Report No. 196
(A) Section 309: attempt to commit suicide (by patient):
So far as the patient is concerned, when he refuses treatment, is he guilty of 'attempt to commit suicide'?
The definition of 'attempt to commit suicide, is contained in section 309 which reads as follows:
"section 309: Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year or with fine or with both"
'Suicide' has not been separately defined but generally means 'a deliberate termination of one's own physical existence'.
But, that is different from a patient allowing nature to take its own course. When a person is suffering from disease, he may take medicine to cure himself. There are different systems of medicine and he may feel that none is good enough. Further in the last four or five decades, medical science and technology have progressed so much but medical facilities available in other countries may not be available in India, or those available in India may not be available at the place where the patient is living and his decision not to take medicine may be based on those facts.
Apart from these considerations, a patient may decide for himself that he will allow the disease or illness to continue and be not bothered by taking medicines or invasive procedures. An attitude where a patient prefers nature to take its course has been held in almost all leading countries governed by common law, as pointed out in the preceding chapters, as not amounting to an act of deliberate termination of one's own physical existence.
It is not like an act of deliberate or intentional hanging or shooting one's self to death or attempting to drown in a well or a river or in the sea. In view of the settled law on this aspect, allowing nature to take its course and not taking medical treatment is not an attempt to commit suicide. Hence there is no offence under section 309. In fact, in Airedale the House of Lords clearly held it is not suicide.
(B) Section 306: abetment to commit suicide: (abetment by doctor in relation to competent patients):
So far as the doctor is concerned, let us consider if section 306 which deals with 'abetment to commit suicide' applies. section 306 deals with this offence. It reads:
"section 306: If any person commits suicide, whoever abets the commission of such suicide, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall be liable to fine" Once the competent patient decides not to take medicine and allows nature to take its course, the doctor has to obey the instructions. Administering medicine contrary to the wishes of a patient is battery and is an offence. The omission to give medicine is based on the patient's direction and hence the doctor's inaction is not an offence. In fact, when there is no attempt at suicide or suicide under section 309, there can be no abetment of suicide under section 306.
(c) Even under section 107 of the Indian Penal Code (which we have extracted in Chapter II) which generally deals with 'abetment', the position is the same. Under that section 'abetment' may be by a positive act or even by omission. If a doctor omits to give medical treatment at the instructions of a competent patient, he is not guilty of 'abetment' under section 107, because under section 107 the omission must be "illegal". If under common law, the doctor is bound by the patient's instruction for stoppage of treatment, it is binding on him and his omission is 'legal'. As there is no requirement under the law that he can disobey the instruction, he is not guilty of abetting. In fact, if he disobeys and continues the medical treatment it will amount to battery or assault.
We hav' seen Airedale (UK) and Cruzan (USA) the question of the doctor's omission has been considered elaborately ant it has been held had that where there is no duty under common law to give or continue the medical treatment, the omission of the doctor does not amount to an offence. Hence, the doctor is not guilty of abetment of suicide' under section 306 IPC, even if we read section 306 along with section 1074 which deals generally with 'abetment'
(b) Doctors action in respect of incompetent patients and competent patients who have not taken informed decision: If it amounts to an offence, it clearly falls under exception in Indian Penal Code, 1860: