Active vs Passive Euthanasia

Why in News?

The Supreme Court of India recently permitted passive euthanasia for a 32-year-old patient, Harish Rana, marking the first time the Court has issued such an order to relieve a patient’s suffering.

• Euthanasia - It is the intentional practice of ending a life to relieve intractable pain and suffering.
• Types - Passive vs. Active Euthanasia
  • Passive (Legal) - Withdrawing or withholding medical treatment (like ventilators or feeding tubes) to allow a terminally ill patient to die in the natural course.
  • Active (Illegal) - Using lethal substances to end a patient's life, which remains a criminal act in India.
  • Patients or their families can refuse treatments such as cardio-pulmonary resuscitation, ventilator support, chemotherapy, radiotherapy, dialysis or specialized nutrition.

Active Euthanasia is legal in countries such as the US, Canada, Australia, and parts of Europe but not in India.

• Timeline of Key Judicial Pronouncements

• Recent Supreme Court Verdict - The Supreme Court of India, recently, authorized passive euthanasia of 32-year-old Harish Rana, who has been in a persistent vegetative state (PVS) for the last 13 years, following an accident in 2013.
• These ruling builds upon the legal foundation established by the Common Cause vs. Union of India (2018) case, which recognized the "Right to Die with Dignity" as a fundamental right under Article 21 of the Constitution.

• Procedure for passive euthanasia in India
• In 2024, the Union Health Ministry released a set of draft guidelines, based on the top court’s 2023 directives, detailing the process hospitals must follow to withhold or withdraw care.
• First, the treating physician needs to decide if the patient has any hope of recovery or having a good quality of life if treatment measures remain in place.
• Then, a primary board has to assess the case and reach a consensus.
• This board comprises the treating physician and two subject experts with 5 or more years of experience.
• The doctors then need to discuss the prognosis with family and whether they want any other treatment.
• A shared decision has to be taken and the team of doctors has to come up with a consistent plan for care.
• If the doctors and the family decide that the measures should be withdrawn, they need to submit a request to be submitted to a secondary medical board.
• This board consists of a doctor nominated by the chief medical officer (CMO) of a district and 2 subject experts with 5 or more years of experience.
• This board has to take a decision within 48 hours.
• Hospitals must also inform magistrates before withdrawal of treatment, though their approval is not required.

Reference

The Hindu | Euthanasia