Human Rights:

Euthanasia - Withdrawal of life support - Writ petition filed in Supreme Court seeking euthanasia for a 60 year old woman - Petitioner was a Staff Nurse working in KEM Hospital, Mumbai, who was assaulted by a sweeper in the hospital who sodomized her and during this act twisted a dog chain around her neck due to which supply of oxygen to the Petitioner's brain stopped and her brain got damaged - Petitioner lay bed-ridden in KEM Hospital, Mumbai since 1973 allegedly in a Persistent Vegetative State (PVS) - Held: The Petitioner cannot be said to be dead - Even from the report of Committee of Doctors it appears that she has some brain activity, though very little - The Petitioner recognizes that persons are around her and expresses her like or dislike by making some vocal sound and waving her hand by certain movements - She smiles if she receives her favourite food, fish and chicken soup - She breathes normally and does not require a heart lung machine or intravenous tube for feeding. Her dementia has not progressed and has remained stable for many years - Whatever the condition of her cortex, her brain stem is certainly alive - Though the Petitioner's parents are dead and other close relatives are not interested in her ever since she had the unfortunate assault on her, however, the KEM hospital staff have been caring for her day and night for so many long years, who really are her next friends. Hence it is for the KEM hospital staff to take a decision on withdrawal of life support to the Petitioner - The KEM hospital staff have clearly expressed their wish that Petitioner should be allowed to live - However, assuming that the KEM hospital staff at some future time changes its mind, in such a situation the KEM hospital would have to apply to the Bombay High Court for approval of the decision to withdraw life support.  Petition accordingly dismissed.

Euthanasia - Withdrawal of life support of a patient in Permanent Vegetative State (PVS) - No statutory provision in India as to the legal procedure for withdrawing life support to a person in PVS or who is otherwise incompetent to take a decision in this connection - Held: Passive euthanasia should be permitted in India in certain situations.

Euthanasia - Withdrawal of life support of a patient in Permanent Vegetative State (PVS) - Law laid down by Supreme Court in this connection until Parliament makes a law on the subject - Held: A decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend - If can also be taken by the doctors attending the patient - However, the decision should be taken bona fide in the best interest of the patient - Even if a decision is taken by the near relatives or doctors or next friend to withdraw life support, such a decision requires approval from the High Court - This is even more necessary since cannot rule out the possibility of mischief being done by relatives or others for inheriting the property of the patient. This is in the interest of the protection of the patient, protection of the doctors, relative and next friend, and for re-assurance of the patient's family as well as the public - This is also in consonance with the doctrine of parens patriae.

Euthanasia - Withdrawal of life support to a person who is unable to take a decision as regards such withdrawal. Application for, by near relatives or next friend or the doctors hospital staff- Power of High Court u/Art.226 - Held: Article 226 gives abundant power to the High Court to pass suitable orders on the application filed by the near relatives or next friend or the doctors/hospital staff praying for permission to withdraw the life support - Procedure to be adopted by the High Court when such an application is filed - When such an application is filed the Chief Justice of the High Court should forthwith constitute a Bench of at least two Judges who should decide to grant approval or not - Before doing so the Bench should seek the opinion of a committee of three reputed doctors to be nominated by the Bench after consulting such medical authorities/medical practitioners as it may deem fit.

Preferably one of the three doctors should be a neurologist, one a psychiatrist, and the third a physician - For this purpose a panel of doctors in every city may be prepared by the High Court in consultation with the State Government Union Territory and their fees for this purpose may be fixed - The committee of three doctors nominated by the Bench should carefully examine the patient and also consult the record of the patient as well as taking the views of the hospital staff and submit its report to the High Court Bench - Simultaneously with appointing the committee of doctors, the High Court Bench shall a/so issue notice to the State and close relatives e.g. parents, spouse, brothers/sisters etc. of the patient, and in their absence his/her next friend, and supply a copy of the report of the doctor's committee to them as soon as it is available - After hearing them, the High Court bench should give its verdict - The above procedure should be followed all over India until Parliament makes legislation on this subject

- The High Court should give its decision speedily at the earliest, since delay in the matter may result in causing great mental agony to the relatives and persons close to the patient. he High Court should give its decision assigning specific reasons in accordance with the principle of 'best interest of the patient' - The views of the near relatives and committee of doctors should be given due weight by the High Court before pronouncing a final verdict which shall not be summary in nature - Constitution of India, 1950 - Article 226. Euthanasia - Types of- Held: Euthanasia is of two types: active and passive - Active euthanasia entails the use of lethal substances or forces to kill a person e.g. a lethal injection given to a person with terminal cancer who is in terrible agony - Passive euthanasia entails withholding of medical treatment for continuance of life, e.g. withholding of antibiotics where without giving it a patient is likely to die, or removing the heart lung machine, from a patient in coma. Further categorization of euthanasia between voluntary euthanasia and non voluntary euthanasia - Voluntary euthanasia is where the consent is taken from the patient, whereas non voluntary euthanasia is where the consent is unavailable e.g. when the patient is in coma, or is otherwise unable to give consent.

Euthanasia - Legal position all over the world - Held: The general legal position all over the world seems to be that while active euthanasia is illegal unless there is legislation permitting it, passive euthanasia is legal even without legislation provided certain conditions and safeguards are maintained.

Euthanasia - Active Euthanasia and Physician assisted suicide - Legal position in India - Held: In India active euthanasia is illegal and a crime under section 302 or at least section 304 IPC - Physician assisted suicide is a crime under section 306 IPC (abetment to suicide). Euthanasia - Distinction between euthanasia and physician assisted suicide - Held: The difference is in who administers the lethal medication - In euthanasia, a physician or third party administers it, while in physician assisted suicide it is the patient himself who does it, though on the advice of the doctor.

Precedents - Foreign decisions - Value of - Held: Foreign decisions have only persuasive value in our country, and are not binding authorities on our Courts - Hence one can even prefer to follow the minority view, rather than the majority view, of a foreign decision, or follow an overruled foreign decision.

Penal Code, 1860 - s.309 - Held: s.309 should be deleted by Parliament as it has become anachronistic - A person attempts suicide in a depression, and hence he needs help, rather than punishment.

Medical Jurisprudence - When can a person be said to be dead - Held: If the brain is dead, a person is said to be dead.

Medical Jurisprudence - Brain death - Meaning of- Discussed.

Doctrines - Doctrine of Parens Patriae - Held: The doctrine of Parens Patriae (father of the country) had originated in British law - It implies that the King is the father of the country and is under obligation to look after the interest of those who are unable to look after themselves - The duty of the King in feudal times to act as parens patriae (father of the country) has been taken over in modern times by the State - In the case of an incompetent person who is unable to take a decision whether to withdraw life support or not, it is the Court alone, as parens patriae, which ultimately must take this decision, though, no doubt, the views of the near relatives, next friend and doctors must be given due weight.

Constitution of India, 1950 - Article 21 - Held: The right to life guaranteed by Article 21 of the constitution of india does not include right to die.