NEW DELHI: In a landmark ruling, the Supreme Court has legalised the right to die in dignity but laid down strict guidelines for it.

Pointing out that human beings have the right to die with dignity, the Supreme Court allowed passive euthanasia while also allowing an individual to draft a living will specifying that they not be put on life support if they slip into an terminal coma requiring life support in the future. In a ‘living will’, a person can make a statement in advance that their life should not be prolonged by putting them on a ventilator or an artificial support system.

The order was passed by a five-judge Constitution bench comprising Chief Justice (CJI) Dipak Misra and Justices A K Sikri, A M Khanwilkar, D Y Chandrachud and Ashok Bhushan on a plea by an NGO ‘Common Cause’.

While the judges gave four separate opinions, all of them were unanimous that a ‘living will’ should be allowed, because an individual should not be allowed to continue suffering in a vegetative state when they do not wish to continue living.

However, strict guidelines have been put in place before executing such a will to ensure the provision is not misused. For this, the Apex Court said a medical board would determine whether the patient in a vegetative state could be revived or not. 

The SC said it was aware of the pitfalls in giving effect to ‘living wills’, considering the property disputes relatives have. Therefore, the SC said the relatives of a patient who has not written a ‘living will’ can approach high courts asking for passive euthanasia.

The NGO had approached the court seeking a direction for the recognition of a ‘living will’ and contended that when a medical expert said that a person afflicted with terminal disease had reached a point of no return, then they should be given the right to refuse being put on life support.

“Right to life includes right to die with dignity. A person cannot be forced to live on support of ventilator. Keeping a patient alive by artificial means against his/her wishes is an assault on his/her body,” the petition had said.

The Centre, however, had told the court that the government had in principle decided to decriminalise attempt to suicide which at present is an offence punishable by up to one year jail term under Section 309 of Indian Penal Code.

The death of 66-year-old nurse Aruna Shanbaug in 2015, had sparked a national debate over the legalisation of euthanasia. She had been sexually assaulted and left in a vegetative state for more than 40 years.

However, the elderly couple from Mumbai, who had also sought legalistation of active euthanasia, said they are not satisfied with the Supreme Court order. Narayan (88) and Iravati (78) do not suffer from any terminal ailment but are motivated by the will to die after having lived a satisfactory life. They also fear having to live without the other. 

The couple told ANI that the government should give the right to active euthanasia and assisted suicide to people above 75.

Senior advocate Mahesh Jethmalani welcomed the Supreme Court decision on passive euthanasia stating that he believes any individual who is very ill and unable to take care of himself should be allowed to make a decision on his life. “Anyone who is reduced to a life that is unlike that of a sentient being should be given the choice of deciding on his/her life. Any liberty that is given is liable to be misused. Care must be taken to ensure this does not happen by putting strict guidelines,” he said.

Passive Euthanasia was made legal in India under exceptional circumstances. On 7 March 2011 the Apex Court legalised passive euthanasia by means of the withdrawal of life support system to patients in a permanent vegetative state. This decision was made as part of the verdict in a case involving Aruna Shanbaug, who had been in a Persistent Vegetative State (PVS) until her death in 2015.

In March 2011, the Supreme Court passed a historic judgement-law permitting Passive Euthanasia in the country. This judgment was passed in wake of Pinki ViraniÂs plea to the highest court in December 2009 under the Constitutional provision of ÂNext FriendÂ. ItÂs a landmark law which places the power of choice in the hands of the individual, over government, medical or religious control which sees all suffering as ÂdestinyÂ.

The Supreme Court specified two irreversible conditions to permit Passive Euthanasia Law in its 2011 Law: (I) The brain-dead for whom the ventilator can be switched off (II) Those in a Persistent Vegetative State (PVS) for whom the feed can be tapered out and pain-managing palliatives be added, according to laid-down international specifications.

The same judgement-law also asked for the scrapping of 309, the code which penalises those who survive suicide-attempts. In December 2014, government of India declared its intention to do so.

However, on 25 February 2014, a three-judge bench of Supreme Court of India had termed the judgment in the Aruna Shanbaug case to be’inconsistent in itself’ and has referred the issue of euthanasia to its five-judge Constitution bench.