MEMORI

ALONBEHALFOFPETI
TIONERS

STATEMENTOFFACTS

BACKGROUND
 MEMORI
ALONBEHALFOFPETI
TIONERS

I
SSUESRAI
SED

I
.
WHETHERRI
GHTTOLI
FEI
NCLUDESRI
GHTTOREMOVELI
FE-
SUPPORTI
NG
SYSTEMS?
I
I.
WHETHERREMOVALOFARTI
FICI
ALLI
FESUPPORTI
NGSYSTEM ASPERTHE
WISHOFTHEPATI
ENTBECONSIDEREDASLEGALLYPERMI
TTED?
I
II
.
WHETHERASSI
STEDSUICI
DEBEALLOWEDFORPATI ENTSWHO ARE
SUFFERI
NGUNBEARABLEPAI
NANDINCURABLEILLNESS,
WHENTHE
DEMANDHASBEENMADEIN“FULLCONSCIOUSNESS”BYTHEPATIENT?

SUMMARYOFARGUMENTS

[1
].RI
GHTTO LI
FEI
NCLUDESRI
GHTTO REMOVELI
FE-
SUPPORTI
NGSYSTEMS

[
2]REMOVALOFARTI
FICI
ALLI
FESUPPORTI
NGSYSTEM ASPERTHE
WI
SHOFTHEPATI
ENTSHOULDBECONSI
DEREDAS
LEGALLYPERMI
TTED
 MEMORI
ALONBEHALFOFPETI
TIONERS

[
3]ASSI
STEDSUI
CIDESHOULDBEALLOWEDFORPATI
ENTSWHO ARE

SUFFERI
NGUNBEARABLEPAI
NANDI
NCURABLEI
LLNESS,
WHENTHE
DEMANDHASBEENMADEI
N“FULLCONSCI
OUSNESS”BYTHEPATI
ENT
 MEMORI
ALONBEHALFOFPETI
TIONERS

WRI
TTENPLEADI
NGS

[1
].RI
GHTTO LI
FEI
NCLUDESRI
GHTTO REMOVELI
FE-
SUPPORTI
NGSYSTEMS

 Thepati
entwi
thanexcr
uci
ati
ngpai
nont
heaccountofmedi
cal
condi
ti
onwho

 expressest
hei
rwi
l
lfort
hewi
thdr
awaloft
hel
i
fesuppor
tsyst
em t
oend
thepain,

suf
feri
nganddi
ewi
thdi
gni
tyshoul
dbef
undament
alr
ightt
oli
vewi
thdi
gni
ty.
Asper
art
icl
e21

gi
venundertheI
ndi
anconst
it
uti
onofr
ightt
oli
vi
ngwi
thdi
gni
tyt
hel
aw al
so
consi
derand

under
standrightt
odi
ewi
thdi
gni
ty.[
1.1
]Thel
awt
hati
smadef
ort
hei
rpeopl
e
pr
ovi
desright

tol
if
ewhi
chunder
standsonl
i
vingwi
thdi
gni
tysuchl
awshoul
dal
sopr
ovi
det
oit
s
peopl
ewi
th

ri
ghttodi
ewithdi
gni
tyt
hatemphasi
sont
hemat
tert
oendmedi
calpai
nand
suff
eri
ngtoi
ts

peopl
ewhi
chr
esul
tsi
ndet
eri
orat
ionsoft
hei
rheal
th,
thushav
inggi
vent
her
ightt
o
l
ivewi
th

di
gni
tymustal
soi
ncl
uder
ightt
odi
ewi
thdi
gni
ty.

 Euthanasi
aorassi
stedsui
cidemeansendi
ngt
hepai
norsuf
fer
ingsof
thepati
ents

byinj
ect
ingt
hepat
ientwi
thal
ethal
subst
ance.
Duet
ofastmov
ingt
echnol
ogyt
he
l
if
esupport

systemsl
ikev
ent
il
ator
set
c.,
hasal
soev
olv
edov
ert
imewhi
chonl
yser
vest
he
purposeof

prol
ongi
nglif
eofapat
ient
,wher
ethedoct
orsmer
elyusei
ttopr
olongt
hel
i
vesof
thepati
ent
s

wit
hthehel
poft
hissyst
em whi
chhasnopur
poseofr
ecov
ery,
Thusonwi
thdr
awal
ofl
ife
 MEMORI
ALONBEHALFOFPETI
TIONERS

support
ingmachi
ne,t
hepat
ienti
slett
odi
eonanat
uralbasi
s[1
.2]t
hati
slegal
i
zed
under

lawsoftheU.
K.,
Aust
ral
i
aet
c.(
thr
oughapr
operpr
ocedur
eofl
aw)whi
chi
s
dif
fer
entfr
om

