NEW DELHI: A five-judge Constitution bench of the Supreme Court headed by CJI Dipak Misra dropped loud hints on Wednesday on devising a mechanism to legitimise a “living will” even as it said it would not revisit its six-year-old ruling permitting passive euthanasia.
Refusing to entertain any doubts on the 2011 judgment in the Aruna Shanbaug case permitting a high court-supervised procedure for passive euthanasia, the bench, also comprising A K Sikri, A M Khanwilkar, D Y Chandrachud and Ashok Bhushan, said: “We cannot take a regressive step. It (Shanbaug judgment) is in vogue since 2011. We are clear that the right to life does not confer on an individual the right to die. But we recognise that every individual has a right to die with dignity, i.e. the process of end of life must be dignified.”
The bench reserved order after concluding the hearing.The bench was hearing a petition by NGO Common Cause seeking to legalise living will, referred to by the court as “advance directive” that allows a person in a sane state of mind to decide that in the event of his/her slipping into a vegetative state or coma, certified by medical experts to be irreversible, life should not be prolonged with artificial life support system.
After senior advocates Arvind Datar and Sanjay Hegde placed various facets and aspects linking passive euthanasia to living will, advocate Devansh Mohta placed a draft pro forma of a living will or advance directive by a person specifying the medical conditions when s/he should not be provided further artificial life support assistance.
The bench said whatever be the living will, it would come into play only if a statutory medical board, after thorough examination of the patient, declares that s/he has slipped into a condition that would inevitably and irreversibly lead to end of life. If the board says that she could be revived from an apparent hopeless medical condition, the living will would not be taken into account, it added.
“The pro forma of the advance directive document must be left to the department of health to draft. Once we pronounce the judgment, the legislature and executive will take a decision,” it said.
“Only after such certification by the medical board, the advance declaration document refusing administration of life support system could be implemented. This would save the relatives of the patient from the moral dilemma of consenting to withdrawal of ventilator and the doctors of medical negligence charge in future,” the CJI said.
It asked additional solicitor general P S Narasimha to inform the court within a week the medical experts from different fields who, in the Centre’s view, should be included in the statutory medical board. When all was going as per the broad views expressed by the five judges, doctor-turned-lawyer R R Kishore raised a query, wondering if anyone, whatever the level of expertise s/he had in medical science, could ever conclusively say a person is sure to die in a particular medical condition.
“As a medical practitioner for 45 years, I know of cases of patients in coma for years getting back to normal life,” he said, asking if the choice of life or death is individualistic, can the PIL petitioner or the court decide this for others. “There was a time when kidney failure was a sure sign of death. But today kidneys are replaced like hot cakes. Can one decide today what would be the state of medical advancement in the future to specify a medical condition when s/he should not be given treatment?” he asked.