BALANCING THE RIGHT TO LIVE AND DIE: EUTHANASIA JURISPRUDENCE IN INDIA

Introduction

The word euthanasia originates from the Greek words ‘eu’, meaning ‘good’, and ‘thanatos’, meaning ‘death’. Euthanasia, or mercy killing, is the practice of painlessly ending the life of an individual who is suffering from a severe and incurable disease or an incapacitating physical disorder, or allowing them to die. Ending life deliberately is known as active euthanasia, while withholding or withdrawing artificial life-support measures is known as passive euthanasia.

Euthanasia is further classified into several forms. Voluntary euthanasia is where both the request and the consent come from the patient. Non-voluntary euthanasia is where the decision is made on behalf of an incapacitated patient. Involuntary euthanasia is performed against the will of the person and is considered not only illegal but also murder. Finally, physician-assisted suicide is where a doctor provides the means for a mentally competent patient to end their own life. Euthanasia is more commonly practised in veterinary medicine, where animals are put to death to end suffering.

When it comes to humans, many religions, cultures and customs across the world hold that life is sacred and that taking it, even with consent, is a sin. It is submitted in this article that a balanced approach towards the right to life and the right to die with dignity is the way forward for the Indian legal system.

The Constitutional Position: Article 21 and Attempt to Suicide

It is a cardinal principle to protect and preserve life. In India, the right to life is a fundamental right enshrined in Article 21 of the Constitution, which states that no person shall be deprived of life or personal liberty except according to procedure established by law. Article 21 has undoubtedly been interpreted broadly and now includes a plethora of rights, such as the right to human dignity, privacy, livelihood, shelter and a clean environment. However, in recent years, the question whether the right to die with dignity falls within Article 21 has become highly debatable as well as controversial. This question is multifaceted.

The Indian Penal Code, 1860 made attempt to suicide a punishable offence under Section 309, with imprisonment of up to one year. With the repeal of the Code by the Bharatiya Nyaya Sanhita, 2023, suicide has been decriminalised in India, shifting the focus to mental health care and support. In P. Rathinam v. Union of India¹, the Hon’ble Supreme Court held Section 309 of the IPC unconstitutional on the reasoning that, just as the right to freedom of speech under Article 19 includes the right not to speak, the right to live under Article 21 includes the right not to live. This judgment was short-lived. In 1996, a five-judge bench of the Hon’ble Supreme Court, in the landmark case of Gian Kaur v. State of Punjab², overruled P. Rathinam v. Union of India.

The Law Commission Reports

In 2006, the Law Commission of India, in its 196th Report, recommended that a law be made to protect terminally ill patients who refuse medical treatment, artificial nutrition or hydration. Further, doctors who obey such a decision of the patient, or who make the decision for incompetent patients in the best interests of such patients, must be protected from punishment under Section 306 of the IPC (abetment of suicide) and Section 299 (culpable homicide). The Report also clarified that the ‘patient’ must be suffering from a terminal illness, that is, an illness, injury or degeneration of a physical or mental condition which causes extreme pain and suffering and which, according to reasonable medical opinion, will inevitably cause the untimely death of the patient.

In its 210th Report, titled ‘Decriminalisation of Attempt to Suicide’, the Law Commission found Section 309 of the IPC inhuman and stated that an attempt to commit suicide is a manifestation of a ‘diseased condition of the mind’. Such a person deserves treatment and care, not punishment. Inflicting additional punishment on a person who is already suffering agony is unjust and unfair. It does not help in preventing suicides or in improving access to medical care for those who have attempted it.

Judicial Recognition of Passive Euthanasia

In Aruna Shanbaug v. Union of India (2011)³, the Supreme Court considered the issue of euthanasia at length and allowed passive euthanasia. Invoking the parens patriae principle (Latin for “parent of the nation”, under which the Court can step in and serve as a guardian), it held that the Court is the ultimate decider of what is best for the patient. Although the Court did not allow the withdrawal of medical treatment in the case of Ms. Shanbaug, the case became significant because of its lengthy and equally important discussion on euthanasia.

