Supreme Court: Right to health already covers palliative care access

NEW DELHI: After devising a passive euthanasia mechanism in 2018 allowing a dignified end for terminally-ill patients in permanent vegetative state, Supreme Court on Thursday said such patients had a fundamental right to palliative care till their eventual death & sought a comprehensive report from the Centre on rollout of such measures in govt hospitals. Appearing for PIL the petitioner, senior advocate Jayna Kothari pleaded for a declaration from SC that palliative care is part of right to health under Art 21 (right to life).

A bench of CJI D Y Chandrachud and Justices J B Pardiwala & Manoj Misra said right to health already includes access to palliative care, hence a declaration would be superfluous.

Kothari said globally, around 14% of the population received palliative care, but in India, only 1-2% of people requiring palliative care had access to it. "There is no uniform provision of palliative care under the public health system in the country," she said.

SC in Gian Kaur case in 1996 had rejected euthanasia and ruled it could only be permissible through a legislation enacted by Parliament. In 2011, in Aruna Ramachandra Shanbaug case, SC allowed passive euthanasia but only in cases where such a plea was approved by jurisdictional high court, which relatives could approach after an elaborate process of examination of the patient by a medical board.

However, in 2018, in the Common Cause case, a five-judge bench laid down guidelines titled 'Advance Medical Directive', which could be executed by an adult of sound mind stating withdrawal of life support system when, in future, he enters a permanent vegetative state without a chance of recovery. But this too could be given effect only after multiple medical boards examining the terminally-ill patient and concurrently arriving at the conclusion that there was no chance of the patient surviving with advanced medical care.

Importantly, SC bench, which included Justice Chandrachud, in 2018 had discussed the need for palliative care as part of right to health, without issuing any direction to govt to devise policy parameters covering the public health system.

After Kothari brought up the untouched field of palliative care in the public health system, CJI-led bench issued notice to the Centre, though all states have been made parties in the PIL, and ordered filing of a comprehensive report on administration of palliative care to terminally-ill patients in govt hospitals. Requesting the court to include palliative care in all health initiatives, including AYUSH, the petitioner said, "Basic palliative care must be provided by all health professionalsas it's an integral part of right to health."