Mains Daily Question
Jan. 25, 2023

Recently the supreme court simplified the process of making a “living will”, an advanced directive that details a person’s desire to refuse medical treatment in case he/she reaches a vegetative state thus authorizing passive euthanasia. Examine to what extent this decision to simplify the procedure for carrying out passive euthanasia is justified. (10 Marks)

Model Answer

Approach:

Introduction: Define euthanasia, mention context like previous judgments

Body: Mention Arguments in favor of the simplification process and then against it.

Conclusion: Suggest a way forward to ensure a balance to uphold the right to life of everyone.

Answer:

Euthanasia is the act of deliberately putting an end to a person’s life in order to eliminate pain or suffering, and it is usually divided into active and passive euthanasia.

In India serious debate on euthanasia started after the Aruna Shanbaug case and later on passive euthanasia(when a person is allowed to die by withholding artificial life support such as a ventilator or a feeding tube) was allowed in the 2018 Common cause case. 

Later on, procedures for an advanced directive ( living will) were allowed. But this procedure was quite complex involving multiple steps like firstly, the formation of a medical board and then finally taking approval of the magistrate. This has been simplified in a recent judgment.

Arguments in favor of simplification of the process of carrying out living will:

  1. It reaffirms the right to die with dignity as part of the right to life as the court also recognized in Common Cause vs Union Of India in  March 2018.
  2. It is as per the changing times as the number of elderly is about to increase in India ( around 19% in 2050 from present 10% as per United Nations) with imperative upon the state to recognize the right to healthy ageing and this also includes death without too much suffering in certain cases.
  3. It is justified on moral compassionate grounds to authorize the removal of procedures rather than remaining distraught in complex procedures for passive euthanasia.
  4. Simplification of procedure was bound to be deliberated once in principle passive euthanasia has been allowed.
  5. Despite the simplification of procedure, there are safeguards such as the formation of two expert boards in case the requestor becomes terminally ill, first by hospital authorities and then by the district collector. Only final authorization by the magistrate has been removed. So, little possibility of misuse is there.
  6. This could potentially save the healthcare system from the costs of prolonging the lives of terminally ill patients

However, this decision might not be justified on certain grounds:

  1. There is a risk of abuse, particularly when most adults in India do not enjoy secure ageing due to a lack of social security. It could affect the rights of most marginalized sections like elderly women dependent upon their families going against article 21.
  2. Safeguards could be tampered with in an imperfect governance system.
  3. This could affirm the changing perspective in society about the elderly where there are being treated as burdens rather than sources of wisdom. 
  4. These directives are from the judiciary with little effort towards making a law, framing institutional architecture by elected representatives as the court also expressed.
    1. Such matters require larger public consultation and debate which could only be possible when draft legislation is opened for public consultation.
  5. Uniform procedures in the case of diverse healthcare systems might affect justice as health is a state subject. The procedure for living will, involves multiple stakeholders. It will be carried out differently in states like Bihar and Tamil Nadu affecting the sanctity of the process. Thus states’ involvement is needed in framing guidelines.
  6. Ethical concerns about our medical system arise when smoothening is allowed in our system knowing that it might cause death to certain people. It might affect the conscience of medical personnel, and cause dilemmas in critical situations.


Overall to ensure a balance and carry out a justified process, there is a need for the formation of a draft law with wider public debate and consultation on this law. A parliamentary committee should also be formed then to come up with recommendations. Overall we should ensure that the right to life of even one person is not affected to ensure that we uphold substantial democracy in India.

Subjects : Current Affairs Polity
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