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The Economics of Death

Living Wills and the Right to Die with Dignity

How India's Supreme Court recognised passive euthanasia and living wills in 2018, simplified the process in 2023, and the ethical and practical issues involved.

In March 2018, India’s Supreme Court (Common Cause case) recognised the right to die with dignity.

Passive euthanasia

The court allowed passive euthanasia: withdrawing life support for terminally ill patients under safeguards.

Living wills

  • A living will (advance directive) lets a person state in advance that they don’t want life-prolonging treatment if terminally ill without hope of recovery.

Simplification

  • The original process was complex, requiring magistrate approval.
  • In January 2023, the court simplified the rules.

Background

The case of Aruna Shanbaug, a nurse in a vegetative state for decades, led to a 2011 ruling that began the legal debate.

Economic angle

  • Families face financial and emotional burdens from prolonged intensive care.
  • Advance directives respect autonomy and can avoid unwanted treatment.

Ethics

Safeguards protect against pressure on vulnerable patients.

The advance directive

A 70-year-old records a living will stating she doesn't want to be kept on a ventilator if she has no hope of recovery.

Thinking India bans all end-of-life choices

The Supreme Court allowed passive euthanasia and living wills in 2018.

Key takeaways
  • The Supreme Court recognised the right to die with dignity in 2018.
  • Passive euthanasia and living wills are allowed.
  • The process was simplified in 2023.
  • Safeguards protect vulnerable patients.
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