From Spiritual Renunciation to Constitutional Autonomy: The Evolution of Voluntary Death and Euthanasia in India

Advances in medical technology have transformed the experience of dying by enabling respiration, circulation, nutrition and other physiological functions to be sustained for prolonged periods even where the underlying disease is irreversible and meaningful recovery is medically improbable. This development has intensified the legal and ethical debate concerning euthanasia, withdrawal of life-sustaining treatment and the constitutional meaning of a dignified death in India. The question is no longer confined to whether life should be preserved, but extends to whether a person may, under legally regulated circumstances, refuse or discontinue medical intervention and permit the natural process of dying to occur. The issue has become particularly significant in cases involving terminal illness, permanent vegetative states and other conditions in which medical intervention may sustain biological functioning without restoring consciousness or meaningful recovery.The normative question of voluntary death, however, is not wholly unfamiliar to Indian jurisprudential thought. Jain traditions recognise sallekhana, while Hindu philosophical and Dharmashastric traditions contain references to prayopavesa and related forms of voluntary fasting unto death under particular conditions. These practices cannot be equated with modern euthanasia because their normative foundations lay in dharma, karma, ahimsa, renunciation, spiritual purification and detachment rather than in contemporary ideas of medical autonomy and patient-centred decision-making. Nevertheless, they demonstrate that Indian intellectual traditions have long reflected upon suffering, mortality, agency and the manner in which death may be consciously approached.This paper examines the movement from these ancient normative frameworks to contemporary constitutional jurisprudence. It traces the judicial development from P. Rathinam v Union of India and Gian Kaur v State of Punjab through Aruna Ramachandra Shanbaug v Union of India and Common Cause v Union of India to the Supreme Court's 2026 decision in Harish Rana v Union of India. The paper argues that Indian euthanasia jurisprudence represents normative continuity without doctrinal equivalence. Ancient approaches located voluntary death within spiritual discipline and renunciation, whereas contemporary constitutional law relocates the question within autonomy, dignity, privacy, bodily integrity, informed consent and protection of vulnerable persons. The recent Harish Rana decision demonstrates that this jurisprudence continues to evolve in response to developments in intensive care, clinically assisted nutrition and hydration, and the practical difficulties of end-of-life decision-making.