Supreme Court judge distinguishes between active and passive euthanasia

The distinction between “active” and “passive” euthanasia goes beyond the simplistic binary of “act” versus “omission”, Supreme Court judge Justice J.B. Pardiwala said on Wednesday (March 11, 2026).

“The true distinction between active and passive euthanasia lies not merely in the nature of the conduct, i.e., acts or omissions, but also in the source of the harm that leads to death,” Justice Pardiwala said in a judgment, upholding the withdrawal of life support to a 32-year-old man in a persistent vegetative state for more than 12 years.

The judge characterised active euthanasia as causing death by introducing a new, external agency of harm, such as a lethal injection. “In such cases, death is not the result of the patient’s underlying illness, but of an intervention that sets a new chain of events in motion. It is for this reason that active euthanasia is understood as an intervention that disrupts the natural path towards death,” Justice Pardiwala observed in the judgment.

Conversely, he explained that passive euthanasia should be understood as allowing death to occur. By withdrawing or withholding life support, the physician is not creating a new risk of death. Rather, the doctors are choosing to allow the underlying fatal condition to take its natural course by no longer continuing the medical interventions that were artificially prolonging life. “The undeniable fact is that the patient’s affliction, i.e., the underlying medical condition, is not caused by any act or omission of the doctor. Rather, the underlying condition is due to factors independent of the doctor or their actions,” Justice Pardiwala said.

However, withdrawing treatment should not violate the duty of care a doctor owes a patient in all circumstances. “The surrendering of any medical effort must not be at loggerheads with the duty of care which joists all medical action,” Justice Pardiwala emphasised.

The judgment said active euthanasia involved a “positive, overt act” designed to curtail the natural lifespan and extinguish life. “Under the mandate of Article 21, no person can be deprived of their life except in accordance with a procedure established by law. Consequently, for active euthanasia to be legally permissible, there must be an explicit legislative enactment authorising such deprivation,” Justice Pardiwala observed.