The Uncharted Territory Of Euthanasia (By- Prarthna Bhatia)

The Uncharted Territory Of Euthanasia

Authored By- Prarthna Bhatia[1]

Abstract

The objective of the study is to assess the prevalence of passive and active euthanasia across the world as well in Indian context that begets the discussion on the allied concepts. The provisions of Indian Penal Code are enunciated and dealt with carefully in order to elaborate and deliberate on the concept of Euthanasia and evaluate its relevance on the yardstick and touchstones of moral and legal grounds. The central ideologies related to Euthanasia and its various forms as well the concept of Living will are discussed at length in an attempt to seek the nexus between the enactment of laws relating to Euthanasia and there overlapping and distinctive features which relate to the abetment of suicide and attempt to suicide. The essential ingredients of Section 306 and Section 309 are taken into consideration and compared with the essence and problems specific to Euthanasia. The analysis of Medical treatment of Terminally Ill patients (Protection of Patients and Medical Practitioners) bill is presented to provide suggestions and conclusions that might guide the enactment of a specific legislation in future. The views expressed in the study aim to strike a balance between Right to life and Right to die with dignity. The state’s primary obligation to preserve the life of those under its jurisdiction and furnish respect for the choices of individuals is taken into consideration and reflected to solve contentions related to Euthanasia at various forums.

Introduction

Euthanasia has been a phenomenal subject that allures the attention of legislature all across the world. The concept of Euthanasia surfaced in the seventeenth century in accordance with the definition coined by Sir Francis Bacon in the medical context. The phrase euthanasia is composed of two Greek words – ‘Eu’ which means good, well or easy and ‘thantos’ which denotes death. A Healthy Human being is one who is psychologically, socially and physically healthy and in the absence of such conditions of survival the individual is often exposed to enormous suffering and pain. The person in permanent vegetative state is acknowledged to suffer both physically and psychologically. The term Euthanasia elucidates the acts and omissions which are concerned with intentional and deliberate life taking of individuals suffering from incurable diseases subject to agonizing condition and are in permanent vegetative state by the virtue of their illness in order to relieve them from pain.[2]

Euthanasia consigns conditions which justify the actions which are conclusive to cause the death of an individual in case of serious illness where the prevention of further damage and chances of improvement in the condition of the terminally ill individual are meager. There are five subsets under the umbrella of the term Euthanasia:

Voluntary Euthanasia: In this variant of euthanasia the consent is granted through a competent person who has deliberate wish to end his life. The individually might be suffering from extensive pain due to the illness to which he is subjected as well as several other critical conditions owning to which he or she expressly declares his desire to end his life by making a request to the people who are in charge of the responsibility to take due care of the person. In most cases the request is made to the medical practitioners. This form of Euthanasia is granted the sanction of law in various countries including Luxemburg, The Netherlands, Belgium, Switzerland and two imminent states of United States: Oregon and Washington.
Involuntary Euthanasia: In this type of Euthanasia, a competent person does not furnish valid consent to terminate his or her life. This form of Euthanasia is usually prohibited and is often regarded as Murder.

Non voluntary Euthanasia: Euthanasia conducted on individuals who are not competent to provide valid consent fall under this category as the person is not in a state to request for termination of his or her life.
Passive Euthanasia: In this case, the death is caused through the omission of certain acts which results fastens the process of death of the individual. A person is subject to slow death due to the deliberate withdrawal of significant life supporting systems like medication, ventilator, food and other essentials for survival of an individual.
Active Euthanasia: In this case, certain acts like use of lethal substances and use of force is used to kill a person and deprive him of his or her life. The term defines the commission of those acts which result in death of the person.  It is also usually not granted the sanction of law in most countries due to the apprehension of abuse of power. The concept has been granted the sanction of law only in Netherlands and Belgium.[3][4]
A variant of Euthanasia is Physician assisted suicide where the physician guides an individual to perform such acts which usually results in death of an individual himself or herself on their express request and desire to end his life.

