The Centre told in Supreme Court that it was yet to examine the pros and cons of a “living will”. It might not be a good policy as the issue was far more complicated given the cultural, religious and legal systems in India.
The court also said it needed to consider the possibility of coercion or fraud by greedy relatives
More than six years after sanctioning passive euthanasia as a legitimate option to end lives of people in a permanent vegetative state, the Supreme Court decided on Tuesday to examine the more complex concept of a “living will” where removal of life support is authorised in case of an irreversible coma.
A “living will” is a document prepared by a person in a healthy state of mind specifying that if s/he slides into a vegetative state because of an irreversible terminal illness, the debilitated existence should not be prolonged with the help of life support systems or other medical interventions.
In such a case, relatives will be spared the agonising decision of removing life support and doctors will be guided solely by the “living will”. In several cases, the reluctance to pull the plug on a loved one even when s/he is in a vegetative state prolongs the pain of the patient.
Appearing for NGO Common Cause, advocate Prashant Bhushan said, “Right to life includes right to refuse medical intervention when a board of doctors certifies that the person would not live without life support system. I am in favour of active euthanasia too. But living will is a corollary to passive euthanasia.” For the Centre, additional solicitor general P S Narasimha said the government was yet to examine the pros and cons of a “living will”, which might not be a good policy as the issue was far more complicated given the cultural, religious and legal systems in India.
Narasimha said the government had already accepted the SC ruling in the Aruna Shanbaug case on March 11, 2011. The SC had said that a specific category of relatives could move the high court concerned to seek permission for passive euthanasia, i.e. withdrawal of life support system from a person in a permanent vegetative state.
The SC had said such a request would be vetted by a board of medical experts and thereafter the HC would go through the report before granting or refusing permission for passive euthanasia.
“There is constant advancement in medical science and who knows what a person thought today was incurable could be easily manageable in the distant future,” he said.
The court also said it needed to consider the possibility of coercion or fraud by greedy relatives. Official sources said the draft bill on passive euthanasia was in a nascent stage and it was possible that the “living will” concept could be added to the body of the legislation.
The sources also said that in an overwhelming majority of cases, when the doctors lost hope of saving a patient, the relatives took them home from hospital, thus signalling the administration of passive euthanasia.
“There is no law that prevents a relative from taking discharge of a patient,” a source said.
The bench of Chief Justice Dipak Misra and Justices A K Sikri, A M Khanwilkar, D Y Chandrachud and Ashok Bhushan, too, faced a dilemma in going through the exercise given the inherent complications associated with the issue.
The bench admitted, “It is a very troubling issue. Let us see how far we can go.” It added, “To die peacefully without suffering is a right under Article 21. But one cannot commit suicide. However, one has a right to say while dying let me not suffer (sic).” CJI Misra recalled that Mahabharata’s Bheeshma was blessed with “ichchha mrityu (the power to choose the time of one’s death)”, and said a “living will” would relieve the relatives of taking the painful decision of advising doctors to withdraw life support from the patient.