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Right to Die with Dignity as a Fundamental Right under Article 21

From the moment of his birth, a person is clothed with basic human rights. Right to life is one of the basic as well as fundamental right without which all rights cannot be enjoyed. Right to life means a human being has an essential right to live, particularly that such human being has the right not to be killed by another human being. But the question arises that if a person has a right to live, whether he has a right not to live i.e., whether he has a right to die? While giving this answer, the Indian courts expressed different opinions.

Right to life including the right to live with human dignity would mean the existence of such right up to the end of natural life. This may include the right of a dying man to die with dignity. But the 'right to die with dignity' is not to be confused with the right to die an unnatural death curtailing the natural span of life.

Thus, the concept of right to life is central to the debate on the issue of Euthanasia. One of the controversial issues in the recent past had been the question of legalizing the Right to Die or Euthanasia. Euthanasia was controversial since it involves the deliberate termination of human life. Patient suffering from terminal diseases are often faced with great deal of pain as the diseases gradually worsens until it kills them and this may be so frightening for them that they would rather end their life than suffering it.

The concept of Life and Death has invited many a thinker, philosopher, writer and physician to define or describe them. Sometimes attempts had been made or efforts had been undertaken to paint gloriously the pictures of both in many a colour and shade. Swami Vivekananda expects one to understand that life is the lamp that is constantly burning out and further suggests that if one wants to have life, one has to die every moment for it. To meet the changing situations, the Court has been endorsed with a duty to interpret Article 21 in a further dynamic manner and it has to be stated without any trace of doubt that the right to life with dignity has to include the smoothening of the process of dying when the person is in a vegetative state.

The Supreme Court has interpreted right to life under Article 21 in a very vast manner and has included various human rights under its purview. From right to life to right to travel, right to dignity, right to dignity, right to privacy, right to pollution free environment etc., Article 21 includes most of the basic human rights which are essential for a dignified life. In its latest judgement on March 9, 2018 the Apex Court included Right to Die with dignity as a part of right to life under Article 21.

Dr D Y Chandrachud, J in his judgement in Common cause v. Union of India[1] has also defined the relationship between life and death as:
Life and death are inseparable. Every moment of our lives, our bodies are involved in a process of continuous change. Millions of our cells perish as nature regenerates new ones. Our minds are rarely, if ever, constant. Our thoughts are fleeting. In a physiological sense, our being is in a state of flux, change being the norm. Life is not disconnected from death. To be, is to die. From a philosophical perspective, there is no antithesis between life and death. Both constitute essential elements in the inexorable cycle of existence.

The concept of life, liberty and dignity
Life and liberty under article 21

Article 21 of the Indian Constitution reads as follows:
21. Protection of life and personal liberty:
No person shall be deprived of his life or personal liberty except according to procedure established by law.[2]

Life as envisaged under Article 21 has been very broadly understood by the Supreme Court. In the case of Board of Trustees of the Port of Bombay v. Dilipkumar Raghavendranath Nadkarni and others[3], the Apex Court had held that the expression life does not merely connote animal existence or a continued drudgery through life. The expression life has a much wider meaning.

In State of Andhra Pradesh v. Challa Ramkrishna Reddy and others[4], it was held by the Supreme Court that right to life is one of the basic human rights and it is guaranteed to every person by Article 21 of the Constitution and not even the State has the authority to violate that right.

In Maneka Gandhi v. Union of India and another[5], Krishna Iyer J., in his own inimitable style, states that among all the great guaranteed rights by the Constitution , life and liberty are the first among equals carrying a universal connotation cardinal to a decent human order and protected by constitutional amour

Article 21 has been interpreted by the Court in most expansive terms, particularly when it comes to the meaning that is assigned to 'right to life'. In Kharak Singh v. State of U.P. & Ors.[6] it was held that the word 'life' in Article 21 means right to live with human dignity and it does not merely connote continued drudgery. Right to life has been treated as more than 'mere animal existence'.

The word 'liberty' is the sense and realization of choice of the attributes associated with the said choice; and the term 'life' is the aspiration to possess the same in a dignified manner. The two are intrinsically interlinked. Liberty impels an individual to change and life welcomes the change and the movement. Life does not intend to live sans liberty as it would be, in all possibility, a meaningless survival.