An example to underline the distinction between active euthanasia and physician assisted suicide could be the administration of poison by the physician himself in the case of active euthanasia and only the prescription of lethal drug and the disclosure of procedure in order guide the patient to intake such a drug which is likely to cause the death of the patient in the presence of learned medical practitioner constitutes the case of physician assisted death which has been recognised in legal systems in Switzerland, Netherlands and state of Oregon in United States.

Evolution And International Perspective

Euthanasia as a conceptual entity could trace its genesis to the Nazi period in the first half of the nineteenth century. Adolf Hitler pronounced the policy of Euthanasia in 1939. Dr Karl Brandt and Chancellery chief Philipp Bouhler were appointed under the aegis of Hitler for the execution of the Euthanasia policy in order to terminate the lives of those whose life was considered to be burdensome for the state. The regime formulated under the reign of Nazi rule made Euthanasia a

means to eliminate those who were terminally ill, sick or are suffering from mental trauma as well as all those who were looked upon as “unworthy of life”. The program resulted in huge loss of lives as nearly 70000 people lost their life explicitly till the program was called off on August 24, 1941 though it is said that covertly it continued and nearly 200000 people were killed. It was evident that such a practice resulted in discriminate practices and was used a weapon in the ancient era to fulfill individual objectives. [5]

The practice of providing Euthanasia the sanction of law has been fastened due to the introduction of laws governing the practice of Euthanasia in many countries. The first country to legalize Euthanasia was Netherlands. Netherlands enacted a legislation which extended acceptance to physician assisted suicide as well as Euthanasia in its judicial system in the first half of nineteenth century. In Netherlands, the Postma case spurred the debate regarding Euthanasia when Postma, a general practitioner was compelled to terminate the life of her mother on her voluntary request in order to end her suffering which made her life difficult and uneasy. She was deaf and suffered from brain hemorrhage which aggravated her condition and she repeatedly pleaded her daughter to end her life. The daughter injected her mother with 200mg morphine injection which resulted in her death. The case gained the attention of the legislations and the law which prescribed punishment for 12 years in case of murder was not upheld in this case and Postma was only convicted with 12 moth probation.[6] Conclusively, The Termination of Life on request and assisted Suicide (Review of Procedure) Act in April 2001 laid down the provisions that governed Euthanasia under the aegis of Royal Dutch Medical Association. Article 2 clearly laid out that that the desire of the individual should be voluntarily expressed in accordance with due considerations given to the present scenario as well as future eventualities and on the cognizance of the very fact that no other solution was construed to be viable as the patient suffered from incurable and imminent pain for a prolonged period. The conditions for practitioners prescribed firstly the requirement of both a consultant as well as a physician in order to examine the gravity of the situation and in case the patient in found in the state stipulated by the statute the physician can assist the patient to end his life with due care as stated by clause ‘e’ and ‘f’ .

In case the patient above sixteen years of age has furnished prior consent and due consideration with reasonable understanding of his interests in a written statement and has later become incompetent to give to a valid consent his desire is to be respected in order to terminate his life in case of infirmities with due care.
In case of a minor person between the age of sixteen and eighteen due consent of parents and guardians needs to be taken into consideration in order to take a decision to terminate the life of individual on request.
In case of person between the ages of twelve to sixteen years, the parental authority and guardian is required to duly furnish the consent in order to terminate the life of the minor under the act.[7] In October 2020, a reform was also instituted by the Dutch government to expand the administration of Euthanasia on children between the ages of one to twelve years.[8]
The jurisprudential system of Netherlands exempts the physicians who practice euthanasia on the ground of application of force majeure clause.[9] Article 293 and 294 of Dutch penal code prescribes the validity of Euthanasia. It was inclusive of the application of Euthanasia for Physical pain, psychiatric suffering as well as potential disfigurement of personality. Thus, Right to die was subsequently included in the legal system of Netherlands. The annual incidences of Euthanasia accounted for almost 1.9% deaths in 1990 which increased to 4.4% in 2017.[10]

