Common Cause v. Union of India

The Legal Question Before the Court

The writ petition sought a declaration that a person of sound mind has the right to execute an Advance Medical Directive — commonly called a Living Will — specifying their refusal of extraordinary medical treatment to artificially prolong life in the event of a terminal illness or persistent vegetative state. The petition raised fundamental questions about the right to die with dignity as an aspect of the right to life under Article 21 of the Constitution.

The Court's Decision

The Constitution Bench unanimously held that the right to die with dignity is an intrinsic facet of the right to life guaranteed under Article 21. A person of sound mind has the right, through an Advance Medical Directive, to refuse the administration of life-sustaining treatment in the event that they become permanently incapacitated to the point of being unable to communicate their wishes.

The court laid down detailed guidelines for the execution, attestation, and invocation of such directives. A Living Will must be in writing, signed by the executor before a Judicial Magistrate of First Class, attested by two independent witnesses, and preserved with the Magistrate. The court also prescribed the medical and institutional procedures for invoking the directive.

The framework was subsequently simplified by the court itself in a 2023 clarification — Common Cause v. Union of India, (2023) 4 SCC 697 — which made the process more accessible by reducing attestation requirements.

The Court's Reasoning

The bench drew upon the doctrine of personal autonomy — a dimension of the right to privacy established in K.S. Puttaswamy v. Union of India (2017). Privacy includes the right to make decisions about one's own body and medical treatment. A person who, while of sound mind, chooses to refuse invasive medical intervention that merely prolongs the dying process is exercising a constitutionally protected choice.

The court distinguished between two categories of conduct: (a) active euthanasia — deliberately causing death — which remains prohibited; and (b) passive euthanasia — withholding or withdrawing extraordinary life-sustaining treatment in accordance with the patient's prior expressed wish — which is constitutionally permissible under the framework the court prescribes. The distinction is between killing and letting die.

Practical Implications — What This Means Today

Common Cause directly animates the firm's Living Will advisory service. An Advance Medical Directive is now a legally valid instrument under Indian law. Any adult of sound mind may engage a legal professional to assist in drafting, executing, and registering a Living Will in compliance with the court's prescribed format and procedural requirements.

For NRI clients with ageing parents in Kerala, this ruling provides a critical planning tool. A parent who wishes to avoid prolonged artificial life support in terminal illness can express that wish through a legally enforceable instrument, rather than leaving the decision to distressed family members or to the hospital administration. The directive travels with the patient's medical record and must be honoured by any treating physician.

The 2023 simplification by the court removed some of the more onerous bureaucratic requirements of the original framework. Legal practitioners must now ensure that Living Wills are executed in compliance with the most current procedural requirements — particularly the revised attestation and registration procedure.

Relevant Statutory Provisions

• Article 21, Constitution of India — Right to life and personal liberty — encompassing the right to die with dignity
• Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 — Medical ethics — withdrawal of life support

Analysis by Vinode V. Luka, Advocate | Published: May 2026 | Last reviewed: May 2026