PROJECT REPORT ON
ACTIVE AND PASSIVE EUTHANASIA
UNDER THE TOPIC OF LAW AND MEDICINE
Euthanasia is a controversial subject,
not only because there are many moral
dilemmas associated with it, but also in
what constitutes its definition.
At the extreme ends of disagreement, some
school of thoughts is of the opinion that
known as physician assisted suicide or
physician aid in dying, is a merciful act of
At the other end, there are opponents of
euthanasia who believe that this method is a
form of murder.
The term ‘euthanasia’ is derived from the Greek
words- ‘eu’ meaning "good“
and ‘thanatos’ meaning "death".
One meaning given to the word is "the intentional
termination of life by another at the explicit request of
the person who dies."
In the modern day context euthanasia means causing
painless death of a person suffering from an incurable
and painful disease. It is limited to the killing of
patients by doctors at their own request in order to
free them of excruciating pain or from terminal illness.
According to the historian N. D. A. Kemp, the origin of the contemporary
debate on euthanasia started in 1870. Nevertheless, euthanasia was
debated and practiced long before that date -Hippocrates (ca. 460 BC - ca. 370 BC)- Euthanasia was practiced in Ancient
Greece and Roman civilizations as they opined that there was no need to
preserve the life of a person who had no interest in living, or who thought
life as a burden.
1300s- According to the English jurisdiction of the suicide
as well as helping people to kill themselves were considered
as a criminal act. Mercy killing was also not supported by the
ascendancy of Christianity (12th till 15th century).
1828- The first law against assisted killing, known as antieuthanasia was passed in New York.
1870- In this year, Samuel Williams suggested the use of
morphine and analgesic medications for assisting quick and
1885- Exactly 15 years after Samuel Williams raised the
proposal, the American Medical Association strongly denied
the use of analgesic for euthanasia.
Beginning of 20th century - mercy killing and assisted
killing already entered the minds of the public.
1905- A bill for making it legal was circulated in Ohio, but it failed.
A similar bill was introduced in the next year, which also failed.
1935- The first group for legalization of euthanasia, called Voluntary
Euthanasia Legislation Society (VELS), was founded by a group of
doctors in London.
1938- A similar organization, known as National Society for the
Legalization of Euthanasia (NSLE) came into existence. Till
date, many cases of physician-assisted suicide have been fought in
1940- Non-voluntary euthanasia was practiced for the first time by
German physicians, to eliminate the diseased and disabled Germans
in closed gas chambers. The main purpose of the program was to
get rid of handicapped children and people with psychiatric
1945- It was estimated that 300,000 Germans had been killed.
20th century- Marked the formation of several organizations for
addressing the concerns regarding euthanasia.
1986- Doctor Joseph Hassman was charged guilty for
administering a lethal dose of Demerol to his mother-in-law. He
was fined and sentenced to two years imprisonment for the act.
1999- Euthanasia became a public issue, with the imprisonment
of Dr. Jack Kevorkian for conducting voluntary euthanasia on
Thomas Youk (52), who was in the final stage of ALS
(amyotrophic lateral sclerosis). Kevorkian was charged with
second-degree murder, and he served eight years in prison
(from 1999 to 2007). It was claimed that he had exercised
euthanasia for at least 130 other patients (in this case, patients
took lethal injections themselves).
The debate on euthanasia and assisting suicide is still going
on, and is expected to continue in the coming years. There are
both pros and cons of euthanasia and whether to stand for or
against mercy killing depends on the ideology and
understanding of each individual. In a survey, approximately 60 80 percent people in the western countries favor physicianassisted suicide for terminally ill patients.
Euthanasia can be classified:(a) On the basis of the nature of act being done, as:
Active or Positive: It is a positive merciful act, to end useless suffering
or a meaningless existence. It is an act of commission, e.g. by giving
large doses of drugs to hasten death.
Passive or Negative: It means not-using or discontinuing the use of
extraordinary life-sustaining measures to prolong life. This includes an
act of omission, such as failure to resuscitate a terminally ill or
hopelessly incapacitated patient or severely defectively newborn
infant. It involves non-use of the measures that would probably delay
death and permit natural death to occur.
(b) On the basis of consent, as:
Voluntary: It covers cases where the person himself requests the
commission of euthanasia (active or passive).
Involuntary: It covers cases where the person on whom euthanasia is
committed is mentally incompetent to make a choice and euthanasia
is committed on the basis of the assessment made by others.
In general, countries attempt to draw a line between passive
euthanasia (generally associated with allowing a person to die) and
active euthanasia (generally associated with killing a person). While
laws commonly permit passive euthanasia, active euthanasia is
Active euthanasia is defined as inducing the
death of a person who is undergoing intense
suffering, and who has no practical hope of
recovery. Since the motive is to release one
from misery, active euthanasia is often called
“mercy killing.” Here we will discuss five
reasons why active euthanasia is wrong. The
reason why active euthanasia is wrong is
(1) There are other options to stop a patient
from suffering, such as great advances in pain
management , palliative care and the
development of hospices to assist people who
(2) Active euthanasia is unethical, because it
is a form of murder.