Belgium laid out a Comprehensive legislation which was passed in May and came into force on September 2002 in order to decriminalize Euthanasia in the country. It prescribed stringent conditions in order to ensure that the practice of Euthanasia and its administration is dealt with care and the patient has expressed his will without any duress as every case has to be registered with special commission. The request has to be made in writing on the account of excessive physical and psychological suffering by a competent person who has attained the age of majority and is capable to furnish his consent.[11] However, an amendment introduced on February 13, 2014 expanded the scope of law to include children as they can opt for lethal injection with due

consideration given to the parent’s will in order to formulate the decision. [12]

Switzerland beholds a special legislation which allows foreign nationals to undertake the practice of Euthanasia. Article 115 of the Swiss penal Code elucidated the provision for selective punishment in cases where the assistance to end life is given with malicious intentions gathered from de facto circumstances and the case of physician assisted suicide administer in good faith to end the suffering of the patient it could be construed as an exception though it is not granted the sanction of law. The Country laws allowed Social Medical Establishments to act on the request of patient with the introduction of Article 74(1) as it was approved with sixty two percent votes on June 17, 2012 on the accord that people have the right to die with dignity.

United Kingdom upheld that the sanctity of life should be preserved by the state on the basis of principle of Parens Patriae. In the famous case of Airedale, The House of Lords held that mercy killing is prohibited in the state. In this case, Anthony Bland aged seventeen who was the supporter of Liverpool Football went to Hillsborough Ground where he sustained several severe injuries. Anthony suffered due to immense damage to his brain as a result of lack of oxygen. His lungs were punctured and crushed and he was subject to irreversible damage which resulted in a prolonged condition of irreversible coma called permanent vegetative state. His condition was pathetic as he could not communicate and remained in the same static condition for three long years. The court held that Euthanasia is not allowed under Common law.[13] The legislature of United Kingdom has taken the first step towards reform to include a provision that validates euthanasia with introduction of private member bill on the suggestion of Baroness Meacher, a social reformer who suggested that the residents of Britain who have resided in England or Wales for more than a year and are suffering from terminal illness are entitled to pronounce their voluntary desire to end their lives provided the patient has attained the age of majority and have the mental capacity to take sound decisions on 26 May 2021.Two practitioners are required to assist the procedure and declare the condition of the patient within the ambit of inevitably vegetative state. The consideration to enact the bill is pending and the deliberation regarding the same is to be held in the autumn session of parliament in 2021.[14]

New Zealand had made its mark in the world due to its effective leadership under its prominent women leader Jacinda Arden. The most recent legislation that granted the practice of Euthanasia the sanction of law was passed in the state on 8th November 2021 with the enactment of End of Life choice Act 2019. A referendum was held in New Zealand where 62 percent of the voters voted in favour of the enactment of the legislation and has seen it as an act of kindness and compassion. The legal system considered the issue when a lawyer named Ms Lecretia Seales approached the court with a plea to grant her permission to end her life and thereby her suffering due her condition of brain tumor. Later her husband took over the charge after her death to introduce laws that govern euthanasia in the country. The legislation allowed patients to seek the application of procedure of euthanasia in case the patient is suffering through a terminal illness and is likely to die in the next six months or has shown a significant decline in health and physical competencies and is competent to sanction a valid consent. It was also delineated that proper care is to be taken in case the doctor assists the patient and such prescription of lethal dose shall be subject to proper scrutiny. The law also elicits conditions that state that no person shall opt for euthanasia in case of mental illness, advanced age and disability alone.[15]

The world has accelerated the process to introduce laws that govern euthanasia as it has gained substantial attention due to various cases of immense suffering where people want to end their life deliberately. The debate is to be scrutinized against the yardstick on the basis of moral, religious, social grounds.

Euthanasia In India

Euthanasia has redefined the idea of meaningful life. It should not be befuddled with other procedures inclusive of instigation to reiterate painful experiences which result in an individual taking his own life believing it to be the last resort, amplification of fastening the effects of pain relieving procedure that might cause death and other suicidal catalysts that facilitate deliberate life taking which are construed to be crimes in Indian society.

