Right To Die With Dignity - Passive Euthanasia Permissible With Guidelines - Says SC

How sexual assault victim Aruna Shanbaug's case started the national debate on euthanasia

The Supreme Court judgment on Friday, allowing a person suffering from terminal illness to refuse medical treatment to avoid "protracted physical suffering" drove a wedge between the scientific and religious domains. The living will is defined as the person's right to issue a pre directive where in which he or she allows the withdrawal of life support or discontinuation of medicine if a situation arises in future of person being in a terminally ill state.

The CJI, while reading out the judgment, said that though there were four separate opinions of the bench but all the judges were unanimous that the "living will" should be permitted since a person can not be allowed to continue suffering in a comatose state when he or she doesn't wish to live. "Following the Supreme Court ruling, the Centre will now have to frame guidelines on the matters around the issue, like who can carry out the process, what is the role of caregivers and such", says Jha.

"In India, you must guard against people terminating the life of another person for properties and other things".

Her plight prompted the Supreme Court to decide in 2011 that life support can be removed for some terminally ill patients in certain circumstances. "Neither the law nor the Constitution compels 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", Justice Chandrachud said.

He said, "Till now advanced medical directives did not have legal validity in our country".

"To decrease the misuse the court has said that making of living will be allowed only after getting certification from a medical authority that the patient's comatose state is irreversible", Rohan added.

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"Today's is a landmark judgement because it comes at a time when medical science allows patients to be kept alive by artificial means and the hospitals to keep charging money", Vipul Mudgal, the head of main petitioner Common Cause, an advocacy group, told the BBC. Anumeha Jha, senior research analyst for the NGO, said that in 2016, the government's medical Bill addressed passive euthanasia as it was after Aruna Shanbaug's case.

Dr K K Aggarwal, vice -pesident of Confederation of Medical Associations in Asia and Oceania, and former IMA president, however, said strict guidelines should be put in place to ensure that there is no abuse of the "living will" by relatives of the terminally ill patient. "The safeguards that the court has built in should allay fears that some people may have", he said. A five-bench judge also defined the rule to implement the procedure in case there would be no living wills.

The 2015 death of 66-year-old nurse Aruna Shanbaug, who was raped and left in a vegetative state for 42 years, reignited India's national debate over euthanasia.

In January, the elderly couple had written a letter to President Ram Nath Kovind seeking permission for "active euthanasia".

In the absence of a law authorizing doctors to invoke an advance directive, they keep incurable patients on life support, he said. "SC has taken a good decision, we've hope now".

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