(3) Euthanasia is also wrong because it’s against God’s will.
(4) Euthanasia is a violation of the right to life (article-21 of constitution
of India); and
(5) Active euthanasia deprives one the right to die naturally.
Overall, active should not be allowed, because it is morally wrong.
Although many people may feel that their loved ones are ready to
die, that doesn’t necessarily mean that one should choose active
euthanasia. There are other options to stop a patient from suffering.
Pain management, palliative care and the development of hospice care
are always a preferable solution.
Like all forms of euthanasia,it involves the intention to hasten
death in the patient’s interests (because of their expected negative quality
What is standard taken to mark off passive as opposed
to active euthanasia is that the former hastens death by
not providing something which would, if provided, delay death—
that is, passive euthanasia involves withdrawing or withholding lifeprolonging medical treatment.
So there are (at least) three necessary conditions
for the occurrence of passive euthanasia:
(1)There is a withdrawing or withholding of life-prolonging treatment
(2) The main purpose (or one of the main purposes) of this withdrawing
or withholding is to bring about(or ‘‘hasten’’) the patient’s death
(3) The reason for ‘‘hastening’’ death is that dying (or dying sooner rather
than later) is in the patient’s own best interests.
The term "passive euthanasia" used by the Supreme Court in its verdict on
Aruna Shanbaug's case is defined as the withdrawal of medical treatment with
the deliberate intention to hasten a
terminally ill-patient's death.
Various medical and legal dictionaries say passive euthanasia is the act of
Hastening the death of a terminallyill patient by altering some form of support and letting nature take its course.
Passive euthanasia can involve turning off respirators, halting medications,
discontinuing food and water so the patient dies because of dehydration or
Passive euthanasia can include giving the patient large doses of morphine to
control pain in spite of the likelihood that the painkiller can cause fatal respiratory
Active and Passive Euthanasia in India
Passive euthanasia is legal in India.
On 7 March 2011 the Supreme Court of India legalized passive euthanasia by means of
the withdrawal of life support to patients in a permanent vegetative state.
The decision was made as part of the verdict in a case involving Aruna Shanbaug,
who has been in a vegetative state for 37 years at King Edward Memorial Hospital.
The high court rejected active euthanasia by means of lethal injection. In the absence of
a law regulating euthanasia in India, the court stated that its decision becomes the law
of the land until the Indian parliament enacts a suitable law. Active euthanasia including
the administration of lethal compounds for the purpose of ending life is still illegal in
India, and in most countries.
Active Vs Passive Euthanasia - An Argument
According to the first argument, euthanasia is always morally wrong.
But the behavior which is described in the standard taxonomy as “passive euthanasia” is not
Therefore, it cannot really be a form of euthanasia and so there is no such thing as passive
•Put like this, the argument seems simplistic and implausible.
However, there is perhaps a slightly better way of articulating it. Some concepts,
so the argument goes, are moral concepts, or at least have a
moral dimension. For example, “murder” (understood here as a moral rather than a legal
term) is typically defined as wrongful killing.
• Or, to put it another way, one necessary condition for an act being a murder is that it is wrong.
So perhaps euthanasia is like murder and part of its definition is that it is a wrongful act.
There are, however, a number of objections to this argument. To being with, it assumes
too much. It starts from the claim that euthanasia is never justified, and builds this into the
definition of euthanasia, excluding on grounds of conceptual incoherence
The possibility of there being a permissible form of euthanasia.
This not only excludes the possibility of passive euthanasia
(assuming this morally permissible) but also excludes the possibility of a moral debate
about the ethical standing of euthanasia.
This point is further strengthened if we consider two ‘‘real life’’ counterexamples.
Firstly, of course, many people think that active voluntary euthanasia is (sometimes)
What if we were to discover somehow that the view of the ‘‘pro’’ active voluntary
euthanasia organizations was the correct one and that active euthanasia is in fact morally
Ought we to conclude from this that there are not any cases of euthanasia, because all of the
apparent cases have turned out not to be wrong, and hence not euthanasia?
Conversely, some moral conservatives believe that even passive euthanasia is wrong..
So the argument is, to say the least, strange insofar as it makes the very existence of
euthanasia (both active and passive) dependent on its moral status.
A fundamental problem with the wrongness of euthanasia argument then is that the
evaluation is driving the conceptualization.
Passive Euthanasia, Is It Morally Permissible?
No, when performing passive euthanasia, no matter the intentions , someone
There is no moral distinction between letting die and killing someone because
the action’s result is the same. If letting a person die is morally permissible then
killing someone is also, and vice versa. Apart from this, there are many plausible
moral rationales against the legalization of euthanasia. Utilitarianism-an ethical
theory which emphasizes the greatest happiness to the greatest number aims
to act to provide maximum benefit. But, according to Utilitarianism,
we cannot focus exclusively on the patient and, even if euthanasia would be in
interest of the patient, it may be wrong because of the bad effect on the
patient’s relatives. Deontology-a view that some kinds of actions are
unconditionally prohibited where it may seem natural to assume that killing
must be one of them. With respect to human beings, this doctrine is very strict
and applies to all human beings, including fetuses and embryos, suicide and
murder. However, it is encouraging that euthanasia is still not legalized in
many, parts of the world.