It has been held by the Supreme Court that the interpretation of the Constitution, especially fundamental rights, has to be dynamic and it is only such interpretative dynamism that breathes life into the written words. As far as Article 21 is concerned, it is imperative to mention that dynamism can, of course, 'infuse life' into life and liberty as used in the said Article.

Dignity
Right to life and liberty as envisaged under Article 21 of the Constitution is meaningless unless it encompasses within its sphere individual dignity. With the passage of time, the Supreme Court through its various judgements has expanded the spectrum of Article 21 to include within it the right to live with dignity as component of right to life and liberty. The first and foremost responsibility fixed upon the State is the protection of human dignity without which any other right would fall apart. In the South African case of S v. Makwanyane[7], O' Regan J. had stated in the Constitutional Court that "without dignity, human life is substantially diminished."

In the nine-Judge Bench decision in K.S. Puttaswamy and another v. Union of India and others[8], dignity has been reaffirmed to be a component under the said fundamental right. Human dignity is beyond definition. It may at times defy description. To some, it may seem to be in the world of abstraction and some may even perversely treat it as an attribute of egotism or accentuated eccentricity.

That is why, the Constitution Bench in M. Nagaraj and others v. Union of India and others[9] lays down:
�.It is the duty of the State not only to protect the human dignity but to facilitate it by taking positive steps in that direction. No exact definition of human dignity exists. It refers to the intrinsic value of every human being, which is to be respected. It cannot be taken away.

It cannot give (sic be given). It simply is. Every human being has dignity by virtue of his existence...
In National Legal Services Authority v. Union of India and others[10], the Apex Court has held that there is a growing recognition that the true measure of development of a nation is not economic growth; it is human dignity.

In the recent case of K.S. Puttaswamy[11], Dr. Chandrachud J., while speaking about life and dignity, has observed life to be precious in itself and had held life to be worth living because of the freedoms available to a person. He continued to say that To live is to live with dignity. He has elaborated dignity as core which unites the Fundamental Rights. It has been gladly taken into cognizance by law that Dignity is the sacred possession of a man. Also, the said sacred possession neither loses its sanctity with the process of dying nor does it evaporates when death occurs.

The Supreme Court in the case of Francis Coralie Mullin v. The Administrator, Union Territory of Delhi[12] has held that Right to Life also included the right to live with human dignity and everything that goes along with it. It has been further held in that case that Every act which offends against or impairs human dignity would constitute deprivation protanto of this right to live and it would have to be in accordance with reasonable, fair and just procedure established by law which stands the test of other fundamental rights.

The Second World War made the governments of the various countries realise the need to cherish and protect the human dignity. Due to this reason only the U.N. Charter, 1945, which was adopted immediately after the Second World War, mentioned 'Dignity of the Individuals' as its core value. The Universal Declaration of Human Rights (1948) also echoed the same sentiments. Article 3 of the Geneva Conventions also explicitly prohibits outrages upon personal dignity.

Legal status of right to die

Right to die with dignity As a Fundamental Right

Right to Life Under Part-III (Article 21) of the Indian Constitution is one of the most basic natural Right of the human beings. Article 21 prohibits person from deprivation of his life or liberty except according to the process established by law. It ensures upon the state the obligation to provide every person a good quality of life and a dignified life. This Right has been interpreted by the judiciary in a very elaborate way to included new rights within its purview. Earlier to the Common Cause judgement, right to die was not considered as a fundamental right. But the Court in its judgement declared Right to Die with Dignity as fundamental right.

Analysis of Judgment in Common cause v. Union of India (2018)

The Supreme Court of India on March 9, 2018 in the instant writ petition of Common Cause (A Regd. Society) v. Union of India[13] had recognised death with Dignity as Fundamental Right under Article 21 of the Constitution and had given effect to the Advanced Medical Directives (Living Will) and the Medical Attorney Authorisation to facilitate the exercise of this Right. This step of the Apex Judiciary welcomed the most awaited demand of legalising Passive euthanasia in the Indian Legal System.

This judgement is an ode to individual autonomy as it had enabled people to draw living wills and attorney authorisation that would enable a person to discontinue his treatment if he is terminally ill or in permanent vegetative state.

