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In a landmark verdict, the Supreme Court on 9th March, 2018 ruled that under specific circumstances, a person has the right to decide against artificial life support by creating a living bill.

What is a living bill?

It is a document to decide on ending life in case the person becomes terminally ill, gets into vegetative state (i.e., coma) and has no hope of recovery.

A five judge constitutional bench led by Chief justice of India – Deepak Misra, upheld a person’s right to choose passive euthanasia, by creating an Advance Medical Directive – commonly referred to as living bill. Although, active euthanasia continues to be illegal in India.

Difference between active and passive euthanasia –

Active euthanasia – Better known as assisted death, in which death is medically administered using a lethal injection.

Passive euthanasia – It refers to the withdrawal of life support or medical treatment in cases where a person has slipped into a permanent vegetative state, or a terminal illness with no hope of recovery.

The judgement was delivered on a Public interest litigation (PIL) filed by Delhi based non-governmental organization, COMMON CAUSE in 2005, pleading for an individual’s right to make living will document for passive euthanasia.

People among classes welcomed the decision. The lawyer arguing on the behalf of COMMON CAUSE said that there was a sigh of relief, because  people were earlier worried and anxious regarding the matter of withdrawing life support, as they could have been prosecuted for culpable homicide for this.

When and why it all started?

The need to change euthanasia laws was triggered by the case of Aruna Ramchandra Shanbaug, a 25 – year old nurse who was raped and choked by a ward boy named Sohanlal Bhartha Walmiki in 1973, with a dog chain and thus the lack of oxygen damaged her brain stem. She was in a vegetative state for over 40 years. In 2009, a plea was filed in SC seeking mercy killing for her, but it was rejected in 2011. The SC, however permitted passive euthanasia. Shanbaug died in 2015 of a cardiac arrest brought on by pneumonia.

When to make a living bill –

  • Person is of sound mind and can comprehend the consequences of executing the document.
  • Voluntarily and under no threat.
  • Person should be an adult.
  • If there is more than one living bill, the most recently signed one will be valid.

 

Essential elements–

  • State the time to withdraw medical treatment
  • State the circumstances : permanent vegetative state, terminal illness, incurable conditions
  • State that the person may revoke the will at any time.

 

REQUIREMENTS

  • Signed by the person, two witnesses and a judicial magistrate.
  • A copy should be handed over to a municipal corporation, municipality or panchayat.

 

EXECUTION OF WILL

  • The hospital will constitute a medical board to form a preliminary opinion on whether or not to put instructions as per the will.
  • After certification by the medical board, the hospital will inform the district collector.
  • The collector will constitute another medical board to give a final opinion on whether or not to withdraw treatment.
  • The judicial magistrate is informed of the second board’s decision, and must visit the patient. He authorizes the decision of medical board.

 

 

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