The Supreme Court of India’s judgment in Common Cause v. Union of India (2018) is a historic milestone in the evolution of fundamental rights under Ar

Common Cause v. Union of India (2018) – Right to Die with Dignity and Passive Euthanasia

The Supreme Court of India’s judgment in Common Cause v. Union of India (2018) is a historic milestone in the evolution of fundamental rights under Article 21 of the Constitution. This case recognized that the right to life also includes the right to die with dignity, laying down legal principles for passive euthanasia and living wills.

By balancing individual autonomy, medical ethics, and constitutional guarantees, the Court addressed one of the most delicate and profound issues of human life—the end of life itself. This decision changed the legal landscape of India, providing clarity on how terminally ill patients can make decisions about their treatment and how their families and doctors should respond.

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Background and Context

Before Common Cause approached the Supreme Court, Indian law on euthanasia was uncertain.

• Section 309 of the Indian Penal Code (IPC) criminalized attempted suicide.

• In Gian Kaur v. State of Punjab (1996), the Supreme Court held that the right to life under Article 21 did not include the right to die, but it allowed that the right to die with dignity during a natural death might be protected.

• In Aruna Shanbaug v. Union of India (2011), the Court allowed passive euthanasia—withdrawal of life support for a patient in a permanent vegetative state—but only with approval of a High Court.

However, there was no uniform legal procedure, and families faced long, stressful court processes.

Common Cause, a public-spirited non-governmental organization working on human rights and good governance, filed a Public Interest Litigation (PIL) in 2005. It asked the Supreme Court to recognize the right to die with dignity as a fundamental right and to permit living wills (advance medical directives) so that individuals could specify their wishes regarding end-of-life care.

The petition raised profound questions about the meaning of life, dignity, and personal autonomy in the final stages of life.

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Facts of the Case

The case of Common Cause v. Union of India (2018) began with a Public Interest Litigation (PIL) filed in 2005 by Common Cause, a non-governmental organization known for its work on governance reforms and human rights. The petition was filed under Article 32 of the Indian Constitution, which allows individuals or organizations to directly approach the Supreme Court for enforcement of fundamental rights.

The NGO argued that while the Constitution guarantees the right to life under Article 21, this right should also include the right to die with dignity when life becomes nothing more than a prolonged and painful existence due to terminal illness or irreversible unconsciousness. It asked the Court to recognize that passive euthanasia—withdrawing life-sustaining treatment in such cases—should be lawful.

The petition also sought the Court’s approval for individuals to make living wills or advance directives. A living will is a document executed by a person of sound mind, stating in advance that if they become terminally ill or enter a permanent vegetative state, they should not be kept alive on life-support machines or other artificial interventions.

The Union of India opposed the petition, arguing that euthanasia raised profound ethical, moral, and social issues. It contended that such matters should be settled by Parliament through legislation rather than by a judicial order. The government also raised concerns about the potential misuse of euthanasia, especially in a society where old or infirm people could be pressured by relatives with financial interests.

Given the importance of the issues raised, the matter was referred to a five-judge Constitution Bench of the Supreme Court, consisting of Chief Justice Dipak Misra and Justices A.K. Sikri, A.M. Khanwilkar, D.Y. Chandrachud, and Ashok Bhushan.

The facts therefore centered on a petition by an NGO seeking clarity on the constitutional validity of passive euthanasia and the legality of living wills, opposed by the State on grounds of sanctity of life, possible misuse, and legislative prerogative. The Court was thus called upon to resolve a fundamental conflict between the sanctity of life and the autonomy of an individual to die with dignity.

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Issues Before the Supreme Court

The Supreme Court framed several crucial issues for determination:

1. Does Article 21 of the Constitution, which guarantees the right to life and personal liberty, include the right to die with dignity?

2. Should passive euthanasia—withdrawing medical treatment that merely prolongs the dying process—be legally recognized?

3. Can individuals make advance medical directives or living wills to specify how they wish to be treated when they are terminally ill and incapable of expressing consent?

4. What safeguards and procedures are necessary to prevent misuse of euthanasia or living wills?

These issues required balancing individual autonomy and dignity with society’s duty to protect life.

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Arguments of the Parties

Petitioner – Common Cause

The petitioner argued that forcing a terminally ill person to undergo life-prolonging treatment amounts to cruelty and violates Article 21. Life means life with dignity; when medical treatment only prolongs suffering, the person should have the right to refuse it.

They pointed out that many countries such as the Netherlands, Belgium, and certain U.S. states permit passive euthanasia under safeguards. They also argued that living wills would reduce trauma for families and doctors by recording the patient’s choices in advance.

Union of India

The government initially opposed the petition, emphasizing the sanctity of life and the risk of misuse of euthanasia. It argued that decisions about ending life should not be left solely to individuals or families because vulnerable patients might face pressure. However, it agreed that guidelines could be framed by the Court until Parliament enacts a law.

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Judgment of the Supreme Court

On 9 March 2018, a five-judge Constitution Bench of the Supreme Court delivered a unanimous but nuanced verdict. The Court was composed of Chief Justice Dipak Misra and Justices A.K. Sikri, A.M. Khanwilkar, D.Y. Chandrachud, and Ashok Bhushan.

Recognition of the Right to Die with Dignity

The Court held that the right to life under Article 21 includes the right to die with dignity. Life is not merely animal existence; it is the right to live with dignity until the natural end. Forcing a person to suffer artificially when death is imminent violates this dignity.