Background to the judgment

P. Rathinam's Case

The question of unconstitutionality of Section 309 of the Indian Penal Code
The issue as to whether Right to Die formed a part of the Guarantee of Right to Life Under Article 21 of the Constitution was first raised before the Apex Court in the case of P. Rathinam v. Union of India[14]. The Challenge raised under this writ petition was with the Constitutional validity of the Section 309 of the Indian Penal Code (IPC) contending that the same was violative of Articles 14 and 21 of the Constitution. Section 309 of the IPC reads as follows:
309. Attempt to commit suicide.�Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year [or with fine, or with both.][15]

The main question raised in this judgment was:
Has a person residing in India a Right to die?
Answering this question, the court referred to the decision of the Bombay High Court in the case of Maruti Shripati Dubal v. State of Maharashtra[16] which placed reliance on R.C. Cooper v. Union of India[17] wherein it was held that:
what was true of one fundamental right was also true of another fundamental right and on the said premise, the Bombay High Court had opined that it cannot be seriously disputed that fundamental rights had their positive as well as negative aspects. The court held that, in any case, a person cannot be forced to enjoy the right to life to his detriment, disadvantage or disliking. Eventually, it came to conclusion that the right to live of which Article 21 speaks of can be said to bring in its trail the right not to live a forced life. Answering all the questions, the Apex Court declared Section 309 of IPC ultra vires and held that it deserved to be effaced from the statute book to humanize our penal laws.

Gian Kaur's Case

The question of unconstitutionality of Section 306 of the Indian Penal Code
The Dictum which was laid down in P. Rathinam did not remain a precedent for a long. The Constitution Bench considered the correctness of the decision rendered in P. Rathinam in Gian Kaur v. State of Punjab[18]. In this case, the appellants were convicted by the trial court under Section 306 of IPC. Section 306 of the IPC is related to abetment of suicide and makes abetment a punishable offence. It reads follows:
306. Abetment of suicide.�If any person commits suicide, whoever abets the commission of such suicide, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine.[19]

The conviction was assailed on the ground that Section 306 IPC was unconstitutional and to sustain their argument, they placed reliance on the authority in P. Rathinam wherein Section 309 IPC was held to be unconstitutional. It was urged in this case that, since Section 309 IPC had been held unconstitutional, any person abetting the suicide was merely assisting in the enforcement of the Fundamental right under Article 21.

The court opined that all fundamental rights are not the same and hence the same standard must not be applied to them. Therefore, while Article 19 had a negative component in its guarantees, Article 21 cannot be read in a similar manner. Thus, an unnatural termination of life could not be treated as a part of the right to life.

The Constitution Bench in this case held that the right to life including the right to live with human dignity would mean the existence of such a right up to the end of natural life. It further explained that the said conception also includes the right to a dignified life up to the point of death including a dignified procedure of death or, in other words, it may include the right of a dying man to also die with dignity when his life is ebbing out. It was clarified by the court that the right to die with dignity at the end of life was not to be confused or equated with the right to die an unnatural death curtailing the natural span of life.

Thus, taking into consideration various aspects, the Constitution Bench declared Section 309 IPC as constitutional. It then examined the question of validity of Section 306 and held it to be constitutional. Eventually, the Court in Gian Kaur overruled P. Rathinam.

Aruna Shanbaug's Case

The approach of Passive Euthanasia vis-�-vis India
For the very first time, the Supreme Court dealt with the issue of permitting or legalising Euthanasia in the case of Aruna Ramachandra Shanbaug v. Union of India and others[20]. Aruna Ramachandra Shanbaug was a staff Nurse who worked in King Edward Memorial Hospital, Mumbai when she was brutally and sustained serious injuries that left her in a permanent vegetative state. She was cared for by the hospital staff and nurses over a long period of thirty-six years, however there was no improvement in her conditions. A writ petition was filed by the next friend of the petitioner seeking permission to stop feeding the petitioner and to allow her to die peacefully.

The two judge Bench relying on Airedale N.H.S. Trust v. Bland[21] (Airedale case) and other international Jurisprudence held that passive euthanasia may be applied for terminally ill patients or patients in a permanent vegetative state provided that certain safeguards were followed. Recognising the autonomy of the patient, the Court held that if the patient was conscious and capable of giving consent, his or her opinion must be taken, otherwise at least the opinion of a next friend was required. After that , the matter would then go to the respective High Court where a Division Bench would be required to be constitute a Board of three competent doctors to fully examine the patient. The court further held that these guidelines need to be followed till the Parliament brings a valid legislation on this matter.