A recent development of death of two elderly people who committed suicide further spurred the debates that surround Euthanasia. The couple lived together in Saraswati Housing society in the colossal city of Ahmedabad. Yogendra Vyas and Anjana Vyas were learned old couple who lived

their life substantially well which could be established by the virtue of the fact that Yogendra Vyas was a linguist and devoted his life working as a teaching professional rendering his services in the Gujarat University. Their life came to an end due to their progressive dismay which developed later in old age as the couple was suffering from serious health problems. Yogendra vyas suffered from a kidney disease from a couple of years and his wife was a cancer patient. Their suicide note clearly stated that despite yoga and meditation the condition of the couple remained sensitive and therefore they choose to end their life.[16] The case indicates that there is a dire need to assist terminally ill individuals and take actions in their best interests.

Crime in Indian society constitutes the commission of acts forbidden by law and omission of acts which were conferred to be duly performed by a competent person within the horizon of the duty conferred to the respective individual under the ambit of law. Crimes are bifurcated into two road categories: Inchoate and Choate Crimes.

Inchoate Crimes: Inchoate literally means incomplete. The category of offences include those acts or omissions which facilitate the performance and conduct of crime inclusive of three major offences which are Attempt, Abetment which constitutes those acts which assist the commission of crime and act as a catalyst as well as the crime of Conspiracy.
Substantive Crimes: Substantive literally means complete. The category of offences is inclusive of all offences which cause harm to the society or its members who form the part of its culture and validate its existence and therefore the commission of such offences results in allocation of stringent punishments to the offender as they constitute settled offences in the Indian Penal Code.[17]
The offences of abetment of Suicide and attempt to suicide elucidated under Section 306 and Section 309 in the Indian Penal Code are discussed parallel with the concept of Euthanasia in order to evolve doctrines that preserve human life and at the same time give due consideration to the right to die with dignity as well as individual preferences of terminally ill patients.

The case of Gian Kaur v. State of Punjab begets the question to deliberate on the

constitutionality of Section 306 and Section 309 in the Indian Legal system.  In this case, Gian Kaur and her husband Harbans singh were held guilty by the court which constituted charges against them for abetment of suicide of their daughter in law Kulwant kaur. The Court sanctioned that both of them should be punishment for a term of six years and also imposed fine of Rs 2000. They appealed to the High court against the decision of the lower court where the High court upheld the ratio decidendi formulated by the lower court though the term of rigorous imprisonment conferred to Gian Kaur was reduced to three years. The case was brought before the Supreme Court by virtue of a Special Leave Petition to deal with the substantial question of law which included the deliberation on constitutionality of Section 306. The Supreme Court overruled the decision of P. Rathinam v Union of India given by Division bench of two learned judges in which Justice Hansaria upheld that Section 309 is violative of Article 21 though he rejected that contention that it violates Article 14. It was held that such a provision should be removed to humanize the legal system and not punish those who are already subject to psychological breakdown. In Gian kaur case, the decision conferred by case of P. Rathinam bench was deferred by a constitutional bench of five judges. It was held that Article 21 is exclusive of the Right to be killed. Therefore, in this decision the Supreme Court elucidated that the process to accelerate the process of natural death through any means is against the law and moral standards stipulated by the society. Section 306 is independent of the essence of Section 309 and both the provisions are constitutionally valid.[18]

In various countries across the world the idea of codifying Euthanasia and Physician assisted suicide have been fastened as the ideology has gained acceptance in the legal framework of various countries. Therefore, India needs to consider the contentions of the subject that arise with its evaluation on the yardstick of provisions related to Abetment and attempt of suicide explicated in the Indian Penal Code

In 2011, Indian Jurisprudence faced various eventualities in the realm of application of Euthanasia and related framework of Physician assisted suicide. The moral and legal as well as conceptual considerations were put forward and dealt with along with the proposal for a specific legislation in the case of Aruna Ramchandra Shanbaug v. Union of India which provided legal sanction to passive Euthanasia. 

