Quick answer
Yes. In Common Cause v. Union of India (9 March 2018), a five-judge Constitution Bench held that the right to live with dignity under Article 21 includes smoothing the process of dying for a terminally ill patient or a person in a persistent vegetative state (PVS) with no hope of recovery. It permitted passive euthanasia (withdrawing or withholding life-prolonging treatment) and recognised advance medical directives, or "living wills", under strict safeguards. It did not legalise active euthanasia, which involves a positive act to end life.
The case
Common Cause (A Regd. Society) v. Union of India, (2018) 5 SCC 1, AIR 2018 SC 1665, Supreme Court of India, 9 March 2018. Bench: Dipak Misra, CJI (for himself and A.M. Khanwilkar, J), with concurring opinions by A.K. Sikri, D.Y. Chandrachud and Ashok Bhushan, JJ. A writ petition sought recognition of the right to die with dignity and of living wills. Held: passive euthanasia and advance directives are lawful, and the Court laid down guidelines under Article 142 that remain in force until Parliament legislates.
Key holdings
- Gian Kaur explained: it is not the ratio of Gian Kaur v. State of Punjab (1996) that passive euthanasia can be introduced only by legislation. The two-judge bench in Aruna Shanbaug (2011) erred in reading it that way.
- Active versus passive: active euthanasia is a positive, overt act to end life; passive euthanasia is withdrawing life support or withholding treatment meant only to prolong life artificially.
- Autonomy: an adult with capacity may refuse treatment, even if refusal risks death. A valid advance directive must be given effect.
- Best interest: where passive euthanasia applies, the patient's best interest overrides the State's interest.
Active versus passive euthanasia
| Point | Active euthanasia | Passive euthanasia |
|---|---|---|
| Nature | Positive act, such as giving a lethal substance | Withdrawing or withholding life-prolonging treatment |
| Cause of death | The act itself | The underlying illness |
| Position in India | Not permitted | Permitted under the Common Cause guidelines |
Safeguards and later changes
- 2018: an advance directive had to be signed before two attesting witnesses and countersigned by the jurisdictional Judicial Magistrate of First Class (JMFC), with review by medical boards.
- 24 January 2023: a five-judge bench modified the guidelines. The directive is now attested before a notary or gazetted officer instead of being countersigned by the JMFC. A primary medical board and a secondary medical board (which includes a doctor nominated by the Chief Medical Officer) decide, preferably within 48 hours, and the JMFC is only informed.
- 11 March 2026: in Harish Rana v. Union of India, a bench of J.B. Pardiwala and K.V. Viswanathan, JJ held that clinically assisted nutrition and hydration is medical treatment, allowed its withdrawal for a patient in PVS for about 13 years, and streamlined the Common Cause guidelines. Its directions include a CMO panel for secondary boards and a 30-day reconsideration period after both boards agree.
Zoya, aged 45 and fully competent, signs an advance directive before two witnesses and a notary saying that if she is ever in a persistent vegetative state, she does not want a ventilator. Years later this happens. If the primary and secondary medical boards both confirm that recovery is not possible and the JMFC is informed, her ventilator support may be withdrawn (after the 30-day reconsideration period set in Harish Rana). Her family cannot, however, ask a doctor to inject a lethal drug; that would be active euthanasia.
For the dignity and autonomy reasoning behind this case, see Justice K.S. Puttaswamy v. Union of India (2017).
Exam point
Common Cause (2018, five judges): dying with dignity is part of Article 21; passive euthanasia and living wills are lawful under court guidelines (simplified in 2023, applied in Harish Rana, 2026); active euthanasia is not.
