Common Cause v. UOI [AIR 2018 SC 1665]

The Supreme Court ruled that the right to die with dignity is a fundamental right and that persisting treatment against a patient’s desires violates not only the concept of explicit consent, but also corporeal privacy and bodily integrity, both of which have been identified as aspects of privacy. 

Bench –  Dipak Misra, A.K. Sikri, Ashok Bhushan, D.Y. Chandrachud and A.M. Khanwilkar.

Facts – In 2005, a registered NGO petitioned the Supreme Court under Article 32 of the Indian Constitution to legalise living wills and passive euthanasia. Previous to this registered society, letters concerning passive euthanasia were sent to the ministries of law and justice, health, and family welfare. The petitioners submitted the PIL after receiving no reply from the government. The petitioners argued that because the right to live with dignity is a person’s right until death, it can be expanded to also include the right to die with dignity a nd that new technology has resulted in a situation in which the patient’s life is needlessly sustained, distressing and agonising the patient and his relatives. The petitioners also advocated for the legalisation of living wills, in which a person in prolonged pain and suffering can try to write about their medical treatment and authorise their family to end it.

Issues – 

  • Whether the right to die is enshrined along with the right to life as under Article 21 of Constitution or not?
  • Whether the concept of passive euthanasia is permissible on a patient’s living will or not?
  • Whether a distinction exists between passive and active euthanasia or not?
  • Whether a person possesses the right to reject a medical treatment, such as withdrawal from life saving devices, or not?

Judgment – It was reiterated by the court of law that the right to die with dignity was a fundamental right, as proclaimed in Gian Kaur case. The Court stated that Gian Kaur decision did not brought in the notion of passive euthanasia. The Court debated the difference between active and passive euthanasia, with active euthanasia requiring an overt action and passive euthanasia involving the pullout of life support. It ruled that the Court erroneously ruled in Aruna Shanbaug by retaining that passive euthanasia can only be implemented through legislation.

Concerning living wills, the Court determined that there is clear evidence of acquiescence of the notion of Advance Medical Directives in India. It went on to say that having the ability to implement an Advance Medical Directive was a step forward into protecting the right to self-determination and bodily dignity. In the treatment of people that were unable to form an informed opinion, a ‘best-interest’ role could be taken, enabling a representative to step in and make this judgment call.

The case went into great detail about the right to privacy, as described in Puttaswamy vs. UOI, and its relationship to autonomy and liberty. In this case, the Court depended on snippets from all six judgments. In addition to Indian instances, the Court looked at decisions from other countries and debated the connection between the right to privacy and its consequences for euthanasia.

The court depended on the decision of In re Quinlan, 1976, wherein it was ruled by New Jersey Supreme Court that as the patient’s survival rate deteriorated, the state’s involvement weakened and the individual’s right to privacy with regard to bodily autonomy began growing stronger. If the people were unable to affirm their privacy on their own, a guardian could do so on their behalf. It also cited the European Court of Human Rights’ decision in the case of Pretty vs. the United Kingdom, in which the Court determined that a person had an option to avert what they considered an indecorous and troubling terminal to their life, and that such an option would be protected as per the provisions of right to respect for private life under Article 8(1) of the European Convention on Human Rights.

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