In this case, Aruna Ramchandra Shanbaug, who was a nurse by profession, went through a tragic incident on 27th November, 1973. She worked in King Edward hospital where she suffered through a rape attempt by one of the sweepers in the hospital who forcefully tried to capture her with the help of a Dog Chain while she was engaged in her work. The gravity of the situation was such that though the sweeper could not rape Aruna in furtherance of his malicious intent as she was subject to menstruation nevertheless the incident resulted in the development of severe condition called plantars extenser in her brain due to lack of supply of oxygen which rendered her bedridden for years to come. She was in a vulnerable state for about 36 years and it was explicitly stated that her condition was severe. She was prone to bed sores and was given mashed food as she was not able to chew. It was contended that the lady was likely to have turned sixty. Aruna was supposed to be in persistent vegetative state as her body was extremely light weighted with brittle bones. She was abandoned by her parents and was taken care of by her colleagues in the Hospital. The case was filed by Ms Pinki Virani to request that Aruna should be allowed to die with dignity by the virtue of taking cognizance of her condition.

The case formulated framework for deliberation on the contentions with regard to the concept of Euthanasia and a delibrate attempt was made by Indian Courts to delve deeply into the intricacies of Euthanasia. In order to elucidate legal points with regards to the practice of Euthanasia Mr. T.R Andhyarujina was appointed as Amicus Curiae.

The issue that gained due consideration in the course of the case and laid down the genesis for debate on related issues like the respect for person’s desire who are in permanent vegetative states, idea of Living will and its execution and the appointment of surrogate.

In this case the court in good faith appointed the dean of the KEM Hospital as the surrogate on her behalf in the absence of a living will. He expressed the ardent care and kinship of colleagues of Aruna towards her and resented the intervention of Ms Pinky as she occasionally met the patient. He said that he has entrusted his faith in judiciary and the idea of care for those who are suffering is deeply woven in Indian society which is not matured enough to extend the acceptance to and welcome the novel practice of Mercy Killing.

Attorney General on the behalf of Indian Union rejected the petition and held that Aruna should be kept alive and no act or omission should be performed which might cause death as such acts would amount to cruelty.

 The petition by Pinky Verma who claims to be the next friend of Aruna stood dismissed.[19]

T.R Andhyarujina provided a dissenting opinion to that of Attorney General who did provide a green signal in order to carry forward the deliberation to grant permission to passive euthanasia through the institution of novel developments in the legal system. T.R Andhyarujina by the virtue of being the Amicus curiae in the case set foot in the domain to evaluate the concept of euthanasia and furnish essential suggestions to grant the sanction of law to the process of passive euthanasia. He delved into the issue and put forward various principles that should govern the application of Passive Euthanasia in the country:

1. Right of Self Determination: The individual shall have the personal autonomy to express his desires explicitly and take informed decisions in case the person is competent to do so as and his wishes shall be duly respected. The observation granted the sanction of law to the concept of Living will which gives autonomous right to individuals to guide the process of their treatment in case they become medically unfit in future and are in the state of immense pain and suffering due to their severe irreversible condition. A person in permanent vegetative condition where the consciousness is minimal is seen to be taken as a yardstick to decide about the administration of passive euthanasia.

2. Appointment of Surrogate: In the absence of a living will as well as in those cases where the person is incompetent to give valid consent a surrogate shall be appointed to furnish consent on the behalf of the person to represent his decisions. The surrogate is expected to act in accordance with the desires of the person and take a decision while putting himself/herself in the position of the individual in the best interests of the person based on enquiry that furnishes the prior preferences of the individual and his attitude towards life.

3. Good faith: The surrogate and the doctors are expected to act in good faith and on the ground level of beneficence for the individual. Their actions shall not be guided by any ulterior motives based on personal convictions in furtherance of their own interests.

