Context:

• The U.K.’s proposed Terminally Ill Adults (End of Life) Bill allows physician-assisted dying for mentally competent adults with less than six months to live, pending House of Lords approval. This marks a major ethical and legal step aligning with trends in several Western nations.
• In contrast, India recognizes only passive euthanasia through Supreme Court rulings, avoiding active euthanasia due to cultural sensitivities, institutional limitations, and socio-economic realities.
• This article highlights how India, while refraining from adopting active euthanasia like the U.K., must reform its passive euthanasia framework.
• It explores the ethical, legal, and procedural challenges that make current provisions inaccessible and proposes digital, institutional, and educational reforms to ensure dignity in dying while safeguarding against misuse.

India’s Ethical Conservatism on Euthanasia: Law in Principle, Barriers in Practice

• While passive euthanasia is legally recognised in India, stringent procedures—advance directives, dual medical boards, and occasional judicial oversight—render it practically inaccessible.
• Families often make end-of-life decisions informally, exposing doctors to legal risk and undermining the law’s humane intent.
• In contrast, the U.K.’s progressive model rests on robust healthcare and institutional safeguards.
• India’s fragmented system, coupled with social and religious sensitivities, makes active euthanasia risky, potentially coercing the vulnerable.
• Though Article 21 ensures the right to die with dignity, it does not extend to a right to be killed.
• Hence, India’s cautious stance reflects ethical prudence aligned with its socio-economic realities.

Strengthening India’s Passive Euthanasia Framework through Digital and Ethical Reforms

• Instead of moving toward active euthanasia, India should improve its passive euthanasia system by making it more humane, transparent, and efficient.
• Experts agree that the current process is overly complicated.
• A national digital portal linked with Aadhaar could allow patients to easily create, update, or revoke advance directives, with doctors verifying mental capacity and intent online.
• Hospital ethics committees—comprising senior doctors, a palliative care specialist, and an independent member—should be empowered to approve life-support withdrawal within 48 hours, while exceptional cases undergo higher review.
• Rather than relying on slow and ineffective ombudsman models, India could adopt a decentralised oversight mechanism using hospital-based digital dashboards and independent medical auditors.
• To prevent misuse, essential safeguards like a seven-day cooling-off period, psychological counselling, and palliative care reviews must be retained.
• Such reforms would balance compassion with caution and align India’s end-of-life care system with global best practices.

Ensuring Dignity in Dying: The Road Ahead for India

• India must extend its constitutional promise of dignity in life to dignity in dying by making passive euthanasia truly workable.
• Rather than adopting the U.K.’s active euthanasia model, India should focus on digital reforms, empowering hospital-based ethics committees, and creating efficient yet non-burdensome oversight mechanisms.
• These measures align with Indian values, protect against misuse, and give patients greater autonomy.
• Equally important is integrating end-of-life ethics and legal education into medical training, ensuring doctors are equipped to handle such sensitive decisions.
• Public awareness campaigns should also promote open discussion on advance care planning.
• Only through trust, awareness, and compassionate implementation can India make its end-of-life care system both humane and effective.

Conclusion

• India’s focus should remain on refining passive euthanasia through digital systems, ethical oversight, and awareness, ensuring end-of-life care is compassionate, accessible, and consistent with constitutional dignity.