Eut
hanasi
awhi
chi
spopul
arl
yknownas“
mer
cyki
l
li
ng”

[1
.1]
AsperArt
icl
e21givenundert
heIndianconsti
tut
ionofr
ighttol
ivi
ngwi
th
di
gnityt
hel
aw alsoconsi
derandunderstandr
ighttodiewi
thdigni
ty

Theconst
it
uti
oni
fxi
ndi
aissi
mil
art
othatofI
ndi
aandt
huswi
tht
her
efer
encef
rom
art
icl
e21of

t
heIndianconst
it
uti
onwhi
cht
alksaboutr
ightt
oli
feunderar
ti
cle21al
soi
ncl
udes
r
ightt
odi e.

CASELAWS

nSt
I at
eOfMahar
asht
ravs.Sh.Mar
utiShr
jpat
iDubalt
heBombayHi
ghCour
thel
d
t
hat

ri
ghtt
olif
ethati
sguar
ant
eedunderAr
ti
cle21i
ncl
udesr
ightt
odi
e,andt
hehon’
ble
HighCourt

str
uckdownsect
ion309I
PCwhi
chpr
ovi
despuni
shmentf
orat
temptt
ocommi
t
sui
cidebya

per
sonasunconst
it
uti
onal
.

nP.
I Rat
hinam vsUni
onOfI
ndi
aaDi
vi
si
onBenchoft
heSupr
emeCour
tsuppor
ti
ng
t
he

decisi
onoftheHi
ghCour
tofBombayhel
dthatunderAr
ti
cle21r
ightt
oli
feal
so
i
ncluderi
ghtto

di
eandl
aiddownt
hatsect
ion309ofI
ndi
anpenalcodeasunconst
it
uti
onal
.
 MEMORI
ALONBEHALFOFPETI
TIONERS

[1
.2]Ont hewit
hdr
awalofl
i
fesuppor
ti
ngmachi
ne,t
hepat
ienti
slett
odi
eona
naturalbasi
s

Theper
cept
ionofwi
thdr
awalofl
i
fesuppor
tsyst
em undert
hel
awofUK:

CASELAWS

I
ntheAir
edal
eNHSTr
ustvsBl
and,t
hesupr
emecour
toft
heU.
K.st
atedt
hatt
he
wit
hdr
awalof

thel
ifesuppor
tsyst
em i
snoti
l
legali
fithasbeendonei
ncaseofani
ncompet
ent
pati
entandif

theactoft
hedoctor
shasbeendoneonani
nfor
medmedi
calbasi
sandi
tisal
so
basedonthebest

i
nter
est
soft
hepat
ientwher
etheyexpr
esst
hei
rwi
l
linf
reeconsent
.

[
2].REMOVALOFARTI
FICI
ALLI
FESUPPORTI
NGSYSTEM ASPERTHE
WI
SHOFTHEPATI
ENTSHOULDBECONSI
DEREDAS
LEGALLYPERMI
TTED

Howcanapersonbet
oldt
hathe/
shedoesnothav
eri
ghtt
opr
eventt
ort
ureonhi
s
body?Ri
ghtt
o

li
feincl
udesri
ghtt
odi
ewi
thdi
gni
ty.
Aper
soncannotbef
orcedt
oli
veonsuppor
t
ofventi
l
ator
.

Keepingapati
ental
i
vebyar
ti
fi
cialmeansagai
nsthi
s/herwi
shesi
sanassaul
ton
hi
s/herbody,
"

i
twassai
dint
hepet
it
ionsi
gnedbyanNGO i
n‘CommonCase

I
tbecomesethi
calandj
ust
if
iedwhent
hequal
i
tyofl
i
feoft
het
ermi
nal
l
yil
lpat
ient
becomesso

l
owthatdeat
hremai
nst
heonl
yjust
if
iabl
emeanst
orel
i
evesuf
fer
ing.
Lackofany
j
ust
if
iabl
e

meansofrecover
yandt
hedyi
ngpat
ienthi
msel
fmaki
ngt
hechoi
cet
oendhi
sli
fe
ar
econdit
ions
 MEMORI
ALONBEHALFOFPETI
TIONERS

whi
chmakeeut
hanasi
amor
ejust
if
iabl
e.

