Euthanasia—often described as “mercy killing”—sits at the confluence of law, medicine, ethics, emotions, and faith. It raises questions that are as personal as they are philosophical: Should a person have the right to end their life if they are suffering beyond measure? Can families make such decisions on behalf of someone they love, and more importantly, who gets to decide what qualifies as a life no longer worth living? In India, a country deeply rooted in spiritual traditions and bound by social and familial obligations, euthanasia is a conversation that’s both overdue and difficult. The law has taken its first cautious steps in this direction, but society is still grappling with the emotional, ethical, and religious weight of such a choice.

Legally speaking, India permits only one form of euthanasia—passive euthanasia, which involves withholding or withdrawing medical treatment that would otherwise prolong life. This form became legal following a significant Supreme Court judgment in 2018 in the case of Common Cause vs Union of India. The court held that the right to die with dignity is a fundamental right under Article 21 of the Indian Constitution, which also guarantees the right to life. The judgment followed the more publicized Aruna Shanbaug case in 2011, in which a nurse who had lived in a vegetative state for decades became the face of the euthanasia debate in India. However, the court’s 2011 decision stopped short of legalizing euthanasia, allowing it only under strict judicial supervision. It was not until 2018 that the legal framework was clarified and passive euthanasia and living wills were formally recognized.

A living will is a legal document in which an individual can state in advance that they do not wish to receive life-sustaining treatment if they become terminally ill or permanently unconscious. It’s an attempt to give people control over their own bodies and medical decisions, especially when they might no longer be capable of expressing their will. However, even with a living will, the process is layered and bureaucratically demanding. The decision must be reviewed by a hospital medical board, validated by a district-level board, and finally sanctioned by a Judicial Magistrate First Class (JMFC). While the structure is meant to prevent misuse, its complexity often delays action, thereby defeating the purpose in time-sensitive cases.

Active euthanasia, on the other hand, which involves directly administering substances to end a patient’s life, like giving a lethal injection, is still illegal in India and considered a criminal offense under the Indian Penal Code, specifically Sections 302 and 304. While passive euthanasia allows nature to take its course, active euthanasia takes a more decisive step in controlling the timing and manner of death. The opposition to legalising active euthanasia stems from several concerns, primarily fears of misuse in a country where corruption, illiteracy, and lack of healthcare access are still prevalent.

Within this legal framework, both families and doctors bear immense responsibility. Families are often the ones navigating the fine line between hope and despair. Watching a loved one suffer without the hope of recovery can be emotionally devastating, but taking the step to legally withdraw treatment can also leave lasting guilt. In India, where familial bonds are strong and deeply rooted in duty and sacrifice, such a decision carries a profound emotional toll. There is the fear of being judged—both by society and one’s own conscience—for not “doing enough” or for giving up too soon.

Doctors, too, walk a tightrope. The medical profession is guided by the Hippocratic Oath to “do no harm,” and determining when life support becomes a harm rather than help is ethically burdensome. They must act not just as clinicians but also as gatekeepers of legal and ethical guidelines. In cases of passive euthanasia, they are part of the team that assesses the patient’s condition and advises whether continuing treatment is futile. But their decision-making process is complicated by the fear of legal repercussions, differing opinions within families, and a lack of clear hospital protocols in many parts of the country.

Apart from legal and medical complexities, India’s social and emotional fabric adds another layer of challenge. Emotionally, euthanasia is not just about the individual, but about everyone connected to them. Many patients fear becoming a burden more than they fear death. Yet, family members may hold onto a sliver of hope, unable to let go even when suffering is obvious. The trauma of watching someone deteriorate, especially in cases like terminal cancer, ALS, or irreversible brain injuries, can be psychologically scarring. Yet for some, choosing to end that suffering feels like giving up, a sentiment deeply ingrained in Indian cultural values that celebrate endurance and faith even in hardship.

The religious sentiments around euthanasia in India are equally complex, and none of the traditions wholeheartedly endorse medical euthanasia as practiced in modern clinical settings.

