New Delhi, Mar 9: The Supreme Court Friday recognised that a terminally-ill patient can write a ‘living will’ that permits doctors to withdraw life support. The court said a person with no will to live shouldn’t suffer in a comatose state.
A five-judge constitution bench headed by Chief Justice of India (CJI) Dipak Misra said passive euthanasia and advance living will are “permissible”.
The bench, also comprising justices AK Sikri, AM Khanwilkar, DY Chandrachud and Ashok Bhushan also laid down guidelines as to who would execute the will and how the nod for passive euthanasia would be granted by the medical board.
The apex court said that advance directives for terminally-ill patients could be issued and executed by the next friend and relatives of such a person after which a medical board would consider it.
The top court said directions and guidelines laid down by it shall remain in force till a legislation is brought on the issue.
The CJI, while reading out the judgement, 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 cannot be allowed to continue suffering in a comatose state when he or she doesn’t wish to live.
The top court had in 2011 recognised passive euthanasia in the Aruna Shanbaug case by which it had permitted withdrawal of life-sustaining treatment from patients not in a position to make an informed decision.
The bench was hearing a PIL filed by NGO Common Cause, saying safeguards were needed while taking a decision by medical boards to withdraw life support of a terminally-ill patient.
The Centre had, January 15, 2016, said that the 241st report of the Law Commission stated that passive euthanasia should be allowed with certain safeguards and there was also a proposed law — Medical Treatment of Terminally Ill Patient (Protection of Patients and Medical Practitioners) Bill, 2006.
# What is a living will?
? It is written document that allows a person to give explicit instructions in advance to doctors who may treat him or her for terminal conditions that may disable them from expressing informed consent. The living will allows a person to outline whether or not s/he wants his or her life to be artificially prolonged in the event of a devastating illness or injury. It is a concept associated with passive euthanasia.
# What is passive euthanasia?
? It refers to the deliberate withdrawal of medical treatment being administered to a terminally ill patient to hasten the person’s death. The Supreme Court has defined it so in its verdict in the Aruna Shanbaug case.
# The fight for euthanasia
? May 11, 2005: SC takes note of PIL of NGO ‘Common Cause’ seeking nod to allow terminally-ill persons to execute a living will for passive euthanasia. It seeks the Centre’s response on the plea which seeks declaration of ‘right to die with dignity’ as a Fundamental Right under Article 21 (right to life) of the Constitution.
? Jan 16, 2006: SC allows Delhi Medical Council (DMC) to intervene and asks it to file documents on passive euthanasia.
? Apr 28, 2006: Law Commission suggests a draft bill on passive euthanasia and says such pleas be made to HCs which should decide after taking experts’ views.
? Mar 7, 2011: SC, on a separate plea on behalf of Aruna Shanbaug, allows passive euthanasia for the nurse lying in vegetative state at a hospital in Mumbai.
? Feb 25, 2014: The Supreme Court cites inconsistencies in earlier verdicts on passive euthanasia including the one given in the Shanbaug case and refers the PIL to a Constitution bench.
? Oct 11, 2017: Five-judge Constitution bench led by CJI Dipak Misra hears arguments and reserves verdict.
? March 9, 2018: SC recognises ‘living will’ made by terminally-ill patients for passive euthanasia and lays down guidelines on procedures to be adopted for it.
OBSERVATIONS OF BENCH
A person’s advance directive intended to die with dignity should take effect only when a medical board affirms that the person’s medical condition was incurable and irreversible.
CJI Dipak Misra
A certificate from a statutory medical board citing that a patient’s condition is beyond cure and irreversible would take care of the fear of relatives and doctors about withdrawing life support.
Justice AK Sikri
Two-fold test [is required] to check how the living will would take effect. Firstly, will can take effect when the medical condition of the patient is irreversible and the second one would be when prolonging his life by machine support would only lead to his pain and suffering thus in a way living will was a will for right to live and not die.
[The government is] afraid about people who are not privileged and [fears the law] would be susceptible to abuse if euthanasia and living wills are legalised in the country.
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