Active
Active euthanasia, also known as positive euthanasia or
aggressive euthanasia, entails a positive act or affirmative
action or act of commission entailing the use of lethal
substances or forces to cause the intentional death of a
person by direct intervention, e.g., a lethal injection given
to a person with terminal cancer who is in terrible agony.
It is illegal in all States in the USA, but physician-assisted
death is legal in the States of Oregon, Washington and
Montana. In Aruna Shanbaug case, the teo judge bench
observed that active euthanasia is illegal unless there is
legislation permitting it
In the case of Rodriguez v. British Columbia (Attorney
General), it was observed that in the cases of active
euthanasia, the patient is killed by any medication given
by the doctor.
In the Airedale case, Lord Goff observed that active
euthanasia involves actively ending a patient ‘s life, for
example, by administering a lethal drug. Active
euthanasia, even voluntary, is impermissible despite
being prompted by the humanitarian desire to end the
suffering of the patient.
Passive
Passive euthanasia, on the other hand, also called
negative euthanasia or non-aggressive euthanasia,
entails withdrawing of life support measures or
withholding of medical treatment for continuance of
life, e.g., withholding of antibiotics in case of a patient
where death is likely to occur as a result of not giving
the said antibiotics or removal of the heart-lung
machine from a patient in coma
In Aruna Shanbaug case, it was observed that passive
euthanasia is legal even without legislation, provided
certain conditions and safeguards are maintained.
In the case of Aruna Shanbaug, judges said that, in
passive euthanasia, the doctors are not actively killing
the patient, they are merely not saving him and only
accelerating the conclusion of the process of natural
death which has already commenced.
The learned Judges categorized passive euthanasia into
voluntary passive euthanasia and non-voluntary passive
euthanasia. Voluntary passive euthanasia is a situation
where a person who is capable of deciding for himself
decides that he would prefer to die because of various
reasons whereas non- voluntary passive euthanasia has
been described to mean that a person is not in a
position to decide for himself, e.g., if he is in coma or
PVS.
In the case of Rodriguez v. British Columbia (Attorney
General), drew the distinction between these two forms
of euthanasia on the basis of intention. Echoing a
similar view, the Supreme Court of the United States
affirmed the said distinction on the basis of ―intention
in the case of Vacco (supra) wherein Chief Justice
Rehnquist observed that the said distinction coheres
with the fundamental legal principles of causation and
intention. In case when the death of a patient occurs
due to removal of life-supporting measures, the patient
dies due to an underlying fatal disease without any
intervening act on the part of the doctor or medical
practitioner.
In the Airedale case, Lord Goff observed that passive
euthanasia includes cases in which a doctor decides not
to provide, or to continue to provide, for his patient,
treatment or care which could prolong his life. It can be
considered lawful because the doctor intends to give
effect to his patient‘s wishes by withholding the
treatment or care, or even in certain circumstances in
which the patient is incapacitated from giving his

In active euthanasia positive steps are taken either by the
treating physician or some other person.
Although for a person terminally ill or
in PSV state, whose process of natural death has
commenced, termination of life may fall in the ambit of
right to die with dignity but in those cases also there
is no right of actively terminating life by a physician.
In Germany, active assisted suicide is illegal.
Law Commission of India submitted its 241st report
which dealt with Passive Euthanasia – ‘A Relook’ ,
reiterated the observations made in Airedale that active
euthanasia can be legalized by means of legislation only.
Active euthanasia constitutes an offence. Hence, it is only
Parliament which can in its legislative wisdom decide
whether active euthanasia should be permitted.
Active euthanasia involves an intention on the part of the
doctor to cause the death of the patient. Such cases fall
under the first clause of Section 300.
Active euthanasia involves an intention to cause the
death of the patient. Mens rea requires a guilty mind;
essentially an intent to cause harm or injury.
consent.
Right to die with dignity in the case of a dying man who
is terminally ill or in a persistent vegetative state, only
passive euthanasia would come within the ambit of
Article 21. Mr. Arvind Datar, submitted that, to
eliminate the possibility of abuse, safeguards can be
taken and guidelines can be framed. But on the plea of
possibility of abuse, the dignity in the process of dying
being a facet of Article 21 should not be curbed.
But, in Germany passive assisted suicide is not illegal. If
doctors stop life-prolonging measures, for instance, on
the written wishes of a patient, it is not considered as a
criminal offence. That apart, it is legal for doctors in
Germany to administer painkillers to a dying patient to
ease pain. The said painkillers, in turn, cause low
breathing that may lead to respiratory arrest and,
ultimately, death.
Law Commission of India submitted its 241st report
which dealt with Passive Euthanasia – ‘A Relook’, the
report summarised that passive euthanasia, both in the
case of competent and incompetent patients, is being
allowed in most of the countries subject to the doctor
acting in the best interests of the patient
Passive euthanasia on the other hand would not
implicate a criminal offence since the decision to
withhold or withdraw artificial life support after
considering the best interest of the patient would not
constitute an illegal omission prohibited by law.
Passive euthanasia does not embody an intent to cause
death. A doctor may withhold life support to ensure
that the life of a patient who is in the terminal stage of
an incurable illness or in a permanent vegetative state,
is not prolonged artificially. In a case involving passive
euthanasia, the affliction of the patient is not brought
about either by an act or omission of the doctor. There
is neither an animus nor an intent to cause death.