The ethical debate is just as contentious. Supporters argue for the right to die with dignity, pointing out that modern medicine’s ability to prolong life has sometimes come at the cost of quality of life. If a patient is in intractable pain, fully aware that death is inevitable, is it not more humane to let them choose a peaceful end rather than drag the body through needless suffering? Critics counter this with the “slippery slope” argument—if we start allowing life to be ended intentionally, even with consent, where do we stop? Could it be misused against the elderly, the disabled, or those with limited financial means? These are not theoretical questions; in a country like India, where access to education and legal literacy is uneven, the fear of coercion or manipulation is very real.

While India inches forward cautiously, many other countries have already legalized active euthanasia or assisted dying. The Netherlands, Belgium, and Luxembourg are among the few that permit active euthanasia. In these countries, strict criteria must be met: the patient must be mentally competent, make the request voluntarily, be suffering unbearably from a terminal or incurable condition, and multiple doctors must confirm the diagnosis and consent. Canada allows Medical Assistance in Dying (MAiD) under similar conditions, and even some U.S. states like Oregon and Washington permit physician-assisted suicide. These countries have structured regulations to balance compassion with caution.

The idea of mercy killing, or euthanasia, can be traced back to ancient civilizations, but it was first formally conceptualized in ancient Greece around the 5th century BCE. Philosophers like Plato and Socrates discussed the notion that individuals suffering from incurable illnesses should be allowed to die peacefully rather than endure prolonged pain. Hippocrates, however, whose oath is foundational to modern medicine, opposed it, stating that doctors must not give any deadly drug, even if asked. In modern times, the term “euthanasia” was popularized in the 17th century by philosopher Francis Bacon, who referred to it as a way for doctors to ease the dying process when healing was no longer possible.

The revolution in the modern euthanasia movement—transforming it from a philosophical idea to a legal and medical reality—was driven by a combination of activists, doctors, legal scholars, and court cases. However, Dr. Jack Kevorkian, often nicknamed “Dr. Death,” is widely recognized as the most controversial and influential figure who brought global attention to the right-to-die debate in the late 20th century.

The science behind euthanasia, particularly in countries that allow active forms, often relies on drugs like sodium pentobarbital. This barbiturate depresses the central nervous system and is commonly used for both human and animal euthanasia in countries where it’s legal. It works by inducing deep unconsciousness followed by respiratory and cardiac arrest. It is crucial that this drug be administered only by trained professionals, as misuse or incorrect dosages can cause suffering or prolong the dying process.

After discussing human euthanasia, it is equally important to touch upon animal euthanasia in India, which carries its own set of legal, emotional, and ethical challenges. Under the Prevention of Cruelty to Animals (PCA) Act, 1960, euthanizing an animal is permitted if it is incurably ill, severely injured, or poses a public health risk. The Animal Welfare Board of India lays out protocols for humane euthanasia, which must be carried out by a registered veterinarian using approved methods. Stray dogs, often at the center of euthanasia debates in India, cannot be arbitrarily culled; they must be evaluated by a medical board and euthanized only in extreme and justified cases. The Animal Birth Control (ABC) Rules clearly prohibit killing healthy strays and encourage sterilization and vaccination instead. For wildlife, euthanasia decisions are overseen by forest departments and require high-level permissions, especially for endangered species. Yet, despite these regulations, incidents of illegal or inhumane animal euthanasia persist, highlighting the need for stronger enforcement and public awareness.

Euthanasia—whether human or animal—forces us to confront our most intimate fears and beliefs about life, suffering, and mortality. India, with its diversity and depth, walks a delicate path between compassion and caution. The legal steps taken so far acknowledge suffering without opening doors to misuse. Yet, laws alone are not enough. The conversation around euthanasia must continue, not just in courtrooms and hospitals, but at dinner tables, in classrooms, and within religious institutions. Only then can we hope to make space for both life and death to be handled with the dignity they deserve.

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