Right to Die with Dignity: Passive Euthanasia Allowed by Supreme Court of India

The issue of euthanasia in India has recently come into sharp focus with the landmark judgment of the Supreme Court in Harish Rana v. Union of India (2026). In this historic case, the Court permitted the withdrawal of life-sustaining treatment of a 32-year-old boy, Harish Rana who had been in a persistent vegetative state for over 12 years.

The Court held that this decision was not about ending life, but about avoiding the artificial prolongation of life without hope of recovery. It emphasized that the Constitution under Article 21 guarantees not just the right to live, but also the right to die with dignity.

This judgment is significant because it represents the first practical implementation of passive euthanasia in India, applying principles evolved through earlier landmark rulings.

INTRODUCTION

Euthanasia has sparked some heated debates over the years. It is an age - old issue which has its roots embedded in classical thinking. This concept revolves around the philosophy of humanism and compassion. Article 21 of the Constitution guarantees ‘right to life’ which is an unalienable right. However, the essence of human life is not merely restricted to breathing rather it is more about living a dignified life. To die with dignity is a concept that has led to major modifications in this field. As of now, there was no concrete law regarding euthanasia in India.

As far as other countries are concerned, many of them have legalized passive euthanasia but are reluctant to welcome active euthanasia. Even most of the religions condemn active euthanasia but permit restricted forms of passive euthanasia.

WHAT IS EUTHANASIA?

The phrase “euthanasia” was coined by Sir Francis Bacon. It is also called as ‘mercy killing’. The term “Euthanasia” has been derived from the two Greek words ‘eu’ and ‘thanotos’, which literally means ‘good death’. Euthanasia is the practice of intentionally ending a life in order to relieve pain and suffering (provided motive should be good & death must be painless as much as possible).

BROAD CLASSIFICATION-

● Active or positive euthanasia - When a person directly and deliberately causes a patient’s death, it is called active euthanasia. In this type of euthanasia, death is brought about by anact. For example, a doctor administering a lethal dose of medication to end a patient’s life or when a person is killed by being given an overdose of pain killers etc.

● Passive or negative euthanasia - In passive euthanasia, death is brought about by an omission. Here, the patient’s life is not directly taken; rather they are just allowed to die i.e., in this case, the doctors are not actively killing the patient; instead, they are simply not saving him. This can be done by intentionally withdrawing or withholding life sustaining treatment.

❖ Withdrawing treatment: for example, turning off a machine that is essential to keep the patient alive so that they die of their disease.

❖ Withholding treatment: for example, omitting to perform a surgery which may extend a patient's life for a short time. Passive euthanasia is usually a slower process than active euthanasia and is comparatively more uncomfortable and emotionally draining.

● Voluntary euthanasia – When euthanasia is carried out with the consent or at the request of the patient, it is known as voluntary euthanasia. It is important to note that full consent is to be received by the concerned person. Also, it must be demonstrated clearly that the person understands what is about to happen.

● Non-voluntary euthanasia – It is carried out when the person is unconscious or permanently incapacitated to make a meaningful choice between living and dying and thus, an appropriate person takes decision on their behalf. Such a decision is usually made by a close family member. It also includes cases where a child is mentally and emotionally fit to take the decision but is not old enough as per law to make such a decision and so someone else must take it on their behalf in order to be valid in the eyes of law.

● Involuntary euthanasia – It refers to a case where the person who dies chooses life but is killed anyway. It is practiced against the consent of the patient. Moreover, it clearly amounts to murder and is prohibited all around the world.

SUICIDE AND EUTHANASIA

These two terms are often considered the same but many are aware that though they have some similarity they have a conceptual distinction between them.

In suicide, the individual voluntarily ends his life by stabbing, injecting any kind of harmful substance which deliberately kills him or through any other mode. It is an instance of intentionally ending one’s life mostly due to depression and various other reasons such as disappointment from day-to-day life, failure in examination or in getting a good job etc., whereas in euthanasia it is an act of some other person to bring an end to the life of the sufferer.

Distinguishing euthanasia from suicide, Justice Lodha in Naresh Maratra Sakhee vs Union of India, 199C (1) BomCR 92, observed that, “suicide by its nature is an act of self-killing or self-destruction, an act of terminating one’s own act and without the aid or assistance of any other human agency. Euthanasia or Mercy killing on the other hand means the intervention of other human agency to end life. Mercy killing is thus not suicide and the provision of section 309 does not cover an attempt at mercy killing. The two concepts are both legally and distinct. Euthanasia or Mercy killing is nothing but homicide whatever the circumstances in which it is affected.”

● Common Cause (A Regd. Society) v. Union of India, (2018) 5 SCC 1, The Supreme Court held that individuals have a right to die with dignity under strict guidelines. In this case, the Court also provided the concept of “living will.”

o LIVING WILL is a document that allows people to make decisions regarding what treatment they want to avail in case they become terminally ill in future and thus, incapable of taking decisions.

As per the Court, these living wills are subject to certain guidelines like:-

o The person making the will should be of sound mind.

o He must be aware of the consequences of the will made.

o He must neither be forced nor influenced to make such will. Moreover,

o A living will should be a written one with at least two persons present at the time when the concerned person signs the will which has to be further countersigned by a Judicial Magistrate of First Class and so on.

The Court observed that Article 21 of the Constitution by virtue of which every person is guaranteed the right to life is completely meaningless unless it contains an element of dignity. It was further held that the right to live with dignity includes smoothing the process of dying in case of a person in Permanent Vegetative State (PVS) with no chance of recovery.

