The SC recently recognized the right of a person to die with dignity in the Harish Rana case | Photo credit: th-online admin
The SC recently recognized a person’s right to die with dignity in the Harish Rana case by confirming that withdrawing life support from patients in a persistent vegetative state with no prospect of recovery cannot be termed as ‘euthanasia’.
However, for the nearly 90% of ordinary citizens whose final days may almost certainly be in a hospital, there is no escaping the cumbersome processes involved in obtaining the right to die with dignity, regardless of whether there is an advanced medical directive (AMD/living will) or not.
“Once a person is taken to the patient and medical interventions have been initiated, it will be difficult to reverse these processes, even if the family produces AMD. Corporate hospitals will have protocols that doctors would find difficult to circumvent,” points out MR Rajagopal, founder and chairman, Pallium India.
The concept of advanced medical directive or living will is gaining popularity in Kerala. AMD allows individuals to record their medical care preferences in advance, especially should they become incapacitated or unable to communicate their end-of-life care wishes.
However, contrary to common perception, although this is a fully legal document, AMD does not guarantee that a person’s wishes will be automatically fulfilled. In addition to procedural complexities, there are ethical dilemmas, issues such as family disagreements, religious concerns, and even misinterpretation of AMD by physicians, which can prevent the execution of AMD.
“The Oversight Committee confirmed that simply prolonging inevitable death through medical procedures violates the patient’s right to die with dignity and causes significant emotional and physical suffering,” says Dr. Rajagopal. “But unless we have a legislative framework that offers legal protection for doctors to withdraw artificial life support when a patient has AMD – or when families declare that pointless life extension is not desirable – patient autonomy will continue to be compromised.”
An important fact pointed out by the SC was that “passive euthanasia” is no longer a valid terminology. The SC distinguished that “passive euthanasia” will henceforth be replaced by “withdrawal of medical care”.
Dr. Rajagopal believes that Kerala is rightly poised to initiate legislation on end-of-life care and the right to die with dignity as the public understands the concept better. In 2020, Kerala became the first state in the country to formulate well-defined clinical protocols for certification of brain death and decoupled the process from organ donation. He also ended the ethical dilemma of doctors by stating that all life-sustaining measures could be withdrawn once brain death had been pronounced.
While this could be the state’s first step towards enacting legislation protecting a citizen’s right to die with dignity, experts stress that wider awareness is essential.
Published – 14 March 2026 21:01 IST