Arguments on Voluntary Passive Euthanasia
It relieves unnecessary suffering
It goes against the human natural
tendency to live. Killing innocent people
is always wrong
It provides all of us the comfort of Such a policy will put pressure on
knowing we can choose to die rather patients to choose to die even when
they want to live.
It allows the exercise of a competent It will lead doctors (slippery slope) not
patient’s autonomy (freedom, self- to work as hard to preserve life
(consequentiality). It contradicts the
purpose of the medical profession (non
It is not morally different from what we There is a fundamental moral difference
appropriately permit now (withdrawal between acting with intent to kill and
of Life-sustaining treatment)
not providing life-sustaining treatment
Main Difference between Active Euthanasia And Passive Euthanasia
In active euthanasia the doctor takes an action with the intention that it will
cause the patient's death where in passive euthanasia the doctor lets the
Active euthanasia is a positive act of commission, such as a lethal injection
where passive euthanasia implies an act of omission, such as the withholding
or withdrawal of treatment.
Active is usually a quicker means of causing death. All forms of active
euthanasia are illegal. However, active euthanasia should be treated differently
from passive euthanasia. Where Passive is usually slower and more
uncomfortable than active.
There is a moral difference based on the fact that active euthanasia leaves no
room for a miracle, is outwardly similar to murder and so would be more
difficult to distinguish from murder than passive, and does not require the
patient to be as ill as passive.
In active euthanasia, something is done to end the patient's life; in passive
euthanasia, something is not done that would have preserved the patient's
Is active euthanasia
philosophers) go even
further and say that
active euthanasia is
because it can be
cleaner, and it may be
less painful for the
What practices would be involved?
The most common suggestion is for voluntary (or "active")
euthanasia, where the person asks to be killed. Although those who
advocate euthanasia do not like the use of the word "kill", it is the only
accurate, non-emotional word to describe the reality, and it is the word
which the law uses.
Assisted suicide is also now being proposed, where a person would be
provided with the means of committing suicide, and would then himself or
herself perform the act.
Less commonly discussed is involuntary euthanasia. This concerns the
killing of persons who cannot express their wishes because of immaturity
(such as a newborn infant), mental retardation or coma. Here it is decided
by others that that person would be better off dead.
By current law, all forms of euthanasia are murder and assisting suicide is
a criminal offence.
Present Scenario of Euthanasia
Like almost in all other countries, euthanasia has no
legal status in India. The practice of euthanasia is a
clear act of offence, either a suicide or assistance to
commit suicide or a murder. The latest judgment of
Supreme Court declares that: Right to DIE is not
included in the Right to LIFE under Article 21 of
Indian Constitution. Article 21 is a provision
guaranteeing protection of life and personal liberty
and by no stretch of imagination can imply
‘EXTINCTION OF LIFE’.
‘Right to life’ is a natural right embodied in Article
21 but suicide is an unnatural termination of life
and therefore not compatible and inconsistent with
the concept of ‘right to life’.
Aruna Shanbaug case
Aruna Shanbaug was a nurse working at the KEM
Hospital in Mumbai on 27 November 1973 when
she was strangled and sodomized by Sohanlal
Walmiki, a sweeper. During the attack she was
strangled with a chain, and the deprivation of
oxygen has left her in a vegetative state ever since.
She has been treated at KEM since the incident and
is kept alive by feeding tube. On behalf of
Aruna, her friend Pinki Virani, a social activist, filed
a petition in the Supreme Court arguing that the
"continued existence of Aruna is in violation of her
right to live in dignity". The Supreme Court made
its decision on 7 March 2011. The court rejected
the plea to discontinue Aruna's life support but
issued a set of broad guidelines legalising passive
euthanasia in India. The Supreme Court's decision
to reject the discontinuation of Aruna's life support
was based on the fact the hospital staff who treat
and take care of her did not support euthanizing
Efforts to change Government
policies on euthanasia in the 20th century
have met limited success in Western
Countries. Euthanasia policies have also
been developed by a variety of NGOs, most
notably medical associations and advocacy
organizations. As of 2011, active euthanasia
is only legal in the three Benelux countries:
the Netherlands, Belgium and Luxembourg.
Assisted suicide is legal in Switzerland and in
the US states of Washington, Oregon and
Views, ideas and laws of euthanasia vary greatly from country to country
and from individual to individual. Euthanasia has been at the centre for a
moral debate for long. The individual’s right over his/her life and the value
placed on human life by the society seems polar opposites in this debate.
Opponents of euthanasia maintain that there is a clear moral distinction
between merely allowing dying and actually causing or deliberately
hastening someone's death. For some it is a crucial moral discernment; for
others, it represents either casuistry or moral fiction. As far as we are
concerned, considering its moral and ethical values of the concept and also
its legal conviction, we are of firm belief and opinion that India must never
practice euthanasia by law.
In this regard it would be quite worthwhile to remember the words of Lord
Edmund Davis – “killing both pain and patient may be good morals, but is
far from CERTAIN that it is good law.”