The right to die with dignity is recognized as a fundamental right under Article 21 of the Constitution, forming an intrinsic part of the right to live with dignity, particularly for terminally ill patients or those in a persistent vegetative state (PVS) where recovery is hopeless, allowing acceleration of the natural death process to reduce suffering (!) .

There is an inherent distinction between active euthanasia (positive act to end life) and passive euthanasia (withholding or withdrawing life-prolonging measures), with passive euthanasia being permissible under Article 21 as it aligns with dignity, while active euthanasia remains impermissible without legislation (!) (!) (!) (!) .

The judgment in Gian Kaur did not approve foreign precedents on euthanasia but merely referenced them, and no binding view on euthanasia was expressed; passive euthanasia can be regulated judicially until Parliament legislates (!) (!) .

Passive euthanasia is lawful when it involves withholding or withdrawing treatment in the best interests of a terminally ill patient or one in PVS with no hope of recovery, prioritizing the patient's dignity over state interest (!) (!) .

Advance medical directives (living wills) are constitutionally valid as an exercise of self-determination and autonomy under Article 21, allowing competent adults to specify refusal of treatment in terminal conditions (!) (!) .

Execution of an advance directive requires the individual to be an adult of sound mind, executed voluntarily with informed consent, clearly stating treatment preferences, signed by two witnesses, and countersigned by a Judicial Magistrate First Class (JMFC) (!) (!) .

The advance directive must be preserved by the JMFC, forwarded to the District Court Registry, and copies provided to local authorities and family physician; it becomes operative only when the individual is terminally ill and incapacitated (!) (!) .

For enforcement, a hospital medical board assesses the directive's validity, followed by a collector-nominated board for certification, and final approval by the JMFC; revocation is possible anytime if the individual regains capacity (!) (!) .

In the absence of an advance directive, withdrawal of treatment for terminally ill patients follows a similar multi-tiered medical board process, culminating in JMFC approval, with High Court oversight if needed (!) .

The guidelines and procedures outlined remain in force until Parliament enacts legislation, ensuring protection against abuse while upholding dignity and autonomy (!) .