Abstract

Euthanasia occupies a profound and intricate space where law, ethics, and medicine converge, prompting deep reflection on the boundaries of personal freedom and the state’s role in life-and-death decisions. It raises poignant questions about whether individuals should have the right to choose a dignified death and how societies balance this with the intrinsic value of life. This article delves into the delicate interplay between criminal responsibility and personal choice in euthanasia, weaving together global and Indian legal perspectives, the constitutional lens of Article 21 in India, and the ethical debates that illuminate both sides of the issue. Through a thoughtful exploration of landmark cases, legal provisions, and philosophical insights, it underscores the necessity for a compassionate yet cautious framework—one that honours individual autonomy while protecting against potential abuse. Ultimately, it reflects on the law’s evolving role in addressing the deeply human questions surrounding the end of life.

Introduction

Euthanasia, meaning a “good death,” involves intentionally ending a person’s life to alleviate unbearable suffering, commonly in cases of terminal illness. It is such a topic that is discussed throughout history, mainly because they fall within the scope of life as a human right, which has been universally defended for many years. However, the meaning of the word euthanasia as good death generates conflicts at social, moral, and ethical levels. Mainly because death is a loss, it is difficult to understand it as something positive.

With medical advancements prolonging life, legal systems worldwide face the challenge of balancing individual autonomy—the right of competent adults to make decisions about their own bodies—with criminal liability, which traditionally punishes the intentional ending of human life. Euthanasia, often described as “mercy killing,” is one of the most controversial subjects in contemporary legal and ethical discourse. At its core lies a conflict between two competing principles: the state’s duty to protect life, enforced through criminal law, and an individual’s right to autonomy, including the freedom to decide the manner and timing of their death.

The debate has gained renewed relevance in India, particularly after the Supreme Court’s judgments in Aruna Shanbaug v. Union of India (2011) and Common Cause v. Union of India (2018), which recognized the validity of passive euthanasia and living wills. These developments signal a shift towards respecting individual choice, yet the shadow of criminal liability persists under the Bharatiya Nyaya Sanhita (BNS).

This article explores euthanasia through the twin lenses of criminal liability and individual autonomy, drawing upon comparative legal approaches, constitutional interpretations, and ethical arguments to examine how law can strike a balance between protecting life and respecting dignity.

Understanding Euthanasia

The term “euthanasia” originates from the Greek words “eu” which means “good” and “Thanatos” which means “death”, therefore the etymological meaning of this word is “good death.” In modern discourse, it refers to the intentional act of ending a person’s life to relieve suffering. Euthanasia, sometimes called “mercy killing,” is legally defined as the deliberate act of ending a person’s life to relieve suffering, typically from an incurable or terminal condition.

Types of Euthanasia

Euthanasia is classified into voluntary, involuntary and non-voluntary types based on consent, and based on action it is of two types- active and passive euthanasia.

• Based on consent
• Voluntary Euthanasia- it occurs with the informed consent of a mentally competent patient requesting relief from suffering. This form of euthanasia is legal in countries like Belgium, the Netherlands, Canada, and some U.S. states.
• Involuntary Euthanasia- this type of Euthanasia is carried out against the will of a person who is capable of giving consent and it is universally illegal; even classified as homicide under the law.
• Non-voluntary Euthanasia- it occurs when the patient cannot consent due to unconsciousness or incapacity, and the decision is made by guardians or courts. For e.g. if a person is in coma for a prolonged time then the decision is made by another person on their behalf. 
• Based on action
• Active Euthanasia- it is the direct intervention to cause death, such as by administering a lethal injection.
• Passive Euthanasia- it is administered by withholding or withdrawing medical treatment that is necessary to sustain life and allowing death to occur naturally, thereby causing death as a result of omission.

Legal position of Euthanasia across jurisdictions

Global perspective on Euthanasia

Netherlands and Belgium

The Netherlands became the first country in the world to formally legalize euthanasia and physician-assisted dying through the Termination of Life on Request and Assisted Suicide (Review Procedures) Act, 2002. This law permits doctors to actively end a patient’s life under stringent conditions: the request must be voluntary and well-considered, the patient must be suffering unbearably, with no prospect of improvement, and an independent physician must confirm the decision.