Euthanasia and its legal position in context of Article 21

Euthanasia: Active And Passive

The term Euthanasia comes from two ancient Greek words: 'Eu' which means 'Good' and 'thantos' which means 'death' and it pertains to the practice of ending a life to relieve pain and suffering. But, the issue of euthanasia is not as simple as its literal translation of the term. The termination of life may either be by Direct intervention (Active Euthanasia) or by may be by withholding life prolonging measures and resources (passive euthanasia). Aruna Shanbaug case[22] discussed the two categories of euthanasia- Active and Passive.

Active Euthanasia

Also known as positive euthanasia or aggressive euthanasia. This type of euthanasia entails a positive act or affirmative action or an act of commission entailing the use of lethal substances or forces to cause the intentional death of a person by direct intervention. This type of euthanasia involves taking specific steps to cause the patient's death such as injecting the patient with some lethal substance.

Passive Euthanasia

Also known as negative euthanasia or non-aggressive euthanasia. This type of Euthanasia entails withdrawing of life support measures or withholding of medical treatment for continuance of life. In active euthanasia a specific act is done to end the patient's life while passive euthanasia is a situation where something is not done which is necessary in preserving the patient's life.
The two Judge Bench in the case of Aruna Shanbaug had observed that the legal position across the world seems to be that while active euthanasia is illegal unless there is a legislation which permits it, passive euthanasia is legal even without any legislation, provided certain conditions and safeguards are maintained. Most of the countries today have legalised passive euthanasia either by way of legislations or through the judicial interpretations, but there now also remains uncertainty whether active euthanasia should be granted legal status. The court in this case held that passive euthanasia would only be permissible when the patient is 'dead' in clinical sense.

The Common Cause Judgement

Constitutional value of Euthanasia

The Supreme Court in many a case has held that the expression life does not merely connote animal existence or a continued drudgery through life. It has a much wider meaning. The court in the case of State of Andhra Pradesh v. Challa Ramkrishna Reddy and others[23] held that right to life is one of the basic human rights and not even the state has the authority to violate that right.

In the case of Aruna Shanbaug, the Court held active euthanasia to be legally impermissible. It permitted passive euthanasia with the condition that this was to be performed under the supervision of the High Court following the due procedure until the legislature comes up with a law.

The Supreme Court in various cases like Kharak Singh v. State of U.P. & Ors[24], K.S. Puttaswamy and Another v. Union of India and Others[25], C.E.S.E. Limited and Others v. Subhash Chandra Bose and Others[26] and in other cases has pointed that Article 21 recognizes right to live with human dignity. Now the question arise as to whether this right to life as enshrined in Article 21 also includes the right to die? The answer to this question has not been provided in a straightforward manner by the Apex Court. Although it has allowed for passive euthanasia but it has a very complex process.

Article 21 is a provision which guarantees right to life and this cannot be stretched to include extinction of life within protection of life. The court has found that committing suicide cannot be formed a part of Article 21. Right to life is a natural right embodied in Article 21 but suicide is an unnatural termination or extinction of life and, therefore, it is incompatible and inconsistent with the concept of right to life.

Matter becomes more complicated when it is examined in context of medical science. Every Doctor is supposed to take a Hippocratic Oath, under which he oaths to make every attempt to safeguard the life of the patient whom he/she is treating and who is under his/her treatment. Thus, this oath puts a moral and professional duty on him to do everything possible to save the life of the patient.

Then, there is also a very high chance/possibility of misuse and it becomes a challenging task to ensure that passive euthanasia does not become a tool of corruption and a convenient mode to ease out the life of a person who is considered inconvenient.

In the context of euthanasia, personal autonomy of an individual, as a part of human dignity, plays an important role. The court in National Legal Services Authority v. Union of India and Others[27] has observed that Article 21, as already indicated, guarantees the protection of personal autonomy of an individual. Along with the personal autonomy, other facets of human dignity, namely, self-expression and right to determine also support the argument that it is the choice of the patient to receive or not to receive the treatment.

