‘BEST INTEREST OVER STATE INTEREST’

PATHBREAKING VERDICT Excerpts from the judgment delivered by the fivemember Supreme Court bench that allowed passive euthanasia for terminally ill patients

I may add that the issue is not purely a legal one. It has moral and philosophical overtones. It has even religious overtones.

Life is mortal. It is transitory. It is as fragile as any other object. It is a harsh reality that no human being, or for that matter, no living being, can live forever. Nobody knows how long he/she will be able to live. The gospel truth is that everybody has to die one day, notwithstanding the pious wish of a man to live forever. As Woody Allen said once: “I do not want to achieve immortality through my work. I want to achieve it through not dying.” At the same time, nobody wants to have a tragic end to life. We all want to leave the world in a peaceful manner. In this sense, the term ‘euthanasia’ which has its origin in Greek language signifies ‘an easy and gentle death’.

Euthanasia is one such critical issue where the law relating to it cannot be divorced from morality

This court acknowledges its awareness of the sensitive and emotional nature of euthanasia controversy, and the vigours of opposing views, even within the medical fraternity, and seemingly absolute convictions that the subject inspires. This is so demonstrated above while discussing philosophical, moral, ethical and religious overtones of the subject involved. These valid aspects, coupled with one’s attitude towards life and family and their values, are likely to influence and to colour one’s thinking and conclusions about euthanasia. Notwithstanding the same, these aspects make the case as ‘hard case’. However, at the end of the day, the court is to resolve the issue by constitutional measurements, free of emotion and of predilection

Having regard to the aforesaid right of the patients in common law, coupled with the dignity and privacy rights, it can be said that passive euthanasia, under those circumstances where a patient is in PVS and he is terminally ill, where the condition is irreversible or where he is brain dead, can be permitted. On the aforesaid reasoning.

My last remarks are a pious hope that the legislature would step in at the earliest and enact a comprehensive law on ‘living will/ advance directive’ so that there is a proper statutory regime to govern various aspects and nuances thereof which also take care of the apprehensions that are expressed against euthanasia. unconditional. Neither the law nor the Constitution compel an individual who is competent and able to take decisions, to disclose the reasons for refusing medical treatment nor is such a refusal subject to the supervisory control of an outside entity.

The Constitution bench in Gian Kaur’s case held that the “right to life, including right to live with human dignity” would mean the existence of such right up to the end of natural life, which also includes the right to a dignified life up to the point of death including a dignified procedure of death. The above right was held to be part of fundamental right enshrined under Article 21 of the Constitution, which we also reiterate.

We agree with the observation made in the reference order of the three-judge bench to the effect that the Constitution bench in Gian Kaur’s case did not express any binding view on the subject of euthanasia. We hold that no binding view was expressed by the Constitution bench on the subject of euthanasia.

The Constitution bench, however, noted a distinction between cases in which physician decides not to provide or continue to provide for treatment and care, which could or might prolong his life and those in which he decides to administer a lethal drug even though with object of relieving the patient from pain and suffering.

The later was held not to be covered under any right flowing from Article 21. Thus, the law of the land as existing today is that no one is permitted to cause death of another person including a physician by administering any lethal drug even if the objective is to relieve the patient from pain and suffering.

An adult human being of conscious mind is fully entitled to refuse medical treatment or to decide not to take medical treatment and may decide to embrace the death in natural way.

Euthanasia, as the meaning of word suggests, is an act which leads to a good death. Some positive act is necessary to characterise the action as euthanasia. Euthanasia is

While upholding the legality of passive euthanasia (voluntary, non-voluntary) and in recognising the importance of advance directives, the present judgment draws sustenance from the constitutional values of liberty, dignity, autonomy and privacy. also commonly called “assisted suicide” due to the above reasons.

We are thus of the opinion that the right not to take a life-saving treatment by a person, who is competent to take an informed decision, is not covered by the concept of euthanasia as it is commonly understood... The right of patient who is incompetent to express his view cannot be outside of fold of Article 21 of the Constitution of India.

We also are of the opinion that in cases of incompetent patients who are unable to take an informed decision, “the best interests principle” be applied and such decisions be taken by specified competent medical experts and be implemented after providing a cooling period to enable aggrieved person to approach the court of law.

An advance medical directive is an individual’s advance exercise of his autonomy on the subject of extent of medical intervention that he wishes to allow upon his own body at a future date, when he may not be in a position to specify his wishes. The purpose and object of advance medical directive is to express the choice of a person regarding medical treatment in an event when he loses capacity to take a decision. The right to execute an advance medical directive is nothing but a step towards protection of aforesaid right by an individual.

The right to die with dignity as a fundamental right has already been declared by the Constitution bench judgment of this court in Gian Kaur case (supra) which we reiterate.

We declare that an adult human being having mental capacity to take an informed decision has right to refuse medical treatment including withdrawal from life-saving devices. A person of competent mental faculty is entitled to execute an advance medical directive in accordance with safeguards.

THE PURPOSE AND OBJECT OF ADVANCE MEDICAL DIRECTIVE IS TO EXPRESS THE CHOICE OF A PERSON REGARDING MEDICAL TREATMENT IN THE EVENT WHEN HE LOSES CAPACITY TO TAKE A DECISION