The issue in one line
India recognises passive euthanasia—withdrawing or withholding life-sustaining treatment when it is medically futile and consistent with the patient’s will—but everyday practice is uneven. Clearer rules, simple paperwork, and stronger palliative care can turn this right into dignified end-of-life care.

Where the law stands 

• Aruna Shanbaug (2011): The Supreme Court first opened a narrow door for passive euthanasia under strict court supervision.
  
• Common Cause v. Union of India (2018): The Court held that the right to die with dignity flows from Article 21 (right to life); recognised Advance Medical Directives (living wills); and created a protocol with medical boards and external oversight.
  
• Supreme Court modifications (2023): The Court simplified the 2018 procedure to reduce delay—easier execution and verification of living wills, time-bound decisions by two medical boards (hospital and independent), and clearer documentation.
  
• What remains unlawful: Active euthanasia (a deliberate act to cause death) continues to be prohibited under criminal law.
  
• Related statute: The Mental Healthcare Act, 2017 decriminalises attempt to suicide and promotes compassionate care; it does not authorise active euthanasia.
  

What exactly is allowed (and what is not)

Allowed (passive): Not starting or stopping ventilator support, dialysis, artificial feeding, or resuscitation when treatment is futile and the patient consents or a valid directive exists; if the patient lacks capacity, two medical boards decide in the best interests of the patient after family consultation.
Not allowed (active): Giving a lethal dose or any act meant to directly cause death.

The field reality—why reform is still needed

• Low awareness: Many citizens and even clinicians are unsure how to make or honour a living will.
  
• Process anxiety: Fear of litigation and uncertain forms lead to defensive care and prolonged suffering.
  
• Uneven capacity: Smaller hospitals lack ethics processes and trained teams.
  
• Weak palliative care: Without strong pain and comfort services, families see a false choice between machines and “doing nothing”.
  

A practical reform blueprint 

• Simple paperwork: One-page Advance Medical Directive in plain language, signed before two witnesses and attested by a designated public authority; a standard Do-Not-Resuscitate form with clear reasons and signatures.
  
• Digital access: Let citizens store the directive in a secure health record so any hospital can verify it quickly.
  
• Two-step review (within 48 hours): The Hospital Medical Board records medical futility and patient wishes; an Independent Board confirms promptly. Unresolved disputes may go to the High Court.
  
• Palliative-care consult: Before withdrawal, a palliative team explains comfort measures, symptom control, and family support.
  
• Good-faith protection: Legal cover for clinicians who follow protocol; penalties for coercion or forgery.
  
• Training and audit: Annual training, active ethics committees, and state dashboards (numbers only) to track timelines and quality.
  
• Access beyond metros: District and large private hospitals should publish board details and referral pathways for smaller facilities.
  

It respects autonomy with safeguards, avoids non-beneficial treatment, builds trust through clear documentation, and places palliative care and dignity at the centre of end-of-life practice.

Key Terms 

• Passive euthanasia: Withholding or withdrawing life-support that no longer benefits the patient, in line with the patient’s wishes or best interests.
  
• Active euthanasia: A deliberate act to cause death; unlawful in India.
  
• Advance Medical Directive / Living Will: A signed document stating what medical care a person wants or refuses if they cannot decide later.
  
• Do-Not-Resuscitate order: A direction not to attempt resuscitation when the heart or breathing stops.
  
• Medical Board: A group of doctors that reviews clinical futility, confirms wishes, and records a reasoned decision.
  
• Palliative care: Care focused on relief from pain and distress and on quality of life.
  

Exam Hook

Key takeaways

• India allows passive euthanasia and living wills under Article 21; active euthanasia remains unlawful.
  
• 2018 Common Cause established the framework; 2023 made it simpler and time-bound with two medical boards.
  
• Implementing reforms—simple forms, digital verification, palliative consults, good-faith protection, training and audit—can deliver dignity in practice.
  

UPSC Mains (150 words)
“Evaluate India’s legal framework on passive euthanasia in light of Article 21 and the Supreme Court’s 2018 and 2023 directions. Propose practical measures to ensure autonomy with safeguards across public and private hospitals.”

UPSC Prelims (MCQ)
Q. Which of the following is correct?

1. India permits passive euthanasia under Supreme Court guidelines.
   
2. Active euthanasia is lawful if two medical boards agree.
   
3. A living will can guide doctors when the patient lacks decision-making capacity.
   Select the correct answer:

(A) 1 only

(B) 1 and 3 only

(C) 2 and 3 only

(D) 1, 2 and 3
Answer: B

One-line wrap: Clear procedures, compassionate care, and honest consent can turn a constitutional promise into dignity at the end of life.