The Supreme court recognizes “living will” grants right to die with dignity

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Right to dignity includes right to refuse treatment and die with dignity.

In a historic decision, the Supreme Court declared passive euthanasia and the right of persons, including the terminally-ill, to give advance directives to refuse medical treatment permissible.

A Constitution Bench led by Chief Justice of India Dipak Misra, in three concurring opinions, upheld that the fundamental right to life and dignity includes right to refuse treatment and die with dignity.

The fundamental right to a “meaningful existence” includes a person’s choice to die without suffering, the apex court held.

Chief Justice Misra spoke about how societal pressure and fear of criminal liability by relatives and medical doctors ultimately led to the suffering and the undignified death of the patient.

The court said it was time to dispense with such shared suffering and sense of guilt and face reality. Doctors who attend the terminally-ill are under pressure and dither in letting the patient go, apprehending criminal liability and fear of being drawn into the “vortex” of a possible family struggle for inheritance.

Chief Justice Misra, in a common judgment with Justice A.M. Khanwilkar, said it was time to “alleviate the agony of an individual” and stand by his right to a dignified passing. A dignified death should follow a meaningful existence, the five-judge Bench agreed in a unanimous voice.

Justice A.K. Sikri, in his separate opinion, said though religion, morality, philosophy, law and society share equally strong and conflicting opinions about whether right to life includes right to death, they all agree that a person should die with dignity.

Hence, the court, Justice Sikri said, is rightly in favour of the right to die with dignity.

Justice Sikri said an advance directive or living will from a patient to stop medical treatment at a particular stage — “particularly when he is brain dead or clinically dead or not revivable” — quells apprehensions of future regret for relatives and criminal action against doctors.

The Chief Justice’s judgment includes specific guidelines to test the validity of a living will, by whom it should be certified, when and how it should come into effect, etc. The guidelines also cover a situation where there is no living will and how to approach a plea for passive euthanasia.

In a separate opinion, Justice Chandrachud observed that modern medical science should balance its quest to prolong life with the need to provide patients quality of life. One is meaningless without the other, Justice Chandrachud observed.

Justice Chandrachud said the issue of death and when to die transcends the boundaries of law, but the court has intervened because it also concerns the liberty and autonomy of the individual.

He read from his judgment that the sanctity of life includes the dignity and autonomy of the individual. He said the search for a meaningful existence, the pursuit of happiness includes the exercise of free will.

“Free will includes the right of a person to refuse medical treatment,” Justice Chandrachud observed.

A person need not give any reasons nor is he answerable to any authority on why he should write an advanced directive.

But the judge held that active euthanasia is unlawful.

For this reason, he said the reasons given by a two-judge Bench of the Supreme Court in the Aruna Shanbaug case allowing passive euthanasia are “flawed” as the convoluted procedure to get a go-ahead for passive euthanasia makes the dignity of a dying person dependent on the whims and will of third parties.

“To deprive a person dignity at the end of life is to deprive him of a meaningful existence,” Justice Chandrachud read from his opinion he sharea with Justice Ashok Bhushan.

 

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