Accor
dingtoanIndi
anExpr
essr
epor
t;benchoft
heapexcour
theadedby
theChi
efJust
iceof

I
ndiaDi
pakMisr
aandcompr
isi
ngJust
icesA.
K.Si
kri
,A.
M.Khanwi
l
kar
,D.
Y.
Chandr
achud

andAshokBhushan,i
ssuedgui
del
i
nesi
nrecogni
ti
onof“
li
vi
ngwi
l
l”madeby
t
ermi
nall
y-

i
llpat
ient
s[2.
1].Thecour
twasi
ssui
ngi
tsver
dictonaPI
Lfi
l
edbyNGO Common
Causein

2005.Accor
di oLi
ngt veLaw,not
edl
awyerPr
ashantBhushanhadar
guedi
nthe
caset
hat

whenamedicalexper
tsuggest
sthatt
hepat
ientsuf
fer
ingf
rom at
ermi
naldi
sease
hasr
eached

apoi
ntofnor
etur
n,sheshoul
dhavet
her
ightt
oref
usear
tif
ici
all
i
fesuppor
t–
medi
cal
ly

r
efer
redt
oaspassi
veeut
hanasi
a[2.
2]–t
oavoi
dpr
olongedagony.

[
2.1
]Li
vi
ngWi
l
lmadebyt
ermi
nal
l
yil
lpat
ient
s:

A“li
vi
ngwil
l
”isadocumentpr
epar
edbyaper
soni
naheal
thyst
ateofmi
nd
speci
fyi
ngt
hati
f

s/hesli
desint
oav
eget
ati
vest
atebecauseofani
rr
ever
sibl
eter
minali
l
lness,
the
debil
i
tated

exi
stenceshoul
dnotbepr
olongedwi
tht
hehel
pofl
i
fesuppor
tsyst
emsorot
her
medical
 MEMORI
ALONBEHALFOFPETI
TIONERS

i
nter
venti
ons.I
nsuchacase,
rel
ati
veswi
l
lbespar
edt
heagoni
zi
ngdeci
si
onof
r
emov i
ngli
fe

suppor
tanddoct
orswi
l
lbegui
dedsol
elybyt
he“
li
vi
ngwi
l
l”.

Wit
ht hel
iv
ingwi
l
l,t
her
eisnochanceofeut
hanasi
aget
ti
ngmi
susedbyr
elat
ivesof
pat
ientwho

maywanthi
mtodi
eir
respect
iveofhi
smedi
calcondi
ti
on.

I
ssui
ngi
tsver
dictonaPI
Lfi
l
edbyNGO CommonCausei
n2005t
hecour
tissued

gui
del
i
nesi
nrecogni
ti
onof“
li
vi
ngwi
l
l”madet
ermi
nal
l
yil
lpat
ient
s.

CASELAWS

nCommonCause(
I ARegd.Soci
ety)vsUni
onOfI
ndi
aaf
ive-
judgebenchoft
he
apexcour
t

headedbytheChi
efJust
iceofI
ndi
aDi
pakMi
sraandcompr
isi
ngJust
icesA.
K.
Sikr
i,A.
M.

Khanwil
kar,D.
Y.Chandr
achudandAshokBhushan,i
ssuedgui
del
i
nesi
n
recogni
ti
on

of“l
ivi
ngwi
l
l”madebyt
ermi
nal
l
y-i
l
lpat
ient
s.Accor
di oLi
ngt veLaw,not
edl
awyer
Pr
ashant

Bhushanhadarguedi
nthecaset
hatwhenamedi
calexper
tsuggest
sthatt
he
pat
ientsuf
fer
ing

f
rom aterminaldi
seasehasr
eachedapoi
ntofnor
etur
n,sheshoul
dhavet
he
r
ightt
or ef
use

art
ifi
ciall
i
fesuppor
t–medi
cal
l
yref
err
edt
oaspassi
veeut
hanasi
a–t
oavoi
d
pr
olonged

agony.