Judicial Evolution of Euthanasia in India

1. Gian Kaur v. State of Punjab (1996)

This case marked the starting point of the legal debate.

● The Supreme Court held that the right to life does not include the right to die.

● However, it made a crucial observation that “death with dignity” in terminal illness may fall within Article 21.

Significance:

It rejected euthanasia in principle but opened a constitutional window for dignified death.

2. Aruna Shanbaug v. Union of India (2011)

This was the first major case directly on euthanasia.

● The Court allowed passive euthanasia under strict safeguards.

● It distinguished between:

o Active euthanasia (illegal)

o Passive euthanasia (conditionally permissible)

The Court introduced safeguards:

● Approval by High Court

● Consent of relatives/“next friend”

● Medical board opinion

Significance:

Continuing treatment in irreversible cases was seen as prolonging suffering rather than preserving life.

3. Common Cause v. Union of India (2018)

This is the most important constitutional judgment.

● A 5-judge bench held:

Right to die with dignity is a fundamental right under Article 21

● It recognized:

o Living wills (advance directives)

o Patient’s right to refuse treatment

Significance:

● Respect for autonomy and bodily integrity

● Forced medical treatment violates dignity

4. Simplification of Guidelines (2023)

The Supreme Court simplified the procedure:

● Living wills made easier

● Medical boards institutionalized

● Reduced procedural delays

Significance:

To make euthanasia practically accessible and humane.

5. Harish Rana v. Union of India (2026)

● First real application of euthanasia law

● Allowed withdrawal of feeding tubes and life support

● Based on:

o Irreversible condition

o No chance of recovery

o Medical board approval

The Court clarified:

● It is “letting die,” not killing

● Focus must be on compassion and dignity

Significance:

To prevent inhuman prolongation of life and suffering and uphold dignity.

Types of Euthanasia

Euthanasia can be classified as follows:

1. Based on Method

● Active Euthanasia

o Directly causing death (e.g., lethal injection)

o Illegal in India

● Passive Euthanasia

o Withdrawal/withholding of life support

o Legal in India under strict safeguards

2. Based on Consent

● Voluntary Euthanasia – with patient consent

● Non-voluntary Euthanasia – patient unable to consent (coma)

● Involuntary Euthanasia – against patient’s will (illegal and unethical)

Why the Court Ultimately Allowed Euthanasia ?

From all judgments, the reasoning becomes clear:

1. Right to Dignity under Article 21

Life under the Constitution means meaningful and dignified existence, not mere biological survival.

2. Avoidance of Prolonged Suffering

Artificial life support in irreversible cases leads to:

● Physical suffering

● Emotional trauma

● Financial burden

3. Distinction Between Killing and Letting Die

The Court allows only passive euthanasia because:

● It does not directly cause death

● It allows natural death

4. Respect for Autonomy

Individuals have the right to:

● Refuse treatment

● Decide end-of-life care

5. Safeguards Against Misuse

Strict procedures ensure:

● No arbitrary decisions

● Medical and legal oversight

Conclusion

The journey from Gian Kaur to Harish Rana reflects a gradual and cautious evolution of Indian constitutional law. The Supreme Court has balanced the sanctity of life the dignity of death, ultimately recognizing that in certain irreversible conditions, allowing a person to die naturally is more humane than forcing them to live artificially.

Thus, euthanasia in India is not about choosing death, but about ensuring dignity in the process of dying.

RECENT INTERNATIONAL INSTANCES OF EUTHANASIA

● FRANCE, after recently adding abortion as a constitutional right, is now considering legalising a form of assisted dying called "aid in dying".

The proposed bill will have strict conditions, allowing ASSISTED DYING for individuals with incurable illnesses expected to cause death in the short- or middle-term. The country already allows passive euthanasia.

ASSISTED DYING: Assisted dying involves individuals who are terminally ill seeking medical assistance to obtain lethal drugs, which they then administer themselves to end their own lives.

● It typically occurs when patients are facing unbearable suffering due to a terminal illness and wish to have control over the timing and manner of their death.

● The primary distinction of assisted dying is that individuals actively participate in the process of ending their lives with the aid of medical professionals.

● Former Dutch PM Dries van Agt, and his wife Eugenie van Agt-Krekelberg die by euthanasia [Feb. 2024]

Former Dutch prime minister Dries van Agt and his wife Eugenie van Agt-Krekelberg died by euthanasia early this year owing to deteriorating health issues. They both were 93. According to The Rights Forum, a human rights organisation he founded in December 2009, van Agt died by euthanasia, “hand in hand” together with his wife. As per its director Gerard Jonkman, both were very ill but “couldn’t go without one another”.

Euthanasia law in Netherlands

Euthanasia and assisted suicide have been legal in the Netherlands since 2002 under six conditions, including:-

● Unbearable suffering,

● No prospect of relief and a long-held, independent wish for death.

Euthanasia and assisted suicide are legal only if the criteria laid down in The Dutch Termination of Life on Request and Assisted Suicide (Review Procedures) Act are fully observed. Only then is the physician concerned immune from criminal prosecution. Requests for euthanasia often come from patients experiencing unbearable suffering with no prospect of improvement. Their request must be made earnestly and with full conviction. They see euthanasia as the only escape from the situation. However, patients have no absolute right to euthanasia and doctors have no absolute duty to perform it.