Belgium soon followed in 2002 with similar legislation. Belgium’s framework is notable for later extending euthanasia rights even to minors in exceptional cases (2014), provided they possess the capacity for discernment and parental consent is given.

Canada

Canada took a landmark step in Carter v. Canada (2015), where the Supreme Court struck down the blanket prohibition on physician-assisted dying, holding that it violated the constitutional right to life, liberty, and security under the Canadian Charter of Rights and Freedoms. Following this, Canada enacted the Medical Assistance in Dying (MAiD) law in 2016, permitting terminally ill patients to seek medical assistance to end their lives under regulated conditions. The scope was further expanded in 2021 to include those suffering from grievous and irremediable conditions, even if death is not imminent. Canada thus represents a rights-based approach, firmly grounding euthanasia within the framework of individual autonomy and dignity.

United States

In the U.S., euthanasia remains largely prohibited at the federal level, but physician-assisted dying has been legalized in several states through “Death with Dignity Acts.” Oregon was the first to do so in 1997, followed by states such as Washington, Vermont, California, Colorado, and New Jersey, among others. These laws generally restrict eligibility to mentally competent adults with a terminal illness and a prognosis of six months or less to live. Procedural safeguards include multiple requests (oral and written), mandatory waiting periods, and medical confirmation of the diagnosis. The U.S. model is cautious, emphasizing patient consent while restricting the scope to terminal illness.

Indian Context

India’s approach to euthanasia has been shaped almost entirely by judicial interpretation, as there is no comprehensive legislation specifically governing the subject.

Aruna Shanbaug v. Union of India (2011)

This case marked the first significant judicial recognition of euthanasia in India. Aruna Shanbaug, a nurse who had been in a persistent vegetative state (PVS) for nearly four decades following a brutal assault, became the focal point of the debate. The Supreme Court rejected the plea for active euthanasia but, in a landmark move, recognized the permissibility of passive euthanasia under strict conditions.

The Court laid down detailed guidelines, which required:

• Approval from the patient’s close relatives or “next friend.”
• Clearance from a medical board constituted by the hospital.
• Authorization by the jurisdictional High Court.

These safeguards were designed to prevent misuse while acknowledging the need to allow withdrawal of life-sustaining treatment in cases of irreversible suffering. However, the ruling was case-specific and left the broader issue unresolved.

Common Cause v. Union of India (2018)

The debate took a decisive turn with this judgment, where a five-judge Constitution Bench unanimously recognized the right to die with dignity as a part of the right to life underarticle 21 of the Constitution. The Court upheld the validity of living wills and advance directives, enabling individuals to specify in advance whether they wished to receive life-sustaining treatment in the event of terminal illness or incapacitation.

Key aspects of the judgment include:

• Affirmation that the right to life includes the right to live with dignity, and by extension, the right to die with dignity.
• Legal recognition of advance medical directives, provided they meet prescribed procedural safeguards.
• A shift from judicially-created guidelines (as in Aruna Shanbaug) to a broader constitutional principle of autonomy.

Currently, Active euthanasia remains illegal and punishable under the Indian Penal Code sections 302 and 304 (which is under sections 103 and 105 in BNS). Passive euthanasia, which is permitted under Aruna Shanbaug case and reaffirmed in Common Cause, is legally recognized but subject to procedural safeguards.

Criminal Liability and Euthanasia

The Bharatiya Nyaya Sanhita (BNS) presents significant hurdles to the legalization of euthanasia, since its provisions are primarily oriented toward the protection of life rather than its termination, even when termination is sought voluntarily. This creates a paradox: actions motivated by compassion or respect for autonomy may nonetheless be punishable as serious crimes.

Section 302 IPC – Punishment for Murder & Section 304 IPC – Punishment for Culpable Homicide not amounting to Murder (sections 103 and 105 of BNS). Active euthanasia, involving the deliberate administration of a lethal substance by a physician or relative, falls squarely within the scope of these provisions. Section 302 criminalizes “murder,” which carries the death penalty or life imprisonment. Section 304 addresses “culpable homicide not amounting to murder,” which still attracts severe punishment.

