Report No. 241
2. Law Commission's 196th Report
2.1 The Law Commission of India, in its 196th Report1Medical Treatment to Terminally Ill Patients (Protection of Patients and Medical Practitioners), had in its opening remarks clarified in unmistakable terms that the Commission was not dealing with "euthanasia" or "assisted suicide" which are unlawful but the Commission was dealing with a different matter, i.e., "withholding life-support measures to patients terminally ill and universally in all countries, such withdrawal is treated as lawful".
Time and again, it was pointed out by the Commission that withdrawal of life support to patients is very much different from euthanasia and assisted suicide, a distinction which has been sharply focused in Aruna's case as well. Aruna's case (supra) preferred to use the compendious expressio.- "passive euthanasia".
2.2 The 17th Law Commission of India took up the subject for consideration at the instance of Indian Society of Critical Care Medicine, Mumbai which held a Seminar attended by medical and legal experts. It was inaugurated by the then Union Law Minister. The Law Commission studied a vast literature on the subject before the preparation of report.
2.3 In the introductory chapter, the Law Commission also clarified:
"In this Report, we are of the view that 'Euthanasia' and 'Assisted Suicide' must continue to be offences under our law. The scope of the inquiry is, therefore, confined to examining the various legal concepts applicable to 'withdrawal of life support measures' and to suggest the manner and circumstances in which the medical profession could take decisions for withdrawal of life support if it was in the 'best interests' of the patient.
Further, question arises as to in what circumstances a patient 4 Medical Treatment to Terminally Ill Patients (Protection of Patients and Medical Practitioners). can refuse to take treatment and ask for withdrawal or withholding of life support measure, if it is an informed decision."
2.4 The following pertinent observations made by the then Chairman of the Law Commission in the forwarding letter dated 28 August 2006 addressed to the Hon'ble Minister are extracted below:
"A hundred years ago, when medicine and medical technology had not invented the artificial methods of keeping a terminally ill patient alive by medical treatment, including by means of ventilators and artificial feeding, such patients were meeting their death on account of natural causes. Today, it is accepted, a terminally ill person has a common law right to refuse modern medical procedures and allow nature to take its own course, as was done in good old times.
It is well-settled law in all countries that a terminally ill patient who is conscious and is competent, can take an 'informed decision' to die a natural death and direct that he or she be not given medical treatment which may merely prolong life. There are currently a large number of such patients who have reached a stage in their illness when according to well-informed body of medical opinion, there are no chances of recovery.
But modern medicine and technology may yet enable such patients to prolong life to no purpose and during such prolongation, patients could go through extreme pain and suffering. Several such patients prefer palliative care for reducing pain and suffering and do not want medical treatment which will merely prolong life or postpone death."
2.5 As stated in Airdale's case by Lord Goff: "It is of course the development of modern medical technology, and in particular the development of life-support systems, which has rendered such as the present so much more relevant than in the past". That observation made in 1993 in the case of a PVS patient applies with greater force to the present day medical scenario.