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       REPORTABLE    

IN THE SUPREME COURT OF INDIA

CIVIL ORIGINAL JURISDICTION

WRIT PETITION (CIVIL) NO. 215 OF 2005

 Common Cause (A Regd. Society)       .... Petitioner (s)

Versus

Union of India                                     .... Respondent(s)       

O R D E R  

P.Sathasivam, CJI.

1) This writ petition, under Article 32 of the Constitution of  

India, has been filed by Common Cause-a Society registered  

under the Societies Registration Act, 1860 engaged in taking  

up  various  common  problems  of  the  people  for  securing  

redressal, praying for declaring ‘right to die with dignity’ as a  

fundamental right within the fold of ‘right to live with dignity’  

guaranteed under Article 21 of the Constitution and to issue  

direction to the respondent, to adopt suitable procedures, in  

consultation  with  the  State  Governments  wherever  

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necessary,  to  ensure  that  the  persons  with  deteriorated  

health or terminally ill should be able to execute a document,  

viz., ‘my living will  & Attorney authorization’ which can be  

presented to hospital for appropriate action in the event of  

the  executant  being admitted  to the  hospital  with serious  

illness  which  may  threaten  termination  of  life  of  the  

executant or in the alternative, issue appropriate guidelines  

to this effect and to appoint an Expert Committee consisting  

of  doctors,  social  scientists  and  lawyers  to  study  into  the  

aspect  of  issuing guidelines  regarding execution of  ‘Living  

Wills’.

2) On 19.06.2002 and 25.06.2002, the petitioner-Society  

had  written  letters  to  the  Ministry  of  Law,  Justice  and  

Company  Affairs  and  the  Ministry  of  Health  and  Family  

Welfare  with  a  similar  prayer  as  in  this  writ  petition.  

Concurrently, the petitioner also wrote letters to the State  

Governments  in  this  regard,  as  hospitals  come within  the  

jurisdiction of both the State Governments and the Union of  

India.   

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3) In  the  above said  communication,  the  petitioner  had  

emphasized the need for a  law to be passed which would  

authorize  the  execution  of  the  ‘Living  Will  &  Attorney  

Authorization’. Further, in the second letter, the petitioner-

Society  particularly  relied  on the  decision of  this  Court  in  

Gian Kaur vs. State of Punjab (1996) 2 SCC 648 to support  

its request. Since no reply has been received, the petitioner-

Society has preferred this writ petition.

4) Heard  Mr.  Prashant  Bhushan,  learned counsel  for  the  

petitioner-Society,  Mr.  Sidharth  Luthra,  learned  Additional  

Solicitor General for the Union of India and Mr. V.A. Mohta,  

learned  Senior  Counsel  and  Mr.  Praveen  Khattar,  learned  

counsel for the intervenors.  

Contentions:

5) According to the petitioner-Society, the citizens who are  

suffering from chronic diseases and/or are at the end of their  

natural life span and are likely to go into a state of terminal  

illness or permanent vegetative state are deprived of their  

rights to refuse cruel and unwanted medical treatment like  

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feeding  through  hydration  tubes,  being  kept  on  ventilator  

and  other  life  supporting  machines,  in  order  to  artificially  

prolong their natural life span.  Thus, the denial of this right  

leads to extension of pain and agony both physical as well as  

mental which the petitioner-Society seeks to end by making  

an informed choice by way of clearly expressing their wishes  

in advance called “a Living Will” in the event of their going  

into a state when it will not be possible for them to express  

their wishes.     

6) On  the  other  hand,  Mr.  Sidharth  Luthra,  learned  

Additional Solicitor General submitted on behalf of the Union  

of India that as per the Hippocratic Oath, the primary duty of  

every doctor  is  to  save lives of patients.  A  reference was  

made  to  Regulation  6.7  of  the  Indian  Medical  Council  

(Professional  Conduct,  Etiquette  and  Ethics)  Regulations  

2002,  which  explicitly  prohibits  doctors  from  practicing  

Euthanasia. Regulation 6.7 reads as follows:-

“Practicing  euthanasia  shall  constitute  unethical  conduct. However, on specific occasion, the question  of  withdrawing  supporting  devices  to  sustain  cardiopulmonary  function  even  after  brain  death,  shall be decided only by a team of doctors and not  

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merely  by  the  treating  physician  alone.  A team of  doctors shall declare withdrawal of support system.  Such team shall consist of the doctor in charge of the  patient,  Chief  Medical  Officer/Medical  Officer  in  charge of  the  hospital  and a  doctor  nominated  by  the in-charge of the hospital from the hospital staff  or  in  accordance  with  the  provisions  of  the  Transplantation of Human Organ Act, 1994.”    

