Case Briefing: Common Cause (A Registered Society) vs. Union of India 2023
Case Title and Citation
COMMON CAUSE (A REGD. SOCIETY) VERSUS UNION OF INDIA, MISCELLANEOUS APPLICATION NO. 1699 OF 2019 IN WRIT PETITION (CIVIL) NO. 215 OF 2005.
Factual Background
The matter originated from a 2018 Constitution Bench judgment which provided guidelines for Advance Directives (living wills) and the withdrawal of life support, recognizing the right of a person to die with dignity. The current application was filed by the Indian Society of Critical Care Medicine seeking clarification of the 2018 judgment. The applicant highlighted that in the actual working of the original directions, “insurmountable obstacles” were being posed. Specifically, the mandatory requirement that an Advance Directive be countersigned by the jurisdictional Judicial Magistrate of First Class (JMFC) was pointed out as a clause that impaired, if not completely defeated, the object of the Court’s directions. The applicant requested the Court to revisit and modify the directions to establish a mechanism that effectively carries out the original object.
Issue(s)
Whether the procedural safeguards laid down in the original judgment (specifically paragraphs 198 and 199 concerning the execution of Advance Directives and the structure of Medical Boards) required modification or deletion due to practical difficulties encountered during implementation.
Decision of the Supreme Court
The Supreme Court decided that the directions contained in paragraphs 198 and 199 of the original judgment require to be modified/deleted.
Reason for the Decision
The modifications were deemed necessary to resolve the practical obstacles highlighted by doctors and the Union of India, ensuring the effective implementation of the right to execute an Advance Directive. The primary reasons and changes are:
- Simplification of Execution: The mandatory requirement for the Advance Directive to be countersigned by the JMFC was deleted. The document now needs to be attested before a Notary or Gazetted Officer.
- Custodian Changes: The obligation for the JMFC to preserve copies of the document in their office and forward them to the District Court Registry was deleted. The executor must now inform and hand over copies to the nominated guardian(s) and family physician, and may incorporate the directive into digital health records.
- Medical Board Restructuring: The rigid requirements for the Medical Boards were simplified:
- The Hospital Medical Board (now the Primary Medical Board) must consist of the treating physician and at least two subject experts of the concerned specialty with at least five years’ experience (replacing the previous requirement of three experts with twenty years’ standing).
- The Secondary Medical Board (which previously involved the jurisdictional Collector) was restructured to comprise one registered medical practitioner nominated by the Chief Medical Officer and at least two subject experts (not part of the Primary Board), with at least five years’ experience.
- Reduced Judicial Process in Implementation: The requirement for the JMFC to visit the patient, verify reports, and authorize the withdrawal decision based on the Collector-nominated Medical Board’s decision was effectively deleted in cases both with and without Advance Directives. The hospital now conveys the final decisions of the Primary and Secondary Medical Boards to the JMFC before withdrawal is implemented.
Conclusion
The Supreme Court modified the original safeguards relating to Advance Directives and passive euthanasia, primarily by removing the mandatory involvement of the Judicial Magistrate of First Class (JMFC) in the execution and preservation stages, and by simplifying the composition and experience criteria for the Medical Boards, thereby streamlining the procedural mechanism for implementing the constitutional right to die with dignity. The revised directions shall remain in force until Parliament makes legislation on the subject.
Case Materials:
Day 1 of Arguments: 17 January 2023 (Video Recording)
Day 2 of Arguments: 18 January 2023 (Video Recording)
Day 3 of Arguments: 19 January 2023 (Video Recording)
Day 4 of Arguments: 24 January 2023 (Video Recording)
