Justice Ashok Bhushan

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 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 looses 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 LOOSES CAPACITY TO TAKE A DECISION.