In  addition,  the  respondent  relied  on  the  findings  of  this  

Court in  Parmanand Katara vs.  Union of India (1989) 4  

SCC 286 to emphasise that primary duty of a doctor is to  

provide treatment and to save the life whenever an injured  

person is brought to the hospital or clinic and not otherwise.  

7) The  petitioner-Society  responded  to  the  

abovementioned  contention  by  asserting  that  all  these  

principles work on a belief that the basic desire of a person is  

to get treated and to live. It was further submitted that when  

there is express desire of not having any treatment, then the  

said  person  cannot  be  subjected  to  unwanted  treatment  

against his/her wishes. It was also submitted that subjecting  

a  person,  who  is  terminally  ill  and  in  a  permanently  

vegetative state with no hope of recovery, to a life support  

treatment  against  his/her  express  desire  and keeping him  

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under tremendous pain is in violation of his right to die with  

dignity.  

8) Besides, the petitioner-Society also highlighted that the  

doctors  cannot,  by  some  active  means  like  giving  lethal  

injections, put any person to death, as it would amount to  

“active euthanasia” which is illegal in India as observed in  

Aruna Ramchandra Shanbaug vs. Union of India (2011)  

4  SCC  454.  Therefore,  the  petitioner-Society  pleads  for  

reading the aforesaid regulation only to prohibit the active  

euthanasia and the said regulation should not be interpreted  

in  a  manner  which  casts  obligation  on  doctors  to  keep  

providing treatment to a person who has already expressed a  

desire not to have any life prolonging measure. Thus, it is the  

stand of the petitioner-Society that any such practice will not  

be in consonance with the law laid down by this Court  in  

Gian Kaur (supra) as well as in Aruna Shanbaug (supra).

Discussion:

9) In the light of the contentions raised, it is requisite to  

comprehend  what  was  said  in  Gian  Kaur  (supra) and  

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Aruna Shanbaug (supra) to  arrive  at  a  decision  in  the  

given  case,  as  the  prayer  sought  for  in  this  writ  petition  

directly  places  reliance  on  the  reasoning  of  the  aforesaid  

verdicts.    

10) In Gian Kaur (supra), the subject matter of reference  

before the Constitution Bench was as to the interpretation of  

Article 21 relating to the constitutional  validity of Sections  

306 and 309 of the Indian Penal Code, 1860, wherein, it was  

held that ‘right to life’ under Article 21 does not include ‘right  

to  die’.  While  affirming  the  above  view,  the  Constitution  

Bench also observed that ‘right to live with dignity’ includes  

‘right  to  die  with  dignity’.  It  is  on  the  basis  of  this  

observation, the Petitioner-Society seeks for a remedy under  

Article 32 of the Constitution in the given petition.  

11) Therefore, although the discussion on euthanasia was  

not  relevant  for  deciding  the  question  of  Constitutional  

validity of the said provisions, the Constitution Bench went  

on to concisely deliberate on this issue as well in the ensuing  

manner:-

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“24. Protagonism of euthanasia on the view that existence  in persistent vegetative state (PVS) is not a benefit to the  patient  of  a  terminal  illness  being  unrelated  to  the  principle of Sanctity of life' or the 'right to live with dignity'  is of no assistance to determine the scope of Article 21 for  deciding  whether  the  guarantee  of  'right  to  life'  therein  includes the 'right to die'. The 'right to life' including the  right to live with human dignity would mean the existence  of  such  a  right  up  to  the  end  of  natural  life.  This  also  includes the right to a dignified life up to the point of death  including a dignified procedure of  death. In other words,  this may include the right of a dying man to also die with  dignity  when his life is ebbing out.  But the 'right  to die'  with  dignity  at  the  end  of  life  is  not  to  be  confused  or  equated  with  the  'right  to  die'  an  unnatural  death  curtailing the natural span of life.

25. A question may arise, in the context of a dying man,  who is, terminally ill or in a persistent vegetative state that  he  may  be  permitted  to  terminate  it  by  a  premature  extinction of his life in those circumstances. This category  of cases may fall within the ambit of the 'right to die' with  dignity as a part of right to live with dignity, when death  due to termination of natural life is certain and imminent  and the process of natural death has commenced. These  are not cases of extinguishing life but only of accelerating  conclusion  of  the  process  of  natural  death  which  has  already commenced. The debate even in such cases to  permit  physician  assisted  termination  of  life  is  inconclusive.  It  is  sufficient  to  reiterate  that  the  argument  to  support  the  view  of  permitting  termination of life in such cases to reduce the period  of  suffering  during  the  process  of  certain  natural  death  is  not  available  to  interpret  Article    21   to    include therein the right to curtail the natural span  of life  .”   

