The DPSP, though non-justiciable, are far from ornamental. Articles such as 39(e), 41, and 47 collectively impose a duty upon the State to protect health, ensure humane conditions, and improve public health. These provisions, when read harmoniously with Article 21, suggest that the State’s obligation is not neutral, it is affirmatively life-preserving. A jurisprudence that permits the withdrawal of life support risks diluting this obligation into one of passive disengagement.
The Supreme Court has, in earlier judgments, expanded Article 21 into a repository of dignity. However, dignity cannot be selectively interpreted. If dignity includes the right to die with dignity, it must equally include the right to be sustained with dignity, even in conditions of severe incapacity. The present approach appears to privilege autonomy over protection, without adequately reconciling the socio-economic realities of India, where decisions on life support may be influenced by financial constraints, institutional fatigue, or familial pressure. This is where comparative law becomes instructive.
Emphasis on
continuity of care
In Scandinavian jurisdictions particularly in countries such as Sweden and Norway the legal and ethical framework surrounding life support adopts a markedly different posture. The emphasis is placed on continuity of care and preservation of life, even where recovery appears unlikely. The guiding principle is not expediency, but respect for the natural process of life and death. Withdrawal of life support is approached with extreme caution, and the presumption tilts in favour of sustaining life until the body ceases to function organically.
Such an approach is not merely medical it is deeply normative. It reflects a societal commitment that life, once sustained artificially, should not be terminated by decision, but allowed to conclude by biological inevitability. This stands in contrast to the Indian judicial approach, which increasingly recognises living wills and passive euthanasia, thereby shifting the locus of decision-making from the inevitability of nature to the discretion of human actors.
The danger of this shift cannot be understated. In a country where access to healthcare is uneven, and where public hospitals are often overburdened, the normalisation of life-support withdrawal may inadvertently create a pathway for systemic neglect. Decisions that ought to be guided by medical ethics may, in practice, become influenced by resource constraints.
Danger lies in
normalisation
That is why the present judicial trend sits uneasily with the constitutional structure. Once the law permits the withdrawal of life-sustaining treatment through judge-fashioned standards, it creates a zone in which vulnerability may be managed rather than protected. The danger is not always overt abuse. The danger lies in normalisation. What begins as an exceptional ethical mechanism may gradually become an administratively convenient response to prolonged incapacity.
Further, the cultural context of India cannot be ignored. Indian constitutional philosophy has historically leaned towards collective responsibility rather than individual absolutism. The family, the State, and the medical institution are all stakeholders in the preservation of life. To reduce this complex interplay into a question of individual autonomy risks importing a model that is neither fully compatible with Indian conditions nor sufficiently safeguarded against misuse.
It is also pertinent to note that the Court’s approach may not fully align with international human rights norms when interpreted through a broader lens. While certain jurisdictions recognise passive euthanasia, there remains a strong global discourse emphasising the sanctity of life and the duty of care owed to vulnerable individuals.
The Scandinavian model demonstrates that advanced healthcare systems can uphold both dignity and life without resorting to premature withdrawal.
The present decision, therefore, calls for a re-examination not necessarily in the form of judicial reversal, but through legislative clarification.
Parliament must step in to establish clear, uniform safeguards that ensure decisions regarding life support are insulated from economic, institutional, or coercive pressures. The absence of such safeguards risks transforming a right into a vulnerability.
Ultimately, the Constitution does not merely protect life, it values life. The DPSP reinforces this value by directing the State towards policies that enhance, rather than curtail, the conditions necessary for human survival.
Any legal framework that permits the withdrawal of life support must be carefully calibrated to ensure that it does not undermine this foundational commitment.
In choosing between autonomy and preservation, the law must tread with restraint. For once life is withdrawn by decision, it cannot be restored by regret. The Constitution, in its wisdom, envisages a State that stands on the side of life not one that quietly steps aside from it.
The Constitution of India, read as a whole, does not stand indifferent between life and withdrawal. Its moral direction is towards protection, assistance, and public responsibility. The Directive Principles reinforce that orientation by requiring the State to build conditions in which the vulnerable are sustained, not silently surrendered.
