Advance Medical Directives And Article 21: Balancing Individual Autonomy And Procedural Safeguards
G. Parinitha, School of Law, CHRIST (Deemed to be University), Bangalore
ABSTRACT
The concept of individual autonomy in end-of-life decision making has been significantly expanded through the recognition of the right to die with dignity under Article 21 of the Indian Constitution. The Supreme Court has recognized Advance Medical Directives (AMDs) as a means for people to exercise their autonomy regarding life-sustaining medical treatment in the event of future incapacity, particularly in Common Cause v. Union of India (2018) and in its subsequent 2023 modification of the guidelines. However, the practical use of AMDs raises questions regarding the balance between procedural safeguards and individual choice. The evolution of autonomy and the right to die with dignity under Article 21 is examined, with an emphasis on the evolving precedent regarding Advance Medical Directives. It examines whether the procedural protections governing AMDs sufficiently shield people from coercion and misuse without creating unnecessary obstacles to the exercise of autonomy. The study also examines the institutional and legal issues surrounding the use of AMDs and discusses the need for a clearer, more accessible framework. The analysis also takes into account developments in Harish Rana v. Union of India (2026), specifically regarding the role of medical boards and the removal of life-sustaining care. It contends that although protections are necessary to preserve the sanctity of life, they must be reasonable and support the fundamental guarantees of autonomy and dignity under Article 21, rather than destroy them.
Keywords: Advance Medical Directives, Article 21, Right to die with Dignity, Individual Autonomy, Procedural safeguards
