In a historic ruling on Friday, the Supreme Court authorised passive euthanasia nationwide, stating that the right to die with dignity is a basic right. According to an Indian Express story, a five-judge panel of the Supreme Court, led by Chief Justice of India Dipak Misra and consisting of Justices A.K. Sikri, A.M. Khanwilkar. These rules cover things like who can carry out the will and when the medical board can approve passive euthanasia. According to Firstpost, the Supreme Court added that its rules and orders would not change unless legislation was introduced to address the matter.

According to LiveLaw, renowned attorney Prashant Bhushan had argued in the case that a patient with a terminal illness should have the freedom to refuse artificial life support, also known as passive euthanasia, when a medical expert indicates that the patient has reached a point of no return to prevent excruciating pain. On October 11, 2017, the bench had previously reserved its decision, noting that Article 21 of the constitution stated that the right to life and the right to die in peace were inextricably linked.

In the Gian Kaur case, the Supreme Court ruled that the term "life with dignity," as defined by Article 21, which states that only elements of life that contribute to dignity may be included in this article, could not coexist with the right to die. But in the March 2011 case of Aruna Ramchandra Shanbaug v. Union of India, the Supreme Court ruled that, in certain exceptional circumstances, passive euthanasia might be permitted under strict oversight from the highest court.

Pinki Virani, a social activist, journalist, and author, filed a writ case on behalf of Aruna Shanbaug, who had been in a vegetative condition since 1973, alleging that her constitutionally guaranteed right to life had been infringed. According to the SC, a decision about a person's death cannot be made exclusively by the patient's family or "next friend," as was the case with the nursing staff in the Shanbaug case. At the time, the Centre denied the existence of a "living will" and said that a patient's consent to remove an artificial support system might not have been made voluntarily. 

Active euthanasia differs from passive euthanasia in that the former involves an act that causes death, such as giving someone an excessive amount of painkillers. The cause of death in passive euthanasia is omission. Stated differently, by not performing any medical procedure to preserve the individual's life. When all other life-care procedures fail to improve the quality of life for a patient who is terminally ill or in a vegetative state, euthanasia is considered the sole practical choice.

A living will is a written document that enables a patient to specify ahead of time the medical care that will be provided when they are terminally ill or incapable of giving informed consent. This includes the removal of life support if a medical board determines that all life-saving measures have been taken. The Centre has argued against the idea of a living will, claiming that there was a chance that it would be abused. And that implementing it as public policy might not be feasible.

The Legal Landscape of Assisted Suicide and Euthanasia: A Global Examination

The Netherlands enforces stringent rules and procedures that state that "the patient must be in excruciating pain, their illness must be incurable, and the demand must be made." According to The Guardian, "when patients freely express a wish to die because they are experiencing intractable and unbearable pain, doctors can assist them in ending their lives," even if assisted suicide is not covered by the law. While euthanasia is still prohibited in the US, physicians are permitted to provide fatal dosages of medication to terminally ill patients in five states. In 2013, over 230 people lost their lives as a result of taking lethal medications that were prescribed to roughly 300 Americans who were near death.

1) The Netherlands

• Permitted under stringent limitations outlined in judicial rulings and laws
• The Assisted Suicide and Termination of Life on Request Act of 2001 authorised physician-assisted suicide and euthanasia.

2) Euthanasia became legal in Belgium in 2002.

• permits individuals who are in excruciating pain to die, both voluntarily and involuntarily.
• permits euthanasia requests from foreigners 

3) Switzerland

• Euthanasia is illegal; however, assisted suicide is permitted under some situations.
•  Organisations like Dignitas provide assisted suicide services to eligible patients.

4) Colombia and the UK: 

• A 1997 ruling by the Constitutional Court made euthanasia legal.
• Permits euthanasia in certain conditions, such as excruciating pain brought on by a terminal illness.
  In the UK, 
• Patients in a Permanent Vegetative State (PVS) are permitted to die passively. 
• Based on the 1993 case of Airedale NHS Trust v. Bland

5) Australia: 

• Acknowledges the freedom to decline medical care and make advance medical directives
• Choosing what's best for each individual

6) Canada 

• legalised medical assistance in dying (MAID) in 2016.
• Adults who qualify and have severe, irreversible medical issues can use this service.

7) US: 

• Several states have made assisted suicide and euthanasia lawful.
• For instance, the End of Life Option Act of 2015 in California, the Death with Dignity Act of Seattle (2008), and the Death with Dignity Act of Oregon (1997)

8) Spain:

In 2021, Spain legalised assisted suicide and euthanasia- Accessible to people who are suffering from severe, terminal illnesses

9) France: 

As of 2023, legislation to legalise "aid in dying," a type of assisted dying, is being considered.

Families still have to make tough decisions while caring for very ill loved ones, even if passive euthanasia is now permitted in some circumstances. The high expenses of long-term care frequently increase this strain. The court made it plain that "the right to life under Article 21 includes dignity in the dying process as much as anything else." Euthanasia is still prohibited in India.

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