In  succinct,  the  Constitution  Bench  did  not  express  any  

binding view on the subject of euthanasia rather reiterated  

that legislature would be the appropriate authority to bring  

the change.

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conclusion  that  euthanasia  can  be  allowed  in  India  only  

through a valid legislation. However, it is factually wrong to  

observe that in Gian Kaur (supra), the Constitution Bench  

approved the decision of the House of Lords in Airedale vs.  

Bland (1993)  2  W.L.R. 316 (H.L.).  Para  40 of Gian Kaur  

(supra), clearly states that “even though it is not necessary  

to deal with physician assisted suicide or euthanasia cases, a   

brief  reference  to  this  decision  cited  at  the  Bar  may  be   

made…” Thus, it was a mere reference in the verdict and it  

cannot be construed to mean that the Constitution Bench in  

Gian Kaur (supra) approved the opinion of the House of  

Lords  rendered  in  Airedale  (supra).  To  this  extent,  the  

observation in Para 101 is incorrect.

14) Nevertheless,  a  vivid  reading  of  Para  104  of  Aruna  

Shanbaug (supra) demonstrates that the reasoning in Para  

104 is directly inconsistent with its own observation in Para  

101. Para 104 reads as under:-

“  104.     It may be noted that in Gian Kaur's case    (supra)  although  the  Supreme  Court  has  quoted with approval the view of the House of  Lords  in  Airedale's  case  (supra),  it  has  not  clarified who can decide whether  life support  

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should  be  discontinued  in  the  case  of  an  incompetent  person e.g. a person in coma or  PVS. This vexed question has been arising often in  India  because  there  are  a  large  number  of  cases  where persons go into coma (due to an accident or  some  other  reason)  or  for  some  other  reason  are  unable to give consent, and then the question arises  as to who should give consent for withdrawal of life  support.  This is an extremely important question in  India because of the unfortunate low level of ethical  standards  to  which  our  society  has  descended,  its  raw  and  widespread  commercialization,  and  the  rampant corruption, and hence, the Court has to be  very cautious that unscrupulous persons who wish to  inherit  the  property  of  someone  may  not  get  him  eliminated by some crooked method.”

15) In Paras 21 & 101, the Bench was of the view that in  

Gian  Kaur  (supra), the  Constitution  Bench  held  that  

euthanasia  could  be  made  lawful  only  by  a  legislation.  

Whereas  in  Para  104,  the  Bench  contradicts  its  own  

interpretation of Gian Kaur (supra) in Para 101 and states  

that although this court approved the view taken in Airedale  

(supra), it  has  not  clarified  who can  decide  whether  life  

support  should  be  discontinued  in  the  case  of  an  

incompetent person e.g., a person in coma or PVS. When, at  

the outset, it is interpreted to hold that euthanasia could be  

made  lawful  only  by  legislation  where  is  the  question  of  

deciding whether the life support should be discontinued in  

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the case of an incompetent person e.g., a person in coma or  

PVS.

16) In  the  light  of  the  above  discussion,  it  is  clear  that  

although  the  Constitution  Bench  in  Gian  Kaur  (supra)  

upheld that the ‘right to live with dignity’ under Article 21 will  

be inclusive of ‘right to die with dignity’, the decision does  

not  arrive  at  a  conclusion  for  validity  of  euthanasia  be  it  

active or passive. So, the only judgment that holds the field  

in  regard  to  euthanasia  in  India  is  Aruna  Shanbaug  

(supra),  which upholds the validity  of passive euthanasia  

and  lays  down  an  elaborate  procedure  for  executing  the  

same on the wrong premise that the Constitution Bench in  

Gian Kaur (supra) had upheld the same.  

17) In view of the inconsistent opinions rendered in  Aruna  

Shanbaug  (supra)  and  also  considering  the  important  

question of law involved which needs to be reflected in the  

light of social, legal, medical and constitutional perspective,  

it becomes extremely important to have a clear enunciation  

of  law.  Thus,  in  our  cogent  opinion,  the  question  of  law  

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involved  requires  careful  consideration  by  a  Constitution  

Bench of this Court for the benefit of humanity as a whole.

18)  We  refrain  from  framing  any  specific  questions  for  

consideration  by  the  Constitution  Bench  as  we  invite  the  

Constitution Bench to go into all the aspects of the matter  

and lay down exhaustive guidelines in this regard.  

19) Accordingly,  we  refer this  matter  to  a  Constitution  

Bench of this Court for an authoritative opinion.

……….…………………………CJI.                   (P. SATHASIVAM)                                  

       ………….…………………………J.                   (RANJAN GOGOI)                                   

………….…………………………J.                  (SHIVA KIRTI SINGH)                                   

NEW DELHI; FEBRUARY 25, 2014.

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