Explainer: How is active euthanasia different from passive euthanasia

Explainer: How is active euthanasia different from passive euthanasia

But a five-judge Constitution bench, led by Chief Justice of India Dipak Misra, has now given its nod to passive euthanasia legal by recognising the "living will", but with some riders.

The Supreme court, in what is a being considered a landmark decision, passed a judgement that would make it possible for people to opt for Passive Euthanasia, but with some guidelines that would have to be followed to achieve it. Therefore, the SC said the relatives of a patient who has not written a "living will" can approach high courts asking for passive euthanasia.

Her plight prompted the Supreme Court to decide in 2011 that life support can be removed for some terminally ill patients in certain circumstances. The living will is defined as the person's right to issue a pre directive where in which he or she allows the withdrawal of life support or discontinuation of medicine if a situation arises in future of person being in a terminally ill state.

In the absence of a living will, decisions about medical care become the responsibility of the spouse, family members or other third parties.

While the Centre was in agreement on the question of allowing passive euthanasia, it opposed the concept of living will. It also laid down the difference between active and passive euthanasia observing that in active euthanasia something is done to end the patient's life while in passive euthanasia, something is not done that would have preserved the patient's life.

The apex court ruled on a plea filed by the Delhi-based Common Cause India which had, in 2005, brought up the matter of a person's right to die with dignity by creating a living will.

The bench said if the doctor was satisfied that instructions given in the document needed to be acted upon, he should inform the executor or his guardian or a close relative about the nature of illness, availability of medical care and consequences of alternative forms of treatment.

The bench has said that advance directive by a person in the form of "living will" can even be approved by a magistrate.

The issue of death and when to die transcended the boundaries of law, but the court had intervened because it also concerned the liberty and autonomy of the individual, he said. As of 2006, euthanasia is the most active area of research in contemporary bioethics. The doctors treating such a patient will withdraw medical support provided the patient has left behind a "living will" for pulling the "plug" in such situations.

Passive euthanasia entails a withdrawal of medical treatment to deliberately hasten the death of a terminally-ill patient. In active euthanasia, a patient is put to death through a lethal injection. The Supreme Court has defined it so in its verdict in the Aruna Shanbaug case. The British House of Lords Select Committee on Medical Ethics defines euthanasia as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering".

"Free will includes the right of a person to refuse medical treatment", Justice Chandrachud observed.

A person's advance directive meant to die with dignity should take effect only when a medical board affirms that the person's medical condition was incurable and irreversible.