Passive Euthanasia Legalised

The Court distinguished passive euthanasia (withdrawing medical treatment or life support) from active euthanasia (deliberately causing death by administering a lethal substance). Passive euthanasia was held to be legally permissible in specific situations where medical treatment only prolongs the dying process of a terminally ill patient.

Living Wills or Advance Directives

A major breakthrough was the Court’s approval of living wills. It ruled that any adult of sound mind can execute an advance directive specifying that if they are terminally ill and unable to express their wishes, life support should be withdrawn. This ensures that individuals retain control over critical medical decisions even when unconscious or incapacitated.

Safeguards and Procedure

To prevent misuse, the Court laid down detailed guidelines:

• A living will must be written, signed, and witnessed.

• It should be countersigned by a Judicial Magistrate of First Class.

• Before withdrawing treatment, a medical board of expert doctors must confirm that the patient is terminally ill and recovery is impossible.

• The decision must be endorsed by another medical board set up by the Collector and confirmed by the Magistrate.

These safeguards will operate until Parliament enacts a law.

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Significance of the Ruling

The Common Cause judgment marked a constitutional and ethical transformation in India. Its significance can be seen in several dimensions:

1. Human Dignity: It affirms that dignity must be preserved not just in life but also at the time of death.

2. Patient Autonomy: It allows individuals to make crucial healthcare decisions even in an unconscious state through a living will.

3. Medical Ethics: It provides doctors with a clear legal framework to withdraw futile treatment without fear of prosecution.

4. Legal Certainty: It filled a legislative vacuum until Parliament enacts a comprehensive law on end-of-life care.

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Connection with Article 21

The judgment gave a new dimension to Article 21 of the Constitution, which guarantees that “no person shall be deprived of his life or personal liberty except according to procedure established by law.”

The Court explained that the right to life is not merely about continued biological existence. It includes the right to live with dignity, and when life becomes a prolonged process of suffering with no hope of recovery, the right to die with dignity is also part of Article 21.

This interpretation harmonizes with earlier rulings like Maneka Gandhi v. Union of India (1978), which held that any law restricting personal liberty must be fair, just, and reasonable.

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Ethical and Social Dimensions

The case forced India to confront deep moral and ethical questions:

• Sanctity of Life vs. Autonomy: Respect for life is central to law and religion, but so is respect for personal choice and dignity.

• Medical Dilemmas: Doctors often face situations where continued treatment is futile and painful. The judgment gives them legal clarity.

• Family Concerns: Families can avoid prolonged anguish when a loved one’s wishes are clearly recorded.

The decision thus reflects a balanced approach, recognizing the value of life while respecting the individual’s right to a peaceful and dignified end.

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Global Perspective

The judgment aligns India with international human rights standards.

• Article 3 of the Universal Declaration of Human Rights (UDHR) and Article 6 of the International Covenant on Civil and Political Rights (ICCPR) protect the right to life with dignity.

• Several countries, such as Netherlands, Belgium, Luxembourg, Canada, and some U.S. states like Oregon and Washington, permit euthanasia or physician-assisted dying under strict conditions.

• The European Court of Human Rights has also recognized that forcing life-prolonging treatment on terminally ill patients can violate human dignity.

By legalizing passive euthanasia and living wills, India joined the group of nations that view end-of-life choices as a part of fundamental human rights.

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Related Cases and Legal Development

The Common Cause ruling built upon and refined earlier Indian judgments:

• Gian Kaur v. State of Punjab (1996) – Upheld the constitutional validity of Section 309 IPC but hinted that the right to die with dignity during a natural death may be protected.

• Aruna Shanbaug v. Union of India (2011) – Allowed passive euthanasia but required High Court approval, making the process long and uncertain.

• P. Rathinam v. Union of India (1994) – Had earlier struck down Section 309 IPC (attempt to commit suicide), but this was overruled in Gian Kaur.

In the years after Common Cause, India took further steps. In 2023, the Supreme Court simplified some of the procedures for implementing living wills, making them more practical.

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Criticism and Challenges

While widely welcomed, the judgment also faces criticism and practical hurdles:

• Complex Procedures: The multi-level approvals may delay decisions and prolong suffering.

• Limited Awareness: Many people are unaware of living wills or how to create them.

• Fear of Misuse: There are concerns about potential coercion of elderly or ill persons.

• Need for Comprehensive Legislation: The Court itself emphasized that Parliament should enact a detailed law to replace judicial guidelines.

These challenges show that legal recognition is only the first step; effective implementation requires continuous effort.

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Contemporary Relevance

The Common Cause decision is increasingly relevant in a world where life expectancy is longer, but chronic and terminal illnesses are common. It supports:

• Patient-centric healthcare focused on comfort and dignity rather than unnecessary medical intervention.

• Palliative care and hospice services to provide relief from pain and suffering.

• Digital health records where living wills can be stored and accessed easily.

During the COVID-19 pandemic, when critical-care decisions had to be made quickly, the importance of clear legal and ethical guidelines on end-of-life care became even more obvious.

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Conclusion

Common Cause v. Union of India (2018) is a landmark judgment that humanized Indian constitutional law. It established that the right to life under Article 21 includes the right to die with dignity, recognized passive euthanasia, and allowed living wills to protect patient autonomy.

By balancing compassion with constitutional safeguards, the Supreme Court ensured that the end of life can be met with dignity, choice, and care. The case aligns India with global human rights standards and has become a guiding precedent for lawmakers, doctors, patients, and families.

Even as Parliament works on a comprehensive law, Common Cause remains the constitutional foundation for end-of-life rights in India, proving that the Constitution is a living document capable of responding to the deepest human concerns.