As SC re-examines Harish Rana case, recalling India’s law on euthanasia and landmark cases

The Supreme Court's decision to re-examine the Harish Rana case brings into sharp focus India's nuanced and evolving legal landscape surrounding euthanasia and the 'right to die with dignity'. This development is not just a procedural matter but a crucial moment for refining the legal and ethical framework governing end-of-life decisions in a nation that grapples with diverse moral, social, and medical perspectives.

Historically, India lacked explicit legislation on euthanasia, leaving a significant vacuum that the judiciary has progressively filled. The journey began with the fundamental 'Right to Life' enshrined in Article 21 of the Indian Constitution, which states, "No person shall be deprived of his life or personal liberty except according to procedure established by law." Initially, the debate centered on whether this right implicitly included a 'right to die'. However, the Supreme Court, in landmark judgments, has clarified that while the right to life includes the right to live with dignity, it does not extend to the right to terminate life unnaturally.

The seminal case that truly opened the door for passive euthanasia was the 2011 judgment in the **Aruna Shanbaug vs. Union of India** case. Aruna Shanbaug, a nurse, had been in a persistent vegetative state (PVS) for nearly four decades after a brutal sexual assault. Her friend and a journalist, Pinki Virani, petitioned the Supreme Court for passive euthanasia. The Court, while rejecting the plea in Aruna's specific case due to technicalities, for the first time recognized the legality of passive euthanasia under exceptional circumstances. It laid down stringent guidelines, emphasizing that such a decision could only be taken by the patient's parents or next of kin, and only after approval from a High Court, following a medical board's report.

Building upon this foundation, the Supreme Court, in its **Common Cause (A Regd. Society) vs. Union of India** judgment in 2018, took a significant leap forward. This verdict unequivocally legalized passive euthanasia and, crucially, upheld the validity of 'living wills' or 'advance medical directives'. A living will allows an adult of sound mind to make a declaration in advance about the medical treatment they would or would not want to receive if they were to become terminally ill and unable to communicate their wishes. The Court interpreted the 'right to die with dignity' as an intrinsic component of the fundamental Right to Life under Article 21. It distinguished between active euthanasia (administering lethal substances), which remains illegal in India, and passive euthanasia (withdrawing life support), which is now permissible under strict conditions.

The 2018 guidelines for implementing passive euthanasia and living wills were designed to be robust and prevent misuse. They mandated that a living will must be executed in the presence of two independent witnesses and attested by a Judicial Magistrate First Class (JMFC). If a patient without a living will is in a PVS, the hospital's primary medical board must concur with the decision for withdrawal of life support, and this decision must then be endorsed by a second, independent medical board. Finally, the High Court, through a JMFC, had to approve the decision, ensuring judicial oversight.

The re-examination of the Harish Rana case by the Supreme Court likely stems from the practical challenges and complexities encountered in implementing these stringent 2018 guidelines. Many stakeholders, including medical professionals and legal experts, have pointed out that the process, particularly the requirement for High Court approval and multiple medical boards, is often cumbersome, time-consuming, and emotionally taxing for families already in distress. The current re-examination aims to simplify these procedural hurdles, making the exercise of the 'right to die with dignity' more accessible and practical without compromising essential safeguards.

Key stakeholders in this evolving discussion include the **Supreme Court** itself, which acts as the ultimate interpreter and protector of constitutional rights; **patients and their families** who face agonizing end-of-life decisions; **medical professionals** (doctors, hospitals, palliative care specialists) who are at the forefront of implementing these directives and managing ethical dilemmas; the **government**, which may eventually consider codifying these judicial pronouncements into statutory law; and **civil society organizations** advocating for patient rights and dignified end-of-life care.

For India, the significance of this ongoing judicial discourse is profound. It reinforces the expansive interpretation of Article 21, adding another layer to the concept of individual autonomy and dignity. Socially, it encourages a more open conversation about death, dying, and end-of-life care, potentially reducing suffering and providing solace to families. Ethically, it navigates the complex terrain between preserving life and respecting a person's wish for a dignified exit. Future implications include potentially simplified procedures for living wills, increased awareness about advance medical directives, and a greater emphasis on palliative care within the healthcare system. It might also pave the way for parliamentary legislation that provides a comprehensive statutory framework, moving beyond purely judicial directives, ensuring clarity, uniformity, and greater public confidence in end-of-life care decisions.

This continuous judicial engagement highlights India's commitment to balancing the sanctity of life with individual liberty and the right to a dignified existence, even in its final moments.