4. Consideration of opinions of near and dear ones: The opinions of family members should be given importance and shall have substantial weightage in the decisive action. The opinion of doctors as well as near and dear ones shall be considered to take final decision.[20]

In the case of Common cause society v. Union of India[21], the petitioner a registered society reiterated that the right to die shall be included in the ambit of Article 21 under Constitution of India, 1950. The court explicitly distinguished between active and passive euthanasia and granted the sanction to passive euthanasia through this judgment as it allowed an individual to deny any lifesaving treatment and embrace the idea of natural death through a distinct prospective. The idea of administration of lethal drug is rejected and is unacceptable in accordance with the law of the land. Court held that the Right to die with dignity is included in the rights that flow from Article 21.[22]

Medical treatment of Terminally Ill patients (Protection of Patients and Medical Practitioners) bill

In 2016, a bill was drafted which claimed to enforce the suggestions elucidated in Aruna Ramshandra case. In 2016, the Health Ministry published the bill for public consideration. It was based on 196th and 241st Law Commission Report introduced in the year 2006 and 2012 respectively.

The bill proposed explicitly enunciates several provisions in order to provide guidelines for the practice of Euthanasia:

Competency: In Section 3 of the bill it is spelled out that Patients who have attained the age of sixteen are empowered by the legislation to take an informed decision regarding their treatment inclusive of both its commencement and end. It was clearly stated that the patients might provide consent to the medical practitioners to withhold the treatment.
Section 3 sub clause (2) provides that the decision of the patient shall be binding on the practitioner if it is expressed freely in absence of coercion and duress. It is also spelt out that in case of minor above the age of sixteen, the decision of parents shall guide the conduct of practitioner as their decision and consent is essential.

The cases governing a patient who is incompetent to furnish consent or in cases of individuals though competent could not take any informed decision, the duty to act on their behalf is dedicated to their near and dear ones including parents, spouse, guardians, major children as well people who visit them daily or those who take care of them in the premises of the hospital.

They can approach the High court who is entrusted with the power to review the application with the help of medical experts and are conferred with the authority to act accordingly to take decisions to accept or reject the applications. The High court can issue directions in the case with the institution of Division bench and can also call for appointment of amicus curiae nonetheless the case has to be disposed within a period of thirty days.

Duties of the practitioner: The practitioner is conferred with the duty to inform the near and dear ones of the patient about his decision which includes:
Parents
Spouse
Major Children
Any other person regularly visiting the patient
The doctor is not empowered to give effect to the decision of the patient in case the information is not disseminated to near and dear ones of the patient about his decision for a period of three days.

The practitioner also has the duty to maintain the records of the patient diligently as stated in Section 4 of the bill. The patient and his near and dear ones can claim the copy of the documents.

Section 5 clearly enumerates that the practitioner shall not withdraw the palliative care to the patient irrespective of the condition of the patient.

The practitioner shall act in accordance with the directions of the Medical Council of India.

Living Will: The legislation has taken due consideration from the Aruna Shanbaug case and introduced the concept of advance medical directives which provides information about the prior will of the people though it was not considered binding on the practitioner.
Euthanasia shall constitute no offence: Section 5 and 6 acquits the patients and medical practitioner of trials respectively in case the provisions of the statute are adhered while withholding or withdrawing medical treatment in consonance with the desire of the patients and thus it provides the sanction of law to passive euthanasia. [23]

The Bill has not been enforced till date and the issue is still widely debated. The bill enumerates proper procedure to address the case of incompetent patient. The shortcomings of the bill are:

The bill is ambiguous and does not provide due recognition to the Living will as the document is not binding. The provision should be made in order to deduce the provisions of the living will in a written document which should have received legal recognition and its enforcement shall be dealt on case to case basis.
The legal sanction to the practice of Passive euthanasia might result in fabrication of details about the condition of the patients by the medical practitioners. Stringent provisions shall be made to punish those practitioners who misrepresent the information about the medical status of the patients to provide for all eventualities.
The methods to administer passive euthanasia that are viable and are covered under the ambit of withholding or withdrawing the medical treatment shall be clearly defined so that they do not intervene with the provision for palliative care and its scope does not become wide and arbitrary as euthanasia is concerned with the life of a person and protection of life of those under its jurisdiction is the duty of the state.
Also, Indian Judiciary which has been already overburdened with cases shall not be conferred with responsibility for the trial of cases of Euthanasia. Rather the statute shall provide for the development of a tribunal to deal efficiently with the special cases in close nexus with the medical field.
Contentions rise with respect to the application of Euthanasia and provisions of Section 306 and Section 309 of Indian Penal Code

Section 306 [24]which deals with abetment of suicide shall not be construed as an impediment for the application of laws with respect to Euthanasia. The essentials to attract the application of section 306 are the presence of an abettor and such person must abet to make it applicable which shall result in any action in pursuance of the instigation thereon. Medical practitioners hold a sincere duty to duly inform patients about their condition and are protected from the consequences that flow from such dissemination of information under the exception of communication made in good faith.

