INDEX

(A).

FACTUAL MATRIX

(B).

SUBMISSIONS ON BEHALF OF THE APPLICANT

(C).

SUBMISSIONS ON BEHALF OF THE UNION OF INDIA

(D).

CORE CONCEPTS UNDERLYING THE DECISION IN COMMON CAUSE 2018

I.

The Essential Distinction: Active and Passive Euthanasia

II.

Permissibility of Passive Euthanasia under Article 21 of the Constitution of India

(a)

The unifying and omnipresent force of ‘dignity’ in the discourse on ‘right to die with dignity’

(b)

Viewing the “right to die with dignity” through the prism of self-determination, individual autonomy and privacy.

(c)

Recognising non-voluntary passive euthanasia within the framework of Article 21

(i)

‘Dignity’ as the standalone basis for the recognition of non-voluntary passive euthanasia

(ii)

Unconscious or incompetent patients and their right to bodily integrity.

(iii)

‘Authorized omission’ in consonance with the duty of care of doctors

III.

Impermissibility of Active Euthanasia under Article 21 of the Constitution of India

IV.

Establishing the Permissibility of Advanced Medical Directives

V.

Procedural Framework for Passive Euthanasia

(E).

ISSUES FOR DETERMINATION

(F).

ANALYSIS

(1)

Whether the administration of CANH is to be regarded as “medical treatment”?

(2)

What is the meaning, scope, and contours of the principle of “best interest of the patient” in determining whether medical treatment should be withdrawn or withheld?

(a)

Best interest of the patient in United States of America (USA).

(b)

Best interest of the patient in United Kingdom (UK)

(c)

Best interest of the patient in Ireland

(d)

Best interest of the patient in Italy

(e)

Best interest of the patient in Australia

(f)

Best interest of the patient in New Zealand

(g)

Best interest of the patient in European Union (EU)

(h)

Best interest of the patient in India

(i)

Medical considerations under the best interest principle

(ii)

Non-medical considerations under the best interest principle

(i)

Application of the best interest principle

(3)

Whether it is in the best interest of the applicant that his life be prolonged by continuation of medical treatment?

(4)

What are the further steps to be undertaken in the event that a decision to withdraw or withhold medical treatment is arrived at?

(5)

Streamlining and contextualising the Common Cause Guidelines

I.

Safeguarding Checkpoints that remove any hesitation amongst doctors

II.

Role of the patient’s next of kin/next friend/guardian

III.

Bridging the procedural gap for patients who are undertaking medical treatment in a home-setting

IV.

Nomination of registered medical practitioner by CMO

V.

Reconsideration Period

VI.

Court Intervention

(6)

Legislative inaction and the need for legislation

I.

The 196th Law Commission Report

II.

The decision of Aruna Shanbaug

III.

The 241st Law Commission Report

IV.

The decision of Common Cause 2018

V.

Draft Guidelines of 2024

(G).

CONCLUSION

I.

Summary of our discussion

(a)

Understanding Common Cause 2018

(b)

CANH is a medical treatment

(c)

Best Interest Principle

(d)

Palliative and EOL Care

(e)

Streamlining of the Common Cause Guidelines

(f)

Need for a comprehensive statutory framework

II.

The Final Order