Judgement

 In Gian Kaur the Constitution Bench approved that ‘right to live with dignity’ under
Article 21 of the Constitution will be inclusive of ‘right to die with dignity’. However,
the decision does not arrive at a conclusion for validity of euthanasia, be it active or
passive. Therefore, the only judgment that holds the field in India is Aruna
Ramachandra Shanbaug, which upholds the validity of passive euthanasia and lays
 down an elaborate procedure for executing the same on ‘the wrong premise that the
Constitution Bench in Gian Kaur had upheld the same’.
 Passive euthanasia occurs when medical practitioners do not provide life sustaining
treatment or remove patients from life sustaining treatment. In such cases, the
omission by the medical practitioner is not treated as the cause of death; instead, the
patient is understood to have died because of his underlying condition.
 The Supreme Court allowed passive euthanasia in certain conditions, subject to the
approval by the High Court following the due procedure. It held that when an
application for passive euthanasia is filed the Chief Justice of the High Court should
forthwith constitute a Bench of at least two Judges who should decide whether to
grant approval or not. Before doing so, the Bench should seek the opinion of a
committee of three reputed doctors to be nominated by the Bench after consulting
such medical authorities/medical practitioners as it may deem fit. Simultaneously with
appointing the committee of doctors, the High Court Bench shall also issue notice to
the State and close relatives e.g. parents, spouse, brothers/sisters etc. of the committee
to them as soon as it is available. After hearing them, the High Court Bench should
give its verdict. The above procedure should be followed all over India until
Parliament makes legislation on this subject.
 ‘Right to life’ is a natural right embodied in Article 21 but suicide is an unnatural
termination or extinction of life and, therefore, incompatible and inconsistent with the
concept of ‘right to life’. Thus, the legal position which stands as of today is that right
to life does not include right to die. It is in this background we have to determine the
legality of passive euthanasia.
 Reiterating judgment in Aruna Ramachandra Shanbaug, the court said that having
regard to the right of the patients in common law, coupled with the dignity and
privacy rights, it can be said that passive euthanasia, under the circumstances where
patient is in PVS and he is terminally ill and the condition is irreversible or where he
is braindead, can be permitted.
 In Aruna Shanbaug case, it was held that, the difference between “active” and
“passive” euthanasia is that in active euthanasia, something is done to end the
patient's life while in passive euthanasia, something is not done that would have
preserved the patient's life. An important idea behind this distinction is that in
 “passive euthanasia” the doctors are not actively killing anyone; they are simply not
saving him.
 The right not to take a life saving treatment by a person, who is
competent to take an informed decision is not covered by the concept of euthanasia
as it is commonly understood but a decision to withdraw life saving treatment
by a patient who is competent to take decision as well as with regard to a
patient who is not competent to take decision can be termed as passive euthanasia,
which is lawful and legally permissible in this country.

Recent case- Common Cause (A Regd. Society) Versus Union of India and Another
Arguments made by Arvind Datar-
Implications of Rabies on Human beings

 In a WHO report it was stated that , since as soon as symptoms appear in a human,
death is almost certain within 7 to 10 days. The Center for Disease Control has only
documented six cases in history of humans who demonstrated clinical signs and
symptoms of rabies and survived.

 Rabies Cause of Death- Death from rabies is typically caused by encephalitis, which
is an inflammation of the brain; or myelitis, which is an inflammation of the spinal
cord.
 Many patients with rabies infections experience hydrophobia, which is the fear of
water or swallowing; and aerophobia, which is fear of flying or of fresh air.
 Since rabies causes swelling or inflammation of the brain, hallucinations and
agitation often occur in the patient. Also, slurred speech and disorientation can
occur.
 Many patients with rabies infections experience paresthesia, which is a tingling
sensation in the arms and scalp.