Caring on a need to let go basis

Last week, Britain introduced a bill to allow terminally ill adults with six months or less to live seek medical assistance to end their lives. Such a procedure would need approval from two doctors and a high court, and is limited to those mentally capable of making the decision. Assisted dying is legal in Canada, Spain, Portugal, 11 US states, most of Australia, Switzerland and the Netherlands. In a sense, it's the true test of a society ensuring dignity to the individual.

In India, the legal stance on euthanasia has evolved through three key cases: Gian Kaur v. State of Punjab (1996), Aruna Shanbaug v. Union of India (2011), and Common Cause v. Union of India (2018). In Common Cause, the Supreme Court distinguished between active and passive euthanasia, with the former involving administration of lethal substances and the latter involving death from disease following withdrawal of life support. The court provided guidelines for advance directives (ADs), detailing patients' treatment preferences and designated decision-makers if they become incapacitated. Although guidelines were eased in 2023 to broaden AD implementation, they still impose a heavy burden on applicants. Each AD requires approval from two medical boards, and their decisions can only be contested via writ petitions under Article 226.

The current passive euthanasia framework largely burdens patients' families with a stringent bureaucratic process to implement ADs, which must be notarised and signed before a judicial magistrate. This is understandable, but errs in being over-protective. Also, awareness about ADs remains low. Both these hurdles need to be tackled, with checks against abuse in place, especially in a country where hospice care is costly and limited.