Explore the legal evolution of the right to die with dignity in India, examining passive euthanasia, Article 21, and landmark Supreme Court rulings
Suresh Chandra Sarangi
The Universal Declaration of Human Rights encompasses the fundamental rights to life and security of the person under Article 3 of the Charter. The salient features prescribe that each individual has the right to physical survival, freedom, and safety. As a universal declaration, it extends these rights to everyone globally, without discrimination on the grounds of race, caste, colour, sex, language, region, or status. As per the Universal Declaration of Human Rights, Article 1 further says that all humans are born free and equal in dignity and rights. It is an interesting fact that our founding fathers had taken note of this development and incorporated it under Chapter 3 of the Indian Constitution, Fundamental Rights, under Article 21. This includes personal liberty, extended to include dignity, livelihood, and privacy. Recently, the right to die has been incorporated under Article 21 of the Indian Constitution, which guarantees the right to life and personal liberty.
Article 21 of the Constitution provides that no person shall be deprived of their life or personal liberty, except according to the procedure established by law, available to both citizens and non-citizens as regards its enforceability. This right cannot be violated by the State. In a broader perspective, the right to privacy, recognised as a landmark of the 2017 judgment; the right to health and medical care; the right to a clean and healthy environment; and the right to life and shelter are the basic fundamental rights that secure an individual, and the State has an obligation to maintain those conditions. But in 2018, the Supreme Court of India recognised another right, the right to die with dignity, as a fundamental right after the Shanbaug case and prescribed guidelines for terminally ill patients, a right to die with dignity, by introducing the concept of euthanasia.
The key issues before the Supreme Court of India were whether the constitutional guarantee of the right to life is extended to the right to die, whether euthanasia can be made lawful only by legislation, whether there are differences between active and passive euthanasia, and whether individuals can give advance intimation if it is felt that he or she would lose the ability to communicate in the future. In 2014, as per the petition of Common Cause, a three-judge bench of the Supreme Court referred this case to a larger bench to settle the issue in light of certain anomalies in the case of Aruna Ramchandra Shanbaug vs Union of India, 2012, and another, Gyan Kaur v. State of Punjab. In 2018, a five-judge bench headed by Chief Justice Deepak Mishra delivered a judgment that the right to die with dignity is a fundamental right.
It would be appropriate to know the details of Aruna Shanbaug to throw some light on the origin of the right to die. This gives a clearer idea about the euthanasia debate in India. Aruna Shanbaug was a nurse at KEM Hospital. She was sixty years of age and spent fifty percent of her life in a vegetative state in the ward of KEM Hospital. In November 1973, after discharging her duty, when she was changing her uniform, a hospital sweeper assaulted her by twisting a chain around her neck and left her unconscious. She suffered brain damage as the blood supply was blocked for a long period before she was found in the room.
One journalist, Pinaki Virani, took up her case to the Supreme Court, seeking a direction to KEM Hospital to stop nasal feeding so that she could die with dignity, thereby making a prayer to incorporate the right to die with dignity. Aruna’s body had almost given in; with a feeble body, she could hardly see or hear. In a vegetative state, she had to be provided the option to die peacefully. Mumbai Municipal Corporation filed a counter-affidavit saying she could make facial expressions and hence was not required to die. The Supreme Court of India ordered a team of three doctors to make an objective assessment of Aruna’s health.
The doctors’ report mentioned that Aruna seemed to be in a vegetative state, but she was not brain dead or comatose. She had some facial movement and made some vocal sounds. But Aruna was not in a position to take her decision and, therefore, let the hospital take the appropriate decision. The Supreme Court endorsed the recommendation of the doctors and the dean to make appropriate decisions. The court decided on two forms of euthanasia, active and passive. While differentiating, let it be known that active euthanasia amounts to giving a lethal injection to end life, whereas passive euthanasia is by way of withdrawing life support.
This is implemented in some countries and not implemented in others. The Supreme Court allowed passive euthanasia as permissible, as failing to save a person could not constitute a crime. Though a moral question is linked to it, the judgment was a landmark judgment. In her case, passive euthanasia was allowed under a doctor’s supervision and with a doctor’s certificate regarding the condition of the patient that determines whether passive euthanasia has to be decided at all, as per common guidelines prescribed by the Supreme Court of India. Aruna Shanbaug was subjected to passive euthanasia to end her life.
As per a Supreme Court observer, euthanasia and the right to die with dignity were recognised as a fundamental right under Article 21 of the Indian Constitution by virtue of the Supreme Court order of 2018. In 2026, the rulings expanding Article 21, on March 11, upheld the right to die with dignity in the case of Harish Rana vs Union of India, allowing the withdrawal of life support in a careful, structured process and not as a single hasty act, for a person who spent nearly 13 years in a persistent vegetative state. All these have to be done as per the procedure established by law, meaning that a law is duly enacted by the legislature or the concerned body is valid only if the correct procedure has been followed. Article 21 of the Indian Constitution states, “No person shall be deprived of his life or personal liberty except according to procedure established by law.”
In 2026, the Supreme Court of India permitted passive euthanasia, allowing the withdrawal of life support for 32-year-old Harish Rana, who had been in a permanent vegetative state for 13 years, so that the question of the right to die or not to die has been decided in India with a sincere eye on dignity and the circumstances of the case, after receipt of a report by the medical team necessitating admission of passive euthanasia. It is recognised as a fundamental right under Article 21 of the Constitution. The Supreme Court’s judgment stated that while “the right to life under Article 21 includes the right to die with dignity, it does not include the ‘right to die’ per se.” That means suicide is illegal and punishable, but passive euthanasia is legal under certain circumstances.
(The writer is a former General Manager of Bank of India. Views expressed are personal.)