In ancient times, critically ill patients were expected to die a natural death which was also considered morally and ethically suitable. In such cases, extra-ordinary medical treatment would lead to unnecessary delay in the occurrence of natural death. Therefore, the concept of the right to die cannot be said to be a modern phenomenon as it is as old as the human civilization.
Inference of Right to die can be drawn from mythology as well. Mythology says lord Ram and his brothers took ‘jalasamadhi’ in river Saryu. Ancient history says, Buddha achieved death by seeking it. But, Christianity and Islam forbid the concept of right to die. Ideally, a court of secular country should not give credence to religious texts and our judgements should avoid religious discourse.
Legal Status of Right to Die in India
The question which arises here, is that whether the right to end one’s life comes under the periphery of right to life with dignity. There have been various perspectives over this point.
However, for the first time this question was raised in the case of State of Maharashtra v. Maruty Sripati Dubal, where the court examined the constitutionality of section 309 (Attempt to commit suicide) of IPC.
So, the court came to conclusion that section 309 is ultra vires to the constitution being violative of article 14 and 21. Therefore, right to die comes under the periphery of right to life but this decision was overruled in case of Chenna Jagadeeswar and Anr. V. State of Andhra Pradesh. In this case, the court held that section 309 of IPC is completely valid and does not violate article 21.
Right to Die can be of two types:
Later, in the case of P. Rathinam V. Union of India the Supreme Court examine the constitutional validity of section 309 and compare article 19 and 21 of the Indian Constitution. The court observed that article 19, where it gives the freedom to speak it also includes the right not to speak likewise, in article 21 includes right to life as well as right to die. Thus, section 309 was held to be unconstitutional.
Later, this judgement was overruled in Gian Kaur V. State of Punjab. In this case, petitioners were convicted by trial court for abetment of suicide under section 306 of IPC. On the basis of P. Rathinam V. Union of India petitioners argued that right to life includes right to die. So, a person abetting suicide is merely assisting in enforcement of article 21. The court refused this argument and held that section 306 which is abetment to suicide enact a distinct offence which can survive independent of section 309.
Then, court also held that section 309 is constitutionally valid because article 21 guarantees protection of life and personal liberty, by no stretch extinction of life can be included in protection of life because suicide is unnatural termination of life. Therefore, suicide is inconsistent with the concept of right to life.
Difference between Suicide and Euthanasia
Most of the people commit the mistake of considering suicide and euthanasia as same. But, they are completely different from each other.
Suicide is an act of ending one’s own life intentionally with self help. There can be various reasons for doing so like depression, career stress, relationship problems, etc. There can also be various means for ending one’s own life like drinking poison, jumping from height, drug overdose, etc. There are proper legal provisions for suicide in IPC and is a punishable offence.
Whereas, euthanasia is painless killing (also known as mercy killing) of a patient suffering from incurable or extremely painful disease or is in irreversible coma. The sole reason for euthanasia is to relieve the patient from such pain. There are very limited means for ending patient’s life like injecting lethal substance (active euthanasia), withdrawing life support systems (passive euthanasia). Only passive euthanasia is legal in India with very strict guidelines.
The difference between suicide and euthanasia was observed in the case of Naresh Marotrao Sakhre v. Union of India.
Euthanasia refers to a gentle death or painless killing in case if a person is suffering from any incurable or painful disease or irreversible coma.
Types of Euthanasia
1. On the basis of procedural decision
- Active Euthanasia: Also known as aggressive euthanasia, in which death is caused to the patient by using lethal substance. Eg.- injecting lethal dose of a drug.
- Passive Euthanasia: Intentionally letting a patient die by withdrawing artificial life support such as a ventilator or feeding tube.
2. On the basis of consent
- Voluntary: when the patient himself gives the consent to end his life.
- Non-Voluntary: when the patient is not in the state to give the consent for end his own life.
- Involuntary: when the patient’s life is ended against their will or their consent have not been obtained.
In Gian Kaur V. State of Punjab, the apex Court also held that Euthanasia is only permitted through an express legislation in this regard.
K. Venkatesh’s case in which a 25 year old patient was suffering from muscular dystrophy was kept confined to a wheel chair since 15 years. He demanded death so that his organs could be donated. But, his request was turned down by the court just a day before his death.