Similarly, in case of Euthanasia, Medical practitioners cannot be construed as abettors in administration of passive euthanasia as they act in accordance with the consent given by the person. Rather, the scope of the section shall be expanded to sanction punishment for those doctors who negatively address the patients about their health and destroy their willingness to live in future to act as a safeguard against the unnecessary cases of Euthanasia.

Section 309[25]deals with provision of an attempt to commit suicide. The term Euthanasia includes only those people who are terminally ill and section 309 is applicable on everyone. Euthanasia which provides for mercy killing shall be an exception to the provision as it provides for eventualities in case of extraordinary circumstances.

Conclusion and Suggestions

The purpose of Euthanasia is to govern the dignified end of the life of an individual. It is widely believed that “Killing can never be medical care”. Morally it is often preached that the power to provide life and cease the existence of an individual rests with God. Euthanasia leads to the dilemma between the preservation of piousness of life and the Right to die with dignity. Though legislations all across the world are incorporating provisions to include the practice of Euthanasia in their legal system, such legislations shall clearly indicate that the practice of Euthanasia shall be used only as the last resort.

Circumstances and situations enumerated in various cases across the world compelled the legal jurists to make provisions that regulate the procedure of Euthanasia. In India, Recently an old couple wrote to President that Iravati Lavate and her husband Narayan who are suffering from major health problems shall be allowed to seek doctor assisted death on the pretext that since the President is conferred with the power to grant pardons therefore he shall also be empowered to grant permission for voluntary termination of life. The plea was rejected on the ground that both of them are healthy and active euthanasia is not allowed in the country. [26] Such instances drive the government to review of the concept of Euthanasia and force them to accelerate the process of development of provisions that govern the procedural aspects for administration of Euthanasia.

The challenge is not to develop the provisions that grant the sanction of law to the practice of Euthanasia, it is to delve deep into the prospects that govern the practice and at the same time maintain the sanctity of life. Therefore, various facts can be kept in mind while drafting the legislation:

The legislation that is enacted to lay down rules for administration of Euthanasia should make a provision for patients suffering from terminally illness or are willing to end their life which allows doctors and psychologists to study their state and develop a comprehensive understanding of what things can add meaning to their life. Who so ever requests the doctor to terminate life shall be given special attention and the patient could be handled differently on case to case basis to rejuvenate the spark to relish life and in case the individual shows signs of improvement and drops the idea to terminate life, it would be a huge success for humanity.
India has seen cases where old people have approached courts to help them terminate their lives. Such requests might be a result of lack of care and attention. Old people of the society shall be taken care of to reduce such instances and efforts should be made to provide them with a purpose in life with the help of learned psychologists, medical practitioners, theorists and legal jurists.
Sufficient Consideration: The duration between the request made by patients and the action to conclude the action shall be at least 30 days depending on the gravity of the illness and those 30days shall be used efficiently to provide due care to the patient.
Constitution of a tribunal: A tribunal should be established to deal with all such cases that are related to euthanasia.
New Zealand has made a smarter move by limiting the scope of administration of euthanasia only to those people who are expected to die within next six months. India should consider the same to enact a law that strikes balance between Right to life and Right to die with Dignity.
Advancements in Medical Industry have found out various treatments to prolong life which are painful and make the very existence of individual miserable. Therefore, the enactment of legislation concerned with Euthanasia is the need of the Hour in India as legal principles are developed based on Constitutional morality and to respond to the changes in the society. Nonetheless, such a practice should be encountered in rarest of the rarest cases as there is nothing more beautiful than Human life.