In the case of Gian Kaur, the court held that the right to die is inherently inconsistent with the right to life as is death with life. But The court also pointed out that the right to life embodies the right to live with human dignity which postulates the existence of such a right up to the end of natural life. This, the court observed included the right to lead a dignified life up to the point of death and included a dignified procedure of death. Thus, with refence to Euthanasia, the Bench was careful in observing that the right to a dignified life may include the right of an individual to die with dignity.

Dr D Y Chandrachud, J in his judgement in Common cause v Union of India has made a distinction between Active and passive euthanasia and has supported the legal validity of passive euthanasia. He makes a distinction between the two on basis of Penal provisions. He held that Active euthanasia involves an intention to cause the death of the patient. Mens rea requires a guilty mind; essentially an intent to cause harm or injury. Passive euthanasia does not embody an intent to cause death.

A doctor may withhold life support to ensure that the life of a patient who is in the terminal stage of an incurable illness or in a permanent vegetative state, is not prolonged artificially. By withholding life support system, what he is doing is, not causing death but just allowing the life of the patient to continue till and cease at the end of its natural term.

The Supreme Court in case of Common cause while upholding the legality of passive euthanasia and in recognising the importance of the advance directives, drew sustenance from the constitutional values of liberty, dignity, autonomy and privacy. Thus, through this judgement, the Court reiterated to the view of Constitution Bench in Gian Kaur which has already declared the right to die with dignity as a Fundamental Right. The Court mentioned some Advanced Directives to execute passive euthanasia.

Observation of Law Commission Of India

241st Law Commission Report

The Law Commission of India submitted its 241st report, after the judgment of Aruna Shanbaug, which dealt with Passive Euthanasia � A Relook. [28] In its introduction, the report deals with the concept of euthanasia. The Commission in its report referred to the observations made by the then Chairman of the Law Commission in his letter dated 28th August, 2006 addressed to the Hon'ble Minister which was extracted. The letter addresses how today a patient, who is terminally ill, has a common law right to refuse the modern medical procedures and allow the nature to take its own course.

This report correctly points out that a rational and humanitarian outlook should have primacy in such a complex matter. It highlights how passive euthanasia, both in case of competent and incompetent patients, is allowed in most of the countries, subject to the doctor acting in the best interest of the patient. The principle of the patient's autonomy (or the right to self-determination) and self-beneficence are taken into consideration. The report also refers to the Airedale case in which Lord Keith has made observations for providing for a course to safeguard the patient's best interest.

Although this Report has recognised Passive euthanasia in India, but no law has been enacted up until now.

Advance Medical Directives (Living Will)

The Common Cause judgement written by the Chief Justice Dipak Mishra and Justice A.M. Khanwilkar legalised Living Will or the Advance Medical Directives. Through the Advance Medical Directives, the incompetent patients can beforehand communicate their choices which are made while they are competent. It was contended that a failure to recognise Advance Medical Directives would amount to non-facilitation of the right to have a smoothened dying process.

Advance Medical Directives is defined in the Black's Law Dictionary as:
a legal document explaining one's wishes about medical treatment if one becomes incompetent or unable to communicate.

Medical power of attorney is also a type of Advance Medical Directives which allows an individual (principal) to appoint a trusted person (agent) to take health care decisions when the principal is not able to take such decisions.

The Apex Court in its judgement considered these directives as a fruitful means to facilitate the fructification of the sacrosanct right to life with dignity. The said directive was considered to dispel many doubts at relevant times of need during the course of treatment of patient. It was also believed that it will strengthen the mind of treating doctors because they would now be ensured that they are acting in a lawful manner. The Court also added that these directives cannot operate in abstraction. It recommended for certain safeguards. The Court enumerated some of the safeguards.

These safeguards were:
  1. Who can execute the Advance Directive and how?

    The Supreme Court in the judgement ruled that these Directives:
    • Could only be executed by an adult of sound mind and in healthy state.
    • Must be voluntarily executed without any use of coercion or inducement and having full information.
    • Must have an informed consent without any undue influence.
    • Clearly stated in writing as to when medical treatment may be withdrawn.
  2. What should it contain?

