"The advance directive can be executed only by an adult who is of a sound and healthy state of mind and in a position to communicate, relate and comprehend the goal and consequences of executing the document", the bench headed by Chief Justice Dipak Misra said, stressing that the directive must be "voluntarily executed" without any coercion and should have characteristics of informed consent without undue influence. A "living will" is a document prepared by a person in a healthy state of mind specifying that if s/he slides into a vegetative state because of an irreversible terminal illness, the debilitated existence should not be prolonged with the help of life support systems or other medical interventions. Therefore, the SC said the relatives of a patient who has not written a "living will" can approach High Courts asking for passive euthanasia.
Passive euthanasia is a condition when a medical treatment is deliberately withdrawn to a terminally ill patient with the intention of hastening the death of the said patient. Further the Aruna Shanbaug ruling accepted that euthanasia could be made lawful only through legislation, yet the court accepted the permissibility of passive euthanasia and laid down the procedure for it.
In a separate opinion, Justice Chandrachud observed that modern medical science should balance its quest to prolong life with the need to provide patients quality of life.
The Supreme Court had in 2011 recognised passive euthanasia in what has become known as the Aruna Shanbaug case by which it had permitted withdrawal of life-sustaining treatment from patients not in a position to make an informed decision. While the bench stated that "living will" and "passive euthanasia" were permissible in the country, it also asserted that guidelines would govern who would execute the will and how a green signal for passive euthanasia would be granted.More news: New Zealand welcomes US-North Korea talks
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While the Centre was in agreement on the question of allowing passive euthanasia, it opposed the concept of living will.
Private hospitals that are increasingly at the receiving end of allegations of inflated medical bills through extended ICU admissions of terminally ill and clinically dead patients will now get a reprieve if the person has signed such a "living will".
The steps that are generally taken to cause passive euthanasia include turning off respirators, halting medications, discontinuing food and water so as to allow a person to dehydrate or starve to death, or failure to resuscitate, they say.
In 2015, the death of a 66-year-old nurse Aruna Shanbaug, who was sexually assaulted and left in a vegetative state for more than 40 years, had sparked a national debate over the legalisation of euthanasia.