as a facet of Article 21 of the Indian Constitution to some extent.

1. Active Euthanasia

Active Euthanasia means injecting a patient with a dose of a lethal drug that would end his or her life or, say, poison him. In India, active euthanasia is expressly illegal. If a doctor administers active euthanasia, he shall be convicted under Section 304 of IPC (Punishment for Culpable Homicide not amounting to Murder). On the other hand, if a person administers euthanasia himself, if alive, he would be convicted under Section 309 of IPC (Attempt to Suicide).

2. Passive Euthanasia

Passive euthanasia means the withdrawal of life-saving support from the patient. Such form of euthanasia has been permitted to be administered in case a patient is in a Persistent Vegetative State (PVS), meaning coma. This has been allowed in India to end the pain and suffering of a patient bedridden for a very long time, and there is no chance of revival left. Thus, our subject of discussion is limited to passive euthanasia in India.

The Aruna Ramachandra Shanbaug Case

The petitioner, in this case, stated that  Aruna Ramachandra Shanbaug was a staff Nurse working in King Edward Memorial Hospital, Parel, Mumbai. In 1973, she was attacked by a sweeper in the hospital who wrapped a dog chain around her neck and yanked her back with it. He tried to rape her but found out that she was menstruating, so he sodomized her. To stop her from retailiating, he twisted the chain around her neck. The next day, a cleaner found her unconscious lying on the floor with blood all over. It was alleged that due to strangulation by the chain, the supply of oxygen to the brain stopped, and the brain got damaged. So, she went in coma. Thirty-six years lapsed since the said incident and she was surviving on mashed food and it was said that there was no chance of improvement in her medical condition. Therefore, it was prayed to direct the Respondents to stop feeding Aruna and let her die in peace. 

In this case, the Supreme Court laid down guidelines for passive euthanasia. The guidelines were:

• Withdrawal of life support system which ultimately lead to a person’s death.
• This verdict made passive euthanasia possible in India in certain conditions.
• Later in 2018, the Supreme Court passed another order in the case of Common Cause v. Union of India, in which right to die with dignity was again recognized and  passive euthanasia was legalized.
• The Court also provided with the concept of “living wills” which is a document that allows a person to make decisions in advance with regard to what course of treatment he wants in case he gets seriously ill in the future and becomes unable to take decisions. 

Status of Euthanasia in other countries

Conclusion 

Euthanasia is a subjective issue, and different personalities can have different opinions; therefore, taking a concrete decision on such a sensitive topic which is even ignored by big economies like the US, shouldn’t be hurried now. The right to life aims in the positive direction of protecting life thus right to die shall not be included with it; instead of providing the right to die center, as well as people should aim at enhancing health care facilities and awareness.