Why In The News?

• In a historic move, the Karnataka Health Department issued an order to implement the Supreme Court’s ruling allowing terminally ill patients to die with dignity.
• Karnataka is the second State after Kerala to implement the directive.
• Euthanasia is the intentional act of ending a person’s life to relieve suffering caused by a painful, incurable disease or disorder.

Supreme Court’s Directives on Passive Euthanasia:

=> Legal Recognition (2018 & 2023 Rulings): The Supreme Court legalized passive euthanasia in 2018, recognizing the right to die with dignity under Article 21 of the Constitution. In 2023, the court simplified procedures for withdrawing life support, ensuring a structured and ethical approach.

=> Conditions for Passive Euthanasia: Applicable to terminally ill patients with no hope of recovery. Allowed when the patient is in a persistent vegetative state or prolonged suffering from an incurable condition.

=> Advance Medical Directive (AMD) or ‘Living Will’: Any competent adult can create an AMD specifying their medical treatment preferences in case they lose decision-making capacity. The AMD can nominate two representatives to make decisions on the patient’s behalf.

=> Approval Process for Life Support Withdrawal: Hospitals must set up Primary and Secondary Medical Boards (each with three senior doctors).

• The District Health Officer must be involved in the decision.
• Final decision requires Judicial Magistrate of the First Class (JMFC) approval and reporting to the High Court Registrar.

What is Passive Euthanasia?

=> It is withholding or withdrawing life-sustaining treatment (LST), allowing a terminally ill patient to die naturally.

=> Legal in India (as per Supreme Court rulings in 2018 & 2023) under strict medical and legal procedures.

=> The Ministry of Health and Family Welfare (MoHFW) has released draft guidelines titled “Guidelines for Withdrawal of Life Support in Terminally Ill Patients.”

Ethical Considerations of Euthanasia:

Autonomy and the Right to Die:

• Pro-Euthanasia: Argue that individuals have the right to choose how they live and die. A competent person should be allowed to make decisions regarding their life, including opting for euthanasia.
• Anti-Euthanasia: Opponents believe that allowing euthanasia undermines the intrinsic value of life and could set a dangerous precedent for determining when life is worth living.

Beneficence and Compassion:

• Pro: Physicians take an oath to reduce suffering. For terminally ill patients in unbearable pain, euthanasia can be a compassionate act that provides relief.
• Anti: Opponents argue that palliative care and pain management should be prioritized rather than ending a patient’s life.

Slippery Slope Argument:

• Pro: Some believe euthanasia can be regulated with strict guidelines to prevent misuse.
• Anti: Others argue that legalizing euthanasia could lead to involuntary euthanasia or pressure on vulnerable individuals (elderly, disabled) to end their lives to reduce the burden on families or society.