[2.
2]Therightt
oref
usear
tif
ici
all
i
fesuppor
t–medi
cal
lyr
efer
redt
oaspassi
ve
euthanasi
a

I
npassiveeut
hanasi
a,t
hedeat
hoft
hev
ict
imi
scausedbecauset
het
reat
ment
necessar
yfor

sust
aini
nghi
sli
feisei
therhel
dof
f,ori
snotgi
ven.
Int
hiscase,
themedi
cal
prof
essi
onal
seit
her

donotdosomet
hingt
hati
snecessar
ytokeept
hepat
iental
i
ve,
ort
heyst
opgi
vi
ng
thet
reat
ment
 MEMORI
ALONBEHALFOFPETI
TIONERS

requi
redtokeephi
m al
i
ve.
In“
passi
veeut
hanasi
a”t
hedoct
orsar
enotact
ivel
yki
l
li
ng
anyone;

t
heyar
esi
mpl
ynotsav
inghi
m.

Thegenerall
egalposi
ti
onal
lov
ert
hewor
ldseemst
obet
hatwhi
l
e
act
iveeut
hanasi
ais

i
ll
egalunl
essther
eisl
egi
sl
ati
onper
mit
ti
ngi
t.Passi
veeut
hanasi
aisconsi
der
ed
moral
lysuper
ior

t
oacti
veeut
hanasi
asi
ncei
tmeansal
l
owi
ngt
hepat
ientt
odi
eandnotki
l
li
nghi
m
whi
chcanhave

compl
exmor
alr
ami
fi
cat
ions.
Wit
hpassi
veeut
hanasi
a,t
heassumpt
ioni
sthepat
ient
i
sanyway

goi
ngt
odi
e.Sot
hedeci
si
oncanbel
eftt
othepat
ient
.

CASELAWS

InofAr
unaRamchandr
aShanbaugvsUni
onOfI
ndi
a&Or
s,hasl
aiddownt I
hat“n
our

opi
nion,i
tist
heHi
ghCour
tunderAr
ti
cle226oft
heConst
it
uti
on whi
chcangr
ant
appr
ovalfor

withdr
awalofl
i
fesuppor
ttosuchani
ncompet
entper
son”
.TheSupr
emeCour
thas
al
l
owed

"passi
veeuthanasi
a"i
nthi
slandmar
kdeci
si
on.
Ithel
dthatpassi
veeut
hanasi
a
couldbegivena

nodincaseofexcept
ionalci
rcumst
ancesandunderst
ri
ctmoni
tor
ingoft
heapex
cour
t.

nMcKayv
I sBergst
edfonapet
it
ionbei
ngf
il
edi
ntheCour
tforr
emov
al
ofl
i
fesuppor
ttheCourt

permi
tt
eddisconnect
ionofhi
srespi
rat
or.
TheSupr
emeCour
tofNev
adaaf
fi
rmed
theCourt
's

deci
sioninappeal
.TheCour
thel
dthatdesi
reoft
hepat
ientf
orwi
thdr
awalofhi
s
r
espi
ratordi
d

notamountt
osui
cide.
 MEMORI
ALONBEHALFOFPETI
TIONERS

I
narecentcaseofCommonCause(
aregd.Soci
ety)vsUni
onOfI
ndi
a,i
twashel
d
t he‘
hatt ri
ght

todiewit
hdi
gni
ty’
isaf
undament
alr
ightofaper
son.
Itcanbeav
ail
edbyt
he
pat
ient
swho

suf
ferf
rom i
ncur
abl
e,andpr
olongeddi
seases,
andhav
ereachedt
hest
ateof
per
manent

vegetat
ivest
ate(
p.v
.s.
),wher
ether
eisv
eryl
i
ttl
eornohopeofr
ecov
ery,
andt
he
pati
entsare

keptali
vethr
oughext
ernali
nst
rument
sandmachi
nes,
suchast
hecar
diopul
monar
y
machines.
In

suchcasespassi
veeut
hanasi
acanbeal
l
owed.
 MEMORI
ALONBEHALFOFPETI
TIONERS

[
3].ASSI
STEDSUI
CIDESHOULDBEALLOWEDFORPATI
ENTSWHO ARE

SUFFERI
NGUNBEARABLEPAI
NANDI
NCURABLEI
LLNESS,WHENTHE
DEMANDHASBEENMADEI
N“FULLCONSCI
OUSNESS”BYTHEPATI
ENT

Deat
hisapr
ivat
emat
terandt
hest
ateshoul
dnoti
nter
fer
ewi
tht
hei
ndi
vi
dual
'
sri
ght
t
odie.

