SC Proposes Guidelines To Simplify Passive Euthanasia Process: What To Know

What is passive euthanasia? Where does India's law stand? FIT explains.

Supreme court guidelines on passive euthanasia: While active euthanasia is illegal in most countries, passive euthanasia is, comparatively, more widely embraced.

(Photo: iStock)

The Supreme Court on Tuesday, 24 Janaury, agreed to modify the guidelines for passive euthanasia for terminally ill patients, in a bid to simplify the process.

The new guidelines propose replacing the old 'cumbersome' three-tiered procedure for authorisation with a simpler two-tiered one.

Where does India's law stand when it comes to euthanasia? How do the new guidelines impact it? What is a 'living will'? Here's what to know.

What Is the Proposed Guideline?

A bench of five Supreme Court judges, headed by justice KM Joseph, spent four days deliberating over suggestions put forth by the Indian Council for Critical Care Medicine to modify the existing guidelines, before backing the proposal.

According to the Supreme Court's ruling in 2018, a judicial magistrate would have to attest or countersign a living will to make it legally admissible.

The new guidelines, however, say that an attestation by a notary or a gazetted officer would be enough to make a living will valid.

The 2018 guidelines also said that once the treating doctor confirmed the patient was beyond the point of return, and there is an advanced directive (living will) in place, a primary medical board and a secondary review board of doctors would have 48 hours each to go over the case and give their approval.

The new guidelines propose to bring the time allotted for consideration to both boards down to 24 hours each.

In case there is no advance medical directive, Arvind Datar, advocate representing the Indian Council for Critical Care Medicine, said the close family and next-to-kin of the patient should have the right to decide whether to remove or retain life support.

The new guidelines are said to make the process less complicated for the patient and their family, as well as reduce the legal constraints placed on the hospitals when dealing with cases of comatose and terminally ill patients.

Where Does India's Law Stand?

In India, passive euthanasia was made legal in 2011, for exceptional cases. These typically extend to people who are terminally ill and or in an irreversibly vegetative state. Active euthanasia and assisted suicide are both illegal.

In March 2018, the Supreme Court passed a law allowing people to draw up a 'living will', or an advance medical directive, during their lifetimes seeking euthanasia (passive) in case they go on to develop a terminal illness or end up in an irreversible vegetative state.

It must be noted, however, that the new guidelines don't propose any change to the prerequisites for seeking passive euthanasia.

In its ruling in 2011, the Supreme Court specified two irreversible conditions on allowing passive euthanasia and how it must be carried out:

• The brain-dead for whom the ventilator can be switched off.

• Those in a Persistent Vegetative State (PVS) for whom the feed can be tapered out and pain-managing palliatives be added, according to laid-down international specifications.

What Is a Living Will?

A living will, or an advance medical directive, is a pre-emptive document written by a person when they are of 'sound mind' seeking passive euthanasia if and when they reach a vegetative state due to terminal illness.

Some important criteria that a person needs to meet to be able to write a living will are,

• They must be an adult.

• The must be of a 'sound and healthy state of mind'.

• The must be able to communicate, relate and comprehend the purpose and consequences of executing the document.

• It must be a voluntary choice, and an informed decision without any coercion or inducement or compulsion.

• The document should have specific instructions and clearly state put down the decision to withhold or withdraw life-prolonging treatment, and at what stage.

(Written with inputs from Live Law.)