ADJUDICATING PSYCHIATRIC EUTHANASIA: A NEURO-LEGAL FRAMEWORK FOR JUDICIAL AUTHORISATION OF ASSISTED DYING

When a patient's body succumbs to cancer, courts can read the scan, weigh the prognosis, and anchor their judgment in objective pathology. When the mind itself is the site of suffering when treatment-resistant psychiatric illness strips a person not of breath but of the will to inhabit their own life courts are asked to authorise an irreversible act on evidence that is phenomenological, diagnostically unstable, and legally uncharted. This is the foundational crisis of psychiatric euthanasia. Existing euthanasia frameworks, particularly the due-care regimes of the Netherlands and Belgium, were architectured around somatic pathology. Their extension to psychiatric disorders has exposed a structural void: indeterminate irremediability standards, capacity assessments that fluctuate with the very illness being evaluated, and judicial deference to clinical discretion that would be constitutionally impermissible in any other capital-consequence adjudication. India carrying 14,305 mental illness–linked suicides annually and permitting only passive euthanasia confronts this void without any framework at all. This paper proposes a judicially operable neuro-legal framework requiring (I) neurobiological substantiation, (II) longitudinal decisional capacity assessment, (III) disorder-specific eligibility criteria, and (IV) proportionality review, equipping courts to distinguish legally cognisable medical suffering from non-justiciable existential distress, while safeguarding autonomy, dignity, and the rule of law. The framework is grounded in comparative analysis of the Netherlands, Belgium, and Canada; doctrinal examination of landmark decisions under ECHR jurisprudence and Indian constitutional law; synthesis of a systematic review of 50 peer-reviewed studies; and normative legal analysis calibrated to India's constitutional and infrastructural context.