The Common Cause (A Regd. Society) v. Union of India⁴, arguably one of the most pivotal judgments on euthanasia in India, sought a declaration that the right to die with dignity is part of the right to live with dignity under Article 21 of the Constitution. Furthermore, it sought directions to the State to adopt appropriate procedures to allow persons of deteriorated health, or who were terminally ill, to execute Advance Medical Directives or living wills. The Court examined Indian and international precedent, including the judgment in K.S. Puttaswamy & Anr. v. Union of India & Ors. (2017)⁵, and the Hon’ble Supreme Court held that the right to die with dignity is a fundamental right under Article 21. The Court also validated the use of Advance Medical Directives (Living Wills), specifying that life-sustaining treatment should not be continued if the person becomes terminally ill or enters a permanent vegetative state with no reasonable chance of recovery, thereby upholding the idea of dignity in death. Lastly, it held that such decisions must respect the patient’s autonomy, dignity and informed choice.

The Latest Development: Harish Rana v. Union of India

In March 2026, the Hon’ble Supreme Court, in Harish Rana v. Union of India⁶, held that Clinically Assisted Nutrition and Hydration (CANH) is a “medical treatment” as opposed to primary care. Doctors may exercise clinical judgement to determine whether CANH can be withheld for the purpose of passive euthanasia.

A fall had left Harish Rana in a permanent vegetative state for 13 years. His plea for passive euthanasia was dismissed by the Delhi High Court in 2024 and, in the same year, the Supreme Court upheld the High Court’s decision on the ground that withholding CANH through PEG tubes would result in Rana starving to death. In a miscellaneous application filed in 2025, Rana’s parents sought a declaration that CANH should be classified as “medical treatment” for the purpose of passive euthanasia.

The Hon’ble Court permitted Rana’s plea for passive euthanasia, holding that it would be in his “best interest” and extending Article 21 to the withholding or withdrawal of CANH. It required a holistic assessment of both medical and non-medical factors, which include “the patient’s wishes, feelings, beliefs, values, and any other factor that would be likely to influence the patient’s decision, or which the patient himself would have taken into account, had he retained the capacity to decide.” It held that administering CANH requires clinical judgement and routine checks by medical professionals. The Court observed that Rana’s medical condition was irreversible and that continued CANH treatment was not improving it. This judgment strengthens the constitutional principle that the right to die with dignity is part of Article 21. It builds upon and operationalises the principles laid down in Common Cause v. Union of India and its 2023 modifications.

Conclusion

Human life is precious, and India has adopted a cautious and balanced approach towards the right to die. This approach protects an individual’s dignity, autonomy and freedom from futile medical intervention when death is inevitable, while respecting the sanctity of life and ensuring that compassion and dignity are acknowledged in end-of-life decisions. The Supreme Court has emphasised the right to die with dignity during the natural process of death by allowing passive euthanasia, as it does not intentionally cause death. Rather, it allows nature to take its course where medical intervention has become futile. The recognition of Living Wills strengthens patient autonomy and aligns the Constitution of India with international human rights standards.

Some argue that passive euthanasia may lead to misuse of the law. It is important to note, however, that judicial oversight and medical board review seek to protect vulnerable patients from coercion or abuse. Nevertheless, challenges remain, chiefly the lack, as of now, of a comprehensive legal framework with defined safeguards. In conclusion, a good legal system is one which values both the right to live with dignity and the right to die with dignity, provided the latter is exercised with proper safeguards and under judicial and medical supervision.

Footnote(S):

1. P.Rathinam vs Union Of India, 1994 AIR 1844, 1994 SCC (3) 394
2. Gian Kaur v State of Punjab 1996 AIR 946, 1996 SCC (2) 648
3. Aruna Shanbaug v. Union of India (2011) 4 SCC 454
4. The Common Cause (A Regd. Society) vs Union Of India on 9 March, 2018 AIR 2018 SUPREME COURT 1665
5. K.S. Puttaswamy & Anr. vs. Union of India & Ors. ((2017) 10 SCC 1)
6. Harish Rana v Union of India 2026 SCO.LR 3(3)[14]

Reference(S):

• Euthanasia, Cornell Law School, Legal Information Institute
• Advay Vora, 16th March 2026, In a first, Supreme Court gives green signal for passive Euthanasia
• Legislature
• Constitution of India
• Indian Penal Code 1860
• Bharatiya Nyaya Sanhita 2023