FINANCING THE RIGHT TO DIE: COMPARATIVE STUDY OF INDIA AND NETHERLANDS

Abstract

Advances in medical technology and evolving societal views on autonomy and end-of-life care have brought deliberate life-ending decisions to the forefront of contemporary policy debates. Central to these debates are the distinctions between active and passive euthanasia, voluntary and non-voluntary choices, and related practices such as physician-assisted dying and the withholding or withdrawal of life-sustaining treatment. While these classifications carry significant clinical and legal implications, an equally critical yet understudied dimension concerns the role of insurers and financing systems. Whether euthanasia-related services are publicly funded, contractually recognized by private insurers, or excluded from benefit packages shapes patient access, incentives, and vulnerability to coercion or cost-driven pressures. This article examines “insurance for euthanasia” through a comparative study of the Netherlands and India. The Netherlands represents a statutory framework where euthanasia and physician-assisted dying are legally permitted under stringent safeguards and embedded within a mandatory basic health-insurance system. India, by contrast, relies on judicially crafted principles: courts have legalized the withdrawal of life-sustaining treatment and recognized advance directives, yet implementation is mediated by procedural requirements, a fragmented public-private financing landscape, and minimal insurer guidance. By juxtaposing these contrasting legal regimes and financing structures, the study highlights how statutory regulation versus case-law evolution—and centralized versus fragmented insurance systems—shape insurer behaviour, policy design, and patient outcomes.

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