    The Advance Medical Directives should:

    • clearly indicate the circumstances in which withholding or withdrawal of medical treatment can be resorted to
    • Must be clear and ambiguous and instructions must be clear.
    • Mention that the instructions may be revoked at any time.
    • Disclose that executor had understood consequences of the execution of document.
    • Specify the name of a guardian or close relative who would be authorised to give consent to refuse or withdraw medical treatment in a manner consistent with the Advance Directive.
    • If there is more than one valid Advance Directive, none of which had been revoked, the most recently signed Advance Directive would be considered.
  3. How should it be recorded and preserved?

    • The Directive should be signed by the executor in presence of two attesting witnesses and countersigned by the jurisdictional Judicial Magistrate of First Class (JMFC).
    • The witnesses and the JMFC record their satisfaction that it has been executed voluntarily and without any coercion and with full understanding of all the consequences.
    • The JMFC shall preserve one copy of the document in his office along-with a digital copy.
    • One copy of the document should be forwarded by the JMFC to the Registry of the jurisdictional District Court for being preserved along-with the digital copy.
    • The JMFC shall cause to inform the immediate family members of the executor and make them aware if they were not present at time of execution of the document.
    • A copy should also be handed over to the competent officer of the local Government.
  4. When and by whom can it be given effect to?

    These Advance Medical Directives may be given effect to when:
    • It has been fully satisfied by the Medical Practitioner that the executor is terminally ill and is undergoing a prolonged treatment or is surviving on life support and that the illness of the executor is incurable or has no chances of being cured.
    • If the physician is satisfied that the instructions in Directive need to be acted upon, he should inform executor or his guardians everything of his no chances of recovery.
    • The hospital shall then constitute a Medical Board consisting of the Head of the treating Department and a few experts from the fields of general medicine, cardiology, neurology, nephrology, psychiatry and form an opinion whether to certify or not to certify carrying out the instructions of withdrawal of treatment.
    • If the Board certifies that the instructions ought to be carried out, the hospital shall forthwith inform the jurisdictional Collector about the proposal. The jurisdictional Collector shall then immediately constitute a Medical Board which comprises of the Chief District Medical Officer and three expert doctors from the fields of general medicine, cardiology, neurology, nephrology, psychiatry or oncology with a twenty-year experience.
    • The Chief District Medical Officer, shall convey the decision of the Board to the jurisdictional JMFC before giving effect to the decision to withdraw the medical treatment administered to the executor.
    • The JMFC shall visit the patient at the earliest and verify the medical reports, discuss with the family members and after satisfaction may endorse the decision of the Collector to withdraw or refuse medical treatment to the terminally ill patient.
  5. What if permission is refused by the Medical Board?

    If in case the permission is refused by the Medical Board:
    • It would be open for the executor or his family members to approach the High Court by way of writ petition under Article 226 of the Constitution.
    • It would be open to the High Court to constitute a Medical Board or even an Independent Committee consisting of three doctors to look after the case.
  6. Revocation or inapplicability of Advance Directive [29]

    The Advance Directives can be withdrawn or Altered by an individual at any time when he/she has capacity to do so by following the same procedure as was followed for recording of the Directives.

    An Advance Directive shall not be applicable:
    • If there are reasonable grounds for believing that there exists circumstances which the person making the directive had not anticipate at the time of formulation of directive and which would have affected his decision had he anticipated them.
    • If the Advance Directive is not clear and ambiguous.
Even then there may be cases where there is no Advance Directive. This class of persons cannot be alienated. If in a case there are no Advance Directive, the procedure and safeguards are to be same as are applied to the cases where Advance Directives are in existence. In addition to it, the Hospital Medical Board should discuss about the consequences and all the details of withdrawal with the family physician and the family members and record the minutes of the discussion in writing.

Conclusion
The Supreme Court in the Common Cause had exemplified the application of the Doctrine of proportionality wherein it had balanced the two facets of the same right, i.e. the right to life under Article 21 of the Constitution. On one hand right to life creates a compelling state interest preserving human life, whereas, on the other hand it also assures the individual Autonomy to take decisions with respect to his/her own body.

The Supreme Court in this judgement carried out a measured analysis of the social, ethical, economical, and philosophical aspects with respect to the right to die issue. So, it had very nicely carved out an exception to the principle of the sanctity of the life in the cases where a person's life had lost its meaning and the prolongation of life is in no in any way in his best interest. For this judgement, the Comparative Jurisprudence of various countries, which had been referred by the court, were of great help in providing assistance while undertaking this exercise. The members of the Bench examined the International jurisprudence in an exhaustive way.

