The CJI, while reading out the judgment, said that though there were four separate opinions of the bench but all the judges were unanimous that the "living will" should be permitted since a person can not be allowed to continue suffering in a comatose state when he or she doesn't wish to live.
In asserting the right to die with dignity and giving legal sanction to passive euthanasia and living wills, Supreme Court has reiterated the individual's sovereignty over the body. "Second, when there are limited medical facilities available, should a major part thereof be consumed on those patients who have no chances of recovery?" "Neither the law nor the Constitution compels an individual who is competent and able to take decisions, to disclose the reasons for refusing medical treatment nor is such a refusal subject to the supervisory control of an outside entity", Justice Chandrachud said. "We don't regret that decision as we lived a healthy life", she said.
The Supreme Court's verdict on Friday legalising passive euthanasia owes much to the Aruna Shanbaug case, around which India debated euthanasia. If he (patient) has left a living will that he mustnt be kept on life support, it must be followed. He said the search for a meaningful existence, the pursuit of happiness included the exercise of free will. It includes authorizing his/her family to withdraw life support system in case a medical board declared that they were beyond medical help.
The bench clearly specified that to execute a living will, the person has to be in a position to communicate, relate and comprehend the objective and consequences of executing the document. The court said, however, the living will needs to be drawn up when the person is of sound mind.
The living will should be signed by the executor in the presence of two attesting witnesses, preferably independent, and countersigned by the jurisdictional Judicial Magistrate of First Class so designated by the concerned District Judge.
The apex court also laid down guidelines as to who could execute the advance directive and how, what should it contain, how should it be recorded and preserved, when and by whom can it be given effect to, what if permission is refused by the medical board and also in the event of revocation or inapplicability of advance directive. However, in case of difference of opinion or rejection by the Medical Board on account of ambiguity in the advanced directive, the family or the hospital can approach the High Court that will expeditiously hear and decide the case.
But what about cases where there is no advance directive?
It enshrines the right to refuse care, although under strictly controlled conditions. "For some, even their death could be a moment of celebration".
The landmark decision saw four out of the five judges penning separate judgments each arriving at the same conclusion but with different reasoning.
"This is in contrast to care which is driven by the medical industry whose heroic interventions to extend life can cause huge suffering to the dying person while only delaying the inevitable, also emotionally and financially exhausting families". To be is to die.