The important observation came in a landmark verdict of a five-judge constitution bench headed by Chief Justice Dipak Misra which recognised the right of a terminally-ill patient to execute a "living will" to refuse medical treatment for dying with dignity.
The bench acknowledged the right to refuse treatment of a terminally-ill patient and said "any such person who has come of age and is of sound mind has a right to refuse medical treatment".
"In the 21st century, with the advancement of technology in medical care, it has become possible, with the help of support machines, to prolong the death of patients for months and even years in some cases. At this juncture, the right to refuse medical treatment comes into the picture.
"A patient (terminally ill or in a persistent vegetative state) exercising the right to refuse treatment may ardently wish to live but, at the same time, he may wish to be free from any medical surgery, drugs or treatment of any kind so as to avoid protracted physical suffering," the CJI, who wrote a 192-page separate judgement, said.
The apex court referred to various foreign judgements and said it has been held by a US court that "every human being of adult years and sound mind has a right to determine what shall be done with his own body...".
The top court said the right to refuse medical treatment "stands on a different pedestal as compared to suicide, physician assisted suicide or even euthanasia."
When a terminally ill patient refuses to take medical treatment, it can neither be termed as euthanasia, nor a suicide, it said.
However, both suicide and refusal to take treatment in case of terminal ailment shall result in the same consequences, that is death, "yet refusal to take treatment by itself cannot amount to suicide," it said.
"In case of suicide, there has to be a self-initiated positive action with a specific intention to cause one's own death. On the other hand, a patient's right to refuse treatment lacks his specific intention to die, rather it protects the patient from unwanted medical treatment," it said.
A patient refusing treatment merely allows the disease to take its natural course and if, in this process, death occurs, the cause for it would primarily be the underlying disease and not any self initiated act, it said.
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