The Constitution Bench paved way for Right to die with dignity as a fundamental right and to enforce the same through passive euthanasia. The court issued certain Advance directives for terminally ill patients or for those who are in permanent vegetative state. It also issued some guidelines to be followed for those patients who didn't have an Advance Directive.
Although this right to die with dignity is very helpful for many persons but there are a few chances of exploitation of this right. The poor status of education and legal awareness among Indian masses might become a cause of exploitation of these Directives by the greedy heirs.

Recognition of right to die with dignity for terminally ill patient is only one side of the coin. The question as to how this right would be interpreted and decided for the people demanding to embrace death due to various pressing reasons such as old age, destitution and lack of opportunity to die with dignity in India remains unanswered.

Bibliography
Books:
  • M. P. Singh (ed.), V. N. Shukla's Constitution of India, (Eastern Book Company, New Delhi, 2019)
Journal Articles
  • G.K. Goswami and Siddhartha Goswami, Right to 'Die with Dignity': Analysis of 'Common Cause v. Union of India' (2018) 60 JILI 97 (2018).
  • Vini Singh, On Advance Directives and Attorney Authorisations - An Analysis of the Judgment of the Supreme Court in Common Cause (A Regd. Society) v. Union of India 4.2 CALQ 23 (2018).
Websites:
  1. Constitutionality of the right to die � a brief analysis, available at: http://www.legalservicesindia.com/article/608/Constitutionality-of-the-right-to-die---a-brief-analysis.html (Visited on September 29, 2020)
  2. Article 21 and Constitutional validity of Right to Die, available at: http://www.legalserviceindia.com/article/l374-Article-21-and-Constitutional-validity-of-Right-to-Die.html (Visited on September 29, 2020)
  3. The Right to Die with Dignity: The Indian Supreme Court Allows Passive Euthanasia and Living Wills, available at: https://ohrh.law.ox.ac.uk/right-to-die-with-dignity-a-fundamental-right-indian-supreme-court-allows-passive-euthanasia-and-living-wills/ (Last Modified April 11, 2018)
  4. To Live With Dignity Also Includes A Right To Die With Dignity, Says Indian Supreme Court, available at: https://www.huffingtonpost.in/2018/03/09/to-live-with-dignity-also-includes-a-right-to-die-with-dignity-says-indian-supreme-court_a_23382053/?guccounter=1 (Last Modified March 10, 2018)
  5. Does Right to Life include Right to Die?, available at: https://blog.ipleaders.in/does-right-to-life-include-right-to-die/ (Last Modified May 13, 2019)
End-Notes:
  1. (2018) 5 SCC 1
  2. The Constitution of India, art. 21.
  3. (1983) 1 SCC 124.
  4. AIR 2000 SC 2083 : (2000) 5 SCC 712.
  5. (1978) 1 SCC 248.
  6. AIR 1963 SC 1295.
  7. 1995 (3) SA 391.
  8. (2017) 10 SCC 1.
  9. (2006) 8 SCC 212.
  10. (2014) 5 SCC 438.
  11. Supra note 13
  12. (1981) 1 SCC 608.
  13. Supra note 6.
  14. (1994) 3 SCC 394.
  15. The Indian Penal Code, 1860 (Act 45 of 1860), s.309.
  16. 1987 Cri LJ 473 : (1986) 88 Bom LR 589.
  17. (1970) 2 SCC 298 : AIR 1970 SC 1318.
  18. (1996) 2 SCC 648
  19. The Indian Penal Code, 1860 (Act 45 of 1860), s.306
  20. (2011) 4 SCC 454
  21. (1993) 2 WLR 316: (1993) 1 All ER 821, HL
  22. Supra note 25
  23. AIR 2000 SC 2083 : (2000) 5 SCC 712
  24. Supra note 11
  25. Supra note 13
  26. (1992) 1 SCC 441.
  27. Supra note 15.
  28. Law Commission of India, 241st Report on Passive Euthanasia � A Relook (August, 2012).
  29. Common cause v. Union of India, (2018) 5 SCC 1.

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