Section 306 IPC – Abetment of Suicide (section 108 of BNS). This provision criminalizes the act of instigating, aiding, or abetting the suicide of another person. In cases of physician-assisted dying, where the patient self-administers the means of death but receives assistance (such as prescribing lethal medication), the physician could be prosecuted under Section 306 of IPC. Courts have often taken a strict view of abetment, emphasizing the duty of the state to prevent suicide rather than facilitate it.

 This legal overlap creates an inherent conflict:

• What one might view as an act of compassion — helping a terminally ill patient escape unbearable suffering — the law may interpret as murder or abetment of suicide.
• Conversely, refusing euthanasia may prolong suffering but is seen by law as protecting life.

Individual autonomy and the right to die with dignity

The principle of individual autonomy is the ability of persons to make meaningful decisions about their own bodies, health, and ultimately, their death. Autonomy, in this sense, extends beyond mere freedom of choice; it reflects the recognition of human beings as self-determining agents entitled to chart the course of their lives in accordance with their values and beliefs.

In the Constitution of India, autonomy has been developed under Article 21 of the Constitution, which guarantees the right to life and personal liberty. The right to life has consistently been interpreted as more than just survival and it includes the right to live with dignity as well. This expansive interpretation paved the way for considering whether dignity also extends to the end of life.

The Supreme Court’s judgment in the case of Common cause v. Union of India was transformative in this regard. A Constitution Bench held that the right to die with dignity is an inseparable facet of Article 21. The Court reasoned that forcing an individual to endure unbearable suffering or denying them control over their medical fate diminishes the quality of life that Article 21 seeks to protect. By recognizing living wills and passive euthanasia, the Court gave concrete expression to autonomy—allowing individuals to determine, in advance, whether they wish to be kept alive by artificial means in terminal or irreversible conditions.

Conclusion

Euthanasia stands at a complex crossroads of law, ethics, and human experience, where the sanctity of life meets the deeply personal yearning for dignity in death. This moral and legal conundrum challenges societies to weigh the intrinsic value of life against the right to self-determination, stirring debates that resonate across cultures and jurisdictions. In India, the Supreme Court’s landmark decisions recognizing passive euthanasia and the validity of living wills have marked a pivotal shift, acknowledging that individuals may, under strict conditions, choose to forgo life-sustaining treatment. This judicial acknowledgment, rooted in Article 21 of the Indian Constitution, which guarantees the right to life and personal liberty, underscores the evolving understanding of autonomy as encompassing the right to a dignified death. Yet, despite these progressive strides, the absence of comprehensive legislative clarity leaves a lingering tension between compassion and criminality, as active euthanasia remains largely prohibited and fraught with legal peril.

Globally, the euthanasia debate reveals a spectrum of approaches. Countries like Belgium and the Netherlands have embraced both active and passive euthanasia under stringent safeguards, prioritizing individual choice while maintaining rigorous oversight to prevent abuse. In contrast, nations like India tread cautiously, balancing cultural reverence for life with growing calls for autonomy. The Indian judiciary’s cautious embrace of passive euthanasia, as seen in cases like Aruna Shanbaug (2011) and Common Cause (2018), reflects a nuanced effort to respect personal agency while grappling with ethical concerns about vulnerability, coercion, and the sanctity of life. These rulings permit the withdrawal of treatment in specific circumstances but stop short of endorsing active euthanasia, leaving gaps that legislation must address.

A balanced legal framework is imperative—one that affirms autonomy while embedding robust safeguards to protect against misuse, coercion, or societal pressure. Such a framework must consider the human realities at euthanasia’s core: the profound desire for relief from unbearable suffering, the quest for dignity in life’s final moments, and the deeply personal right to shape one’s own end. Ethical arguments for euthanasia emphasize compassion and self-determination, while opponents warn of a slippery slope toward devaluing life or exploiting the vulnerable. As India’s legal system evolves, it must navigate these competing values with sensitivity, ensuring that compassion does not erode safeguards nor rigidity stifle human dignity. The law must remain a living instrument, responsive to the poignant realities of those facing life’s end, balancing the sanctity of existence with the autonomy to choose its conclusion.