Case analysis: Aruna Ramchandra Shanbaug V. Union of India
FACTS: Aruna Shanbaug, a 25 year old from Uttar Kannada, was a nurse working in King Edward Memorial Hospital, Mumbai. On the night of 27 November 1973, she was sexually assaulted by Sohanlal Bhartha Walmiki, a sweeper on contract at the same Hospital.
Sohanlal attacked her while she was changing clothes in the hospital basement. He wrapped a canine/dog chain around her neck and pulled her back with it. He attempted to rape her however, after finding that she was chumming, he sodomized her.
The following day, a cleaner found her in conscious state lying on the floor with blood all over the place and her body. Strangulating her neck with the dog chain resulted in cut off oxygen to her brain, subsequently leading to injure the cerebrum.
ISSUE: Does right to life (article 21) include right to die?
Petitioner Pinki Virani, relied on the Gian Kaur’s case decision that a person who is in permanent vegetative state or terminally ill, he must be permitted to end his life.
After, a lengthy discussion on euthanasia and its types, the court permitted passive euthanasia in India with certain conditions and laid down a proper procedure for it. Therefore, this case is not only about violation of article 21 but about a person who is in permanent vegetative state to die peacefully. The court also explicitly explained meaning and types of euthanasia.
Finally, in the case of Common Cause V. Union of India, the Supreme Court held that right to die with dignity comes under right to life (article 21). This ruling permitted the withdrawal of life-support systems for the terminally ill or those in irreversible comas. Therefore, passive euthanasia is legal in India under certain conditions.
Arguments in favour of Euthanasia
- Relief from pain: Persons who are suffering from diseases which are extremely painful and incurable, cab be relieved.
- Last resort: when there is no option left, then the only way is to end one’s life with their consent subsequently leading to peaceful death.
- Frees up Medical Funds: even in hopeless cases, people spend a lot of money on high tech healthcare facilities. If euthanasia is considered as a choice, money would not be spent on these kinds of dead-end cases and the machines could be used by other patients who are in dire needs.
- The right to die should be a personal choice, not one that the government mandates.
Arguments against Euthanasia
- Devaluation of human life: every life on existing on this planet is precious. Therefore, ending someone’s life seems that the life of a human being is undervalued.
- Predictions are not always correct: the prediction of a terminal diagnosis is not always accurate and euthanasia is only for terminal cases. This can lead to wrong choices subsequently leading to loss of life.
- It avoids the benefits of palliative care: instead of trying to improve the condition of the patient, euthanasia seeks to take what remains of a person’s life away from them.
- Euthanasia would require a change to the legal and medical statutes in the country. It was believed that more complex laws and structure have to created.
- Issues with consent: sometimes, doctors are unwilling to provide lethal prescription or withdrawing the life supporting systems due to ethical reasons.
Euthanasia and the Poor
Some of the judges have commented in the latest case, that problem with euthanasia is that most of the medical facilities is unavailable to the poor due to high cost of medical treatment in India.
India’s spending on healthcare is among the lowest in the world. According to a joint report published by WHO and the World Bank stated that 49 million Indians are pushed into poverty year due to out of pocket expenditure on healthcare.
Passive euthanasia is simply about ending a patient’s life through withdrawal of life supporting systems. But, what about the poor who can’t even afford them. The only way leading to peaceful death for poor is through suicide or active euthanasia (injecting a lethal substance) which is illegal.
Therefore, Indian government should take some steps to reduce the cost of healthcare facilities and make them accessible easily.
A deep analysis can be made from the aforementioned about the concept of ‘Right to Die in India’. It is evident from the history and mythology that right to die is not a modern phenomenon. A person can end his own life through suicide or euthanasia.
Right to die has always been the most hot and debatable topic in the country as, attempt to suicide is a punishable offence. On the other hand, euthanasia has emerged as a highly sensitive issue over a decade and there were thousands of debate over this topic. The main point of concern in this whole debate is that nobody can escape from death but one thing which every man deserves is right to life as well as right to die with dignity. No one should be deprived from this right. Therefore, passive euthanasia have been legalised with very strict guideline for the patients in extreme pain to die peacefully.
- 1987 (1) BOMCR499
- 1988 CRI LJ 549
- AIR 1994 SC 1844
- AIR 1996 SC 946
- 1996 (1) BomCR 92
- K.Venkatesh Alias K. Venkatesan vs The State Of Andhra Pradesh, 19 December, 2014
- (2011) 4 SCC 454
- (2018) 9 SCC 382
This Article has been written by Kritika Vij, from Amity Law School, Noida.