The distinction between active and passive euthanasia raises important ethical and legal questions in healthcare. Examine its implications for patient autonomy, medical ethics, and the need for a clear legislative framework in India.

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Introduction

Euthanasia refers to intentionally ending a person’s life to relieve suffering from a terminal or incurable illness.
The distinction between active euthanasia (deliberate act to cause death) and passive euthanasia (withholding or withdrawing life-sustaining treatment) raises significant ethical, legal, and medical debates in India.

Implications for Patient Autonomy

Right to Dignified Death: The Supreme Court in Common Cause (2018) recognised the right to die with dignity under Article 21.
Living Wills and Advance Directives: Patients can express their preference to refuse life-prolonging treatment in terminal conditions.
Balancing Autonomy and Protection: Safeguards are necessary to ensure that decisions are voluntary and free from coercion or misuse.

Implications for Medical Ethics

Principle of Beneficence: Doctors must act in the best interest of the patient, balancing relief from suffering with preservation of life.
Non-maleficence (“Do no harm”): Active euthanasia raises ethical concerns as it involves directly causing death.
Professional Responsibility: Physicians may face moral dilemmas when prolonging life leads to prolonged suffering.

Legal and Institutional Challenges

Passive Euthanasia Permitted: The Supreme Court has allowed withdrawal of life support under strict guidelines, but active euthanasia remains illegal under IPC provisions.
Procedural Complexity: Implementation of living wills and approval processes can be complicated in hospital settings.
Lack of Comprehensive Legislation: Absence of a clear statutory framework leads to uncertainty for doctors, patients, and families.

Need for a Clear Legislative Framework

Codification of Guidelines: Parliament can enact a law clarifying procedures, safeguards, and responsibilities.
Institutional Ethics Committees: Hospitals should establish transparent decision-making mechanisms.
Protection Against Misuse: Legal safeguards must protect vulnerable patients from coercion or financial pressures.

Conclusion

The debate on euthanasia reflects the need to balance compassion, patient autonomy, and ethical medical practice.
A clear and comprehensive legal framework can ensure dignity in end-of-life care while preventing misuse in India’s healthcare system.

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