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

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.

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

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.

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.

LEARNING FROM HOME/ WITHOUT CLASSES/ BASICS

Euthanasia is derived from a Greek word “Euthnatos” which means easy killing; A mercy killing

Euthanasia is regarded as the only viable option when all  life care interventions fall short of ensuring a better life for terminally ill patient or one who is in a vegetative state; The killing of a patient suffering from an incurable and terrible sickness or in a irreversible coma painlessly.

Active Euthanasia , a person brings the patient’s death directly and purposefully.

Passive Euthanasia  patient’s life is not taken directly; instead they are left to die by discontinuing treatment.

A per Indian constitution, The right to life is a fundamental right under Art 21.

In Aruna Ramchandra Shanboug (2011) case the Supreme Court held that Passive Euthanasia  could be allowed under exceptional circumstances under strict monitoring.

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.

In common cause (2018) case Supreme Court upheld that the Fundamental Right, under Art 21, to life and dignity includes the Right to refuse treatment and die with dignity. 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.

Active euthanasia is a crime under Section 302 (punishment for murder) of the 1860 Code or at the very least Section 304 of the Indian Penal Code 1860 which deals with punishment for culpable homicide not amounting to murder.