Article 21 of the Indian Constitution, a fundamental right, states that "no one shall be deprived of his life or personal liberty except according to the procedure established by law." While this statement may appear straightforward in layman's terms, its true scope lies in judicial interpretation, one of the judiciary's essential roles. This article examines the interpretation of Article 21 as encompassing the right to die with dignity, focusing on the legal recognition of passive euthanasia in India.

The Right to Die with Dignity

The right to life and personal liberty under Article 21 has been judicially expanded to include the right to die with dignity. Passive euthanasia, as defined below, was first recognized by the Supreme Court in Aruna Ramchandra Shanbaug vs Union of India & Ors. on March 7, 2011. Subsequently, in the landmark judgment of Common Cause vs Union of India on March 9, 2018, passive euthanasia was legalized, making the right to die with dignity a fundamental right under Article 21.

Passive Euthanasia Defined

Passive euthanasia refers to the act of withholding or withdrawing medical treatment, including life support, with the intention of allowing a person to die naturally. This differs from active euthanasia, which involves taking deliberate steps to end a person's life.

Aruna Ramchandra Shanbaug vs Union of India & Ors. (2011)
This case arose from a writ petition filed by Ms. Pinki Virani on behalf of Aruna Ramchandra Shanbaug, a nurse who had been in a persistent vegetative state (PVS) for 36 years.

The petition detailed the horrific circumstances of the incident: Aruna was brutally assaulted and strangled with a dog chain by a hospital sweeper, leaving her in a state of irreversible brain damage. The petitioner argued that Aruna, being unable to communicate or express herself, was essentially a dead person with no state of awareness. The prayer was to direct the hospital authorities to cease feeding her, allowing her to die peacefully.

During the proceedings, the Court appointed a committee of medical experts to evaluate the claims, as discrepancies were noted between the allegations in the petition and the hospital's affidavit.

Recognition of Passive Euthanasia

The Court held that passive euthanasia should be permitted in India under exceptional circumstances. It stated that in cases where the patient is incompetent to make decisions—such as those in a PVS—the Court must ultimately decide whether to withdraw life support, giving due weight to the views of the patient's relatives, next friends, and medical professionals.

Common Cause vs Union of India (2018)

In this case, the Supreme Court addressed broader ethical, moral, and legal issues surrounding the right to die with dignity. The petitioner, a registered society, advocated for the recognition of an individual's "living will"—a document expressing their desire to refuse life-prolonging medical treatment if they reach an irreversible state of terminal illness or PVS.

The Union of India opposed the petitioner's plea, citing concerns about potential misuse and the sanctity of medical ethics. However, the Court emphasized the importance of individual autonomy, dignity, and the right to choose.

It ruled in favor of legalizing passive euthanasia, subject to stringent safeguards, including:

• Execution of a Living Will and Attorney Authorization document.
• Presentation of the document to medical authorities for appropriate action.
• Judicial oversight to prevent misuse or malfeasance.

Key Observations

• The Court's judgment addressed multiple dilemmas, including:
• The moral conflict faced by families and healthcare providers.
• The ethical responsibilities of doctors, who are bound by the Hippocratic Oath to save lives.
• The potential for abuse by individuals who may benefit from a patient's death.
• By legalizing passive euthanasia, the Court established a framework to balance these competing interests while upholding human dignity and autonomy.

Conclusion
The legalization of passive euthanasia in India marks a significant step in recognizing the right to die with dignity under Article 21. However, challenges remain regarding its implementation, ethical considerations, and the risk of misuse. Robust legal safeguards, transparent procedures, and public awareness are crucial to ensure that the process aligns with constitutional principles and human rights.

While the debate on morality and legality continues, it is imperative for lawmakers and legal professionals to engage in meaningful discourse. The goal must be to refine the legal framework, addressing loopholes and ensuring that passive euthanasia is exercised only in the most humane and ethical manner, free from ulterior motives or coercion. A well-established law that protects both individual dignity and societal interests is the need of the hour.