I
tisexpensiv
etokeeppeopl
eal
i
vewhent
her
eisnocur
efort
hei
ril
l
ness.
Euthanasi
awoul
d

Rel
ease pr
eci
ousr
esour
cest
otr
eatpeopl
ewhocoul
dli
ve.
Fami
l
yandf
ri
ends
woul
dbespared

thepai
nofseei
ngt
hei
rlov
edonesuf
feral
ong-
drawn-
outdeat
h.Unbear
abl
epai
n
andi
ncurabl
e

i
l
lnessf
eel
sli
kedyi
ngev
eryday.
Soi
ftheper
sondemandi
ngt
oputhi
sli
fet
oendi
n
f
ull

consci
ousnesst
henheshoul
dbeal
l
owedt
ogof
orassi
stedsui
cide[
3.1
].

[3.
1]Theper
sondemandi
ngtoputhisli
fetoendi
nful
lconsci
ousnesst
henhe
shoul
dbeall
owedtogoforassi
stedsui
cide

Ter
minati
onofl
i
feonr
equestcant
aket
wof
orms.
Int
hecaseofeut
hanasi
a(act
ive
eut
hanasi
a),
 MEMORI
ALONBEHALFOFPETI
TIONERS

t
hephysici
anadmi
nist
ersaf
ataldoseofasui
tabl
edr
ugt
othepat
ient
.Inassi
sted
suici
de,
by

cont
rast
,thephysi
ciansuppl
i
est
hel
ethaldr
ugbutt
hepat
ientadmi
nist
ersi
t.

Assi
steddeat
hor“
medi
calai
dindyi
ng”i
slegali
nel
evenj
uri
sdi
cti
onsofU.
S:
Cali
for
nia,

Color
ado,Di
str
ictofCol
umbi
a,Hawai
i
,Mont
ana,
Mai
ne,
NewJer
sey,
NewMexi
co,
Oregon,

Ver
montandWashi
ngt
on.

CASELAWS

nGonzal
I esv.Or
egon(
1994)t
hest
ateofOr
egoni
ntheUni
tedSt
atespassedt
he
Deat
hwit
h

Di
gnityAct;t
heactdeal
twi
thl
awswhi
chper
mit
tedPhysi
calAssi
stedSui
cidewi
tha
l
ethaldose

ofmedici
nefort
ermi
nal
l
yil
lpat
ient
s.Thecasewentt
otheSupr
emeCour
t,i
twas
hel
dthatthe

useofthecont
rol
l
edsubst
ancef
orPhysi
cian-
Assi
stedSui
cidedoesnotv
iol
ate
theContr
ol

Subst
ancesAct
.

nCr
I uzanv.Di
rect
or,Mi
ssour
iDepar
tmentofHeal
tht
heUSSupr
emeCour
trul
ed
t
hat

competentindi
vi
dual
shav
ether
ightt
oref
usemedi
calt
reat
mentundert
heDue
ProcessClause.

nBaxt
I erv.Mont
ana(
2009)
Thet
ri
alcour
thel
dat
ermi
nal
l
yil
l
,compet
entpat
ient
hasar
ightto

diewithdi
gini
tyunderAr
ti
cleI
I,Sect
ions4and1
0oft
heMont
anaConst
it
uti
onand
thatr
ight

i
ncl
udesar
ightt
ophysi
cianai
dindyi
ng.
MEMORI
ALONBEHALFOFPETI
TIONERS
MEMORI
ALONBEHALFOFPETI
TIONERS
MEMORI
ALONBEHALFOFPETI
TIONERS
MEMORI
ALONBEHALFOFPETI
TIONERS
MEMORI
ALONBEHALFOFPETI
TIONERS
MEMORI
ALONBEHALFOFPETI
TIONERS
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

1
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

2
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

3
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

4
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

5
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

6
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

7
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

8
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

9
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

1
0
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

1
1
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

1
2
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

1
3
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

1
4
XI
IK.
K.LUTHRAMEMORI
ALMOOTCOURTCOMPETI ON,
TI
201
6MEMORIALONBEHALFOFPETI
TIONERS

1
5