Last week, the Karnataka government took a significant decision on a matter of life and death. Following the Supreme Court’s ruling that the right to die with dignity is a part of the right to life under Article 12 of the Constitution, Karnataka facilitated passive euthanasia for terminally-ill patients by setting a legal framework for the process. The top court’s 2023 order allows patients to opt for natural death by withdrawing life-saving treatment, and was preceded by the 2018 Common Cause case that recognised passive euthanasia and living wills.
Karnataka’s progressive step follows ones taken in Kerala, Goa and Maharashtra. Karnataka has put in place guidelines to set up medical boards of senior doctors which will vet requests from patients and advise patients and their families on the ramifications, besides alternative solutions; it has also brought in provisions for legal scrutiny and written consent by family members. The patient’s living will, a legal document, makes the entire process transparent. Those who qualify for passive euthanasia are patients whose conditions are irreversible or incurable, or have suffered severe brain damage with no hope of recovery.
Chronic terminal illness is extremely trying for both the patient and the family. Compassion is the key in allowing closure and peace through death. While mercy killing is common in the veterinary sphere, humans prefer to clutch at straws of hope and prefer prolonging every life. In India, it has been almost unthinkable to voluntarily pull the plug on a patient. Though the new judicial thinking has been generally welcomed by the educated classes, the Indian Medical Association has claimed that doctors have always taken considered decisions and has expressed reservations on this kind of legal scrutiny for the medical fraternity. There are also niggling fears about whether the process can be misused, living wills manipulated, and the patient pressured into signing his or her own death warrant. It raises ethical and religious questions of whether passive euthanasia is another form of suicide. While the Karnataka government claims it wishes “to uphold liberal and equitable values for a more just society”, it should ensure its legal framework is robust and the right to die is exercised only in extreme cases, with utmost care.