Mercy, Morality, and the Law: India’s Euthanasia Debate

The Constitution of India provides its citizens with various kinds of rights and duties but what does it say about death? Do we have a say in our own death? Article 21 of the Constitution talks about the right to physical and mental health, and has been expansively interpreted by the judiciary and it also adds the ‘right to live’ sphere in its ambit. As the conversation around ‘right to death’ and ‘right to live’ emerges, the concept of euthanasia arises along with the concern as to what extent can it be implemented?

Euthanasia can easily be understood by the phrase ‘mercy killing’, it is always advocated in the situations where a person is suffering from terminal diseases like cancer. In various religious texts, a person is always subjected to death when the ‘God’ allows it. Whereas, sometimes the situation is such, that the family of the patient has to face the limitations of medical science and accept the fate of their loved ones. The ‘easy death’ can be seen as demeaning the sanctity of life but for some that’s the last option they have to provide their person a dignified end.

Euthanasia can be divided into two types:

(i)            Active Euthanasia

(ii)          Passive Euthanasia

Active Euthanasia is also known as ‘aggressive euthanasia.’ It refers to taking positive steps to end life like administering a medicine to end one’s life. Active euthanasia is usually confused with ‘physician assisted suicide’ (PAS). In active euthanasia the patient is administered with a lethal drug by a registered doctor, on the patient’s request to end their suffering. Whereas, in the PAS the lethal drug is taken by the patient themselves to perform the final act. In Passive Euthanasia the medical attention, which is necessary for the patient to survive, is withheld with the consent of the family members. The necessary medical attention could include withholding the life support of the patient on a ventilator.   

Active and Passive euthanasia is further divided into three broad forms i.e., (i) Voluntary (ii) Non-Voluntary and (iii) Involuntary.

Globally, different nations have different rules and legislations regarding voluntary active euthanasia. Countries such as the Netherlands, Belgium, Luxembourg, Canada, Spain, New Zealand, and Colombia have enacted comprehensive statutory frameworks permitting active voluntary euthanasia and physician-assisted dying under strict safeguards, including informed consent, unbearable suffering, independent medical review, and post-facto oversight. In contrast, jurisdictions like Switzerland, Germany, Austria, and several U.S. states prohibit active euthanasia but allow physician-assisted suicide, where the final act is performed by the patient. Many countries, including the United Kingdom and India, categorically prohibit active euthanasia but permit passive euthanasia, recognizing the patient’s right to refuse or withdraw life-sustaining treatment, often grounded in constitutional interpretation or judicial pronouncements. A large number of states across Asia, Africa, and the Middle East continue to criminalize both euthanasia and assisted suicide, prioritizing the protection of life. Thus, while global consensus exists on allowing passive end-of-life decisions, active euthanasia remains legally acceptable only in limited jurisdictions with stringent procedural safeguards.

Recently India faced a conundrum regarding the legal position of euthanasia in the case of Harish Rana, he has been in a vegetative state for 13 years now. Harish Rana fell from his PG balcony while he was in late teens and is now suffering from quadriplegia plus 100% disability. On 18^th December’ 2025, the Supreme Court of India examined the plea from the parents of Harish Rana requesting for passive euthanasia for their son. The bench consisting of Justice J.B Pardiwala and K.V Vishwanathan examined the report by AIIMS described the condition as ‘very sad.’ A report was previously constituted by the Noida District Hospital, which declared the condition of Harish Rana as ‘negligible chances of recovery’ and that described his state ‘pathetic.’

In July 2024, the Delhi High Court rejected the petition for euthanasia for Harish Rana which was then subsequently upheld by the Supreme Court. In the view of the Supreme Court, removing of the ryles tube (used for feeding) was an act of active euthanasia. Whereas, in the latest arguments the petitioners argued that the condition of Harish has declined further. The petitioners put forward their argument that Harish has been kept artificially alive, and the nasogastric and gastronomy tubes should be brought into the ambit of ‘life support.’ The report brought forward by AIIMS has convinced the bench to make ‘final call.’

Judiciary at multiple occasions has examined the legal ground of euthanasia. In the matter of K.S. Puttaswamy vs. Union of India defined that right to life is not equal to the right to die. Whereas, the right to live with dignity is equivalent to the right to die with dignity. This judgement isn’t directly related to the concerns of euthanasia but the but the court expressly defined that one’s body, medical treatment and end-of-life care falls within the ambit of privacy. With this principle, it can be interpreted that whether to accept or refuse the treatment or to live a life with a painful and terminal disease comes under the autonomy of the individual. Hence, this judgement constitutionalized the ‘Right to Dignity’ under Article 21.

The landmark case of Aruna Ramchandra Shanbaug vs Union of India (2011) laid the foundation for the legalization of passive euthanasia in India. Aruna Shanbaug, a nurse, had been in a permanent vegetative state for decades following a brutal assault. While the Supreme Court rejected the petitioner’s plea to end her life, it recognized that passive euthanasia, withdrawal of life support in certain “rarest of rare” cases, is permissible under strict judicial supervision. The Court distinguished it from active euthanasia, which remains illegal, and laid down guidelines for High Courts to authorize withdrawal of treatment, ensuring safeguards against misuse while upholding the right to die with dignity under Article 21 of the Constitution.

In 2018, in the matter of Common Cause vs. Union of India the Supreme Court legalized passive euthanasia, whereas, active euthanasia still remains illegal. This judgement also laid some guidelines to balance the state laws and humanitarian grounds. The withdrawal of the patient must be certified by a board appointed by the High Court of to assess the medical condition of the patient. Consent of the patient, if possible, must be taken or the next of kin must consent to euthanasia. The court recognized the concept of a “living will”, where an individual can declare in advance that life support should not be continued if they fall into a terminal condition.

Euthanasia continues to be a deeply complex and sensitive issue, balancing the sanctity of life with the right to die with dignity. Indian jurisprudence has progressively recognized the need for compassionate relief in cases of terminal illness or permanent vegetative states. Landmark judgments, such as Aruna Shanbaug vs Union of India and Common Cause vs Union of India, have legalized passive euthanasia under strict safeguards, while keeping active euthanasia prohibited. These rulings emphasize judicial oversight, informed consent, and protection against misuse, ensuring that end-of-life decisions are guided by both humanitarian considerations and constitutional rights under Article 21. Globally and in India, the trend reflects a careful acknowledgment of personal autonomy, dignity, and ethical responsibility in matters of life and death, without undermining the societal value of human life.