Death with dignity: on SC’s verdict on euthanasia and living wills –

The core philosophy underlying the Supreme Court’s verdict allowing passive euthanasia and giving legal status to ‘advance directives’ is that the right to a dignified life extends up to the point of having a dignified death. In four concurring opinions, the five-member Constitution Bench grappled with a question that involved, in the words of Justice D.Y. Chandrachud, “finding substance and balance in the relationship between life, morality and the experience of dying”. The outcome of the exercise is a progressive and humane verdict that lays down a broad legal framework for protecting the dignity of a terminally ill patient or one in a persistent vegetative state (PVS) with no hope of cure or recovery. For, in such circumstances, “accelerating the process of death for reducing the period of suffering constitutes a right to live with dignity”. The core message is that all adults with the capacity to give consent “have the right of self determination and autonomy”, and the right to refuse medical treatment is also encompassed in it. Passive euthanasia was recognised by a two-judge Bench in Aruna Shanbaug in 2011; now the Constitution Bench has expanded the jurisprudence on the subject by adding to it the principle of a ‘living will’, or an advance directive, a practice whereby a person, while in a competent state of mind, leaves written instructions on the sort of medical treatment that may or may not be administered in the event of her reaching a stage of terminal illness. Passive euthanasia essentially involves withdrawal of life support or discontinuation of life-preserving medical treatment so that a person with a terminal illness is allowed to die in the natural course. The court’s reasoning is unexceptionable when it says burdening a dying patient with life-prolonging treatment and equipment merely because medical technology has advanced would be destructive of her dignity. In such a situation, “individual interest has to be given priority over the state interest”. The court has invoked its inherent power under Article 142 of the Constitution to grant legal status to advance directives, and its directives will hold good until Parliament enacts legislation on the matter. The government submitted that it was in the process of introducing a law to regulate passive euthanasia, but opposed the concept of advance directive on the ground that it was liable to be misused. The stringent conditions imposed by the court regarding advance directives are intended to serve as a set of robust safeguards and allay any apprehensions about misuse. The court is justified in concluding that advance directives will strengthen the will of the treating doctors by assuring them that they are acting lawfully in respecting the patient’s wishes. An advance directive, after all, only reflects the patient’s autonomy and does not amount to a recognition of a wish to die.


1) Underlying

Meaning: Be the cause or basis of (something).

Example: “the fundamental issue which underlies the conflict”

Synonyms: Basic, Primary

Antonyms: Subordinate

2) Euthanasia

Meaning: The painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.

Example: Although some people campaign for the right to euthanasia, it is still illegal in most countries.

Synonyms: Assisted suicide, Mercy killing

3) Dignified

Meaning: Having or showing a composed or serious manner that is worthy of respect.

Example: “she maintained a dignified silence”

Synonyms: Stately, Courtly

Antonyms: Undignified

4) Concurring

Meaning: Happen or occur at the same time; coincide.

Example: “in tests, cytogenetic determination has been found to concur with enzymatic determination”

Synonyms: Coincide, Clash

5) Grappled

Meaning: Engage in a close fight or struggle without weapons; wrestle.

Example: “passers-by grappled with the man after the knife attack”

Synonyms: Wrestle, Struggle

6) Progressive

Meaning: Favouring change or innovation.

Example: “the most progressive art school in Britain”

Synonyms: Modern, Advanced

Antonyms: Conservative, Reactionary

7) Terminally

Meaning: In an extreme manner that is beyond cure or alteration.

Example: “Arsenal’s loss has terminally damaged their title bid”

8) Circumstances

Meaning: A fact or condition connected with or relevant to an event or action.

Example: “we wanted to marry but circumstances didn’t permit”

Synonyms: Situation, Position

9) Accelerating

Meaning: Increase in rate, amount, or extent.

Example: “inflation started to accelerate”

Synonyms: Advance, Increase

Antonyms: Decelerate, Drop

10) Consent

Meaning: Permission for something to happen or agreement to do something.

Example: “no change may be made without the consent of all the partners”

Synonyms: Agreement, Assent

Antonyms: Dissent

11) Encompassed

Meaning: Include comprehensively.

Example: “no studies encompass all sectors of medical care”

Synonyms: Cover, Embrace

12) Jurisprudence

Meaning: A legal system.

Example: “American jurisprudence”

13) Competent

Meaning: (of a person) efficient and capable.

Example: “an infinitely competent mother of three”

Synonyms: Capable, Able

Antonyms: Incompetent

14) Withdrawal

Meaning: The action of withdrawing something.

Example: “the withdrawal of legal aid”

Synonyms: Removal, Termination

Antonyms: Introduction

15) Destructive

Meaning: Negative and unhelpful.

Example: “destructive criticism”

Synonyms: Negative, Hostile

Antonyms: Constructive

16) Invoked

Meaning: Cite or appeal to (someone or something) as an authority for an action or in support of an argument.

Example: “the antiquated defence of insanity is rarely invoked in England”

Synonyms: Cite, Adduce

Antonyms: Waive

17) Enacts

Meaning: Make (a bill or other proposal) law.

Example: “legislation was enacted to attract international companies”

Synonyms: Pass, Approve

Antonyms: Repeal

18) Liable

Meaning: Responsible by law; legally answerable.

Example: “the credit-card company is liable for any breach of contract”

Synonyms: Responsible, Culpable

Antonyms: Exempt, Unaccountable

19) Imposed

Meaning: Require (a duty, charge, or penalty) to be undertaken or paid.

Example: “a fine may be imposed”

Synonyms: Levy, Exact

20) Intended

Meaning: Plan that something should be or do something.

Example: “a series of questions intended as a checklist”

Synonyms: Plan, Mean

21) Apprehensions

Meaning: Anxiety or fear that something bad or unpleasant will happen.

Example: “he felt sick with apprehension”

Synonyms: Anxiety, Worry

Antonyms: Confidence

22) Recognition

Meaning: Acknowledgement of the existence, validity, or legality of something.

Example: “the unions must receive proper recognition”

Synonyms: Acknowledgement, Acceptance