Report No. 196
(A) Section 299: culpable homicide:
Even if the cases under (a), where the adult patient who is competent refuses treatment, on the basis of informed decision, does not involve the offences of 'attempt to suicide' (section 309) and 'abetment of suicide' (section 306), it is still necessary to consider whether the action of the doctor in refusing to provide medical treatment, though with consent of the competent patient, amounts to 'culpable homicide' not amounting to murder. The question of 'culpable homicide' also arises where in the cases of incompetent patients and competent patients who have not taken informed decision, and the doctor takes a decision to withhold or withdraw treatment in the best interests of the patient.
section 299: of the Indian Penal Code, 1860 reads as follows:
"section 299: culpable homicide: Whoever causes death by doing an act with the intention of causing death, or with the intention of causing such bodily injury as is likely to cause death, or with the knowledge that he is likely by such act to cause death, commits the offence of culpable homicide.
Explanation 1: A person who causes bodily injury to another who is labouring under a disorder, disease or bodily infirmity, and thereby accelerates the death of that other, shall be deemed to have caused the death.
Explanation 2: Where death is caused by bodily injury, the person who causes such bodily injury shall be deemed to have caused the death, although by resorting to proper remedies and skilful treatment the death might have been prevented.
Explanation 3: The causing of the death of child in the mother's womb is not homicide. But it may amount to culpable homicide to cause the death of a living child, if any part of that child has been brought forth, though the child may not have breathed or been completely born."
Under section 299, whoever causes death by doing an ac.-
(i) with the intention of causing death, or
(ii) with the intention of causing such bodily injury as is likely to cause death, or
(iii) with the knowledge that he is likely by such act to cause death, commits the offence of culpable homicide.
Therefore, if death is caused with the knowledge that he, the doctor, is likely. by such act to cause death, then, the act amounts to culpable homicide not amounting to murder and is punishable under section 304 which may extend upto ten years imprisonment, fine or both. It will not be an offence if the act comes within any exceptions provided in the Penal Code.
Elaborating the above, we may state again that under the main part of section 299, the doctor is not guilty because he had no intention to cause death or bodily injury which is likely to cause death. But where he knows that withdrawal of life support will cause death, is he guilty under section 299? Now under this third part of section 299, he will be guilty only if the knowledge above mentioned was that the act of withdrawal would cause death.
This third part gets attracted to the act of the doctor and he will be guilty of culpable homicide not amounting to murder, punishable under Part II of section 304. We shall consider separately whether the exceptions in ss 76, 79, 81 and 88 of the Penal Code apply to protect the doctor. We shall consider the applicability of section 299 in the case of (i) competent patients, informed decision, (ii) competent patients, no informed decision and (iii) incompetent patients, separately