The campaign to recognise a patient’s right to refuse ICU care and other aggressive modes of treatment, especially as part of end-of-life care, received a shot in the arm with the Supreme Court judgment recognising privacy as a fundamental right.In his judgment in the case, Justice J Chelameswar stated that “an individual’s right to refuse life-prolonging medical treatment or terminate his life is another freedom which falls within the zone of the right to privacy”. Concerns of privacy arise when the state seeks to intrude into the body of subjects, said Justice Chelameswar, adding that he was conscious of the fact that the issue was pending before the SC.In May this year, a writ petition was filed by senior advocate Girish Gokhale, Dr RK Mani, Dr Sreenagesh Simha and Dr Roop Gursahani seeking directions to make it possible for any person with the mental capacity to make decisions to choose or even refuse any kind of medical treatment, as “a right which cannot be curtailed by any healthcare provider”.Earlier, in 2005, the NGO Common Cause had filed a writ petition to allow Indian citizens to execute a legally valid advance will to be able to choose the manner of medical interventions towards the end of life. It invoked inviolable right to privacy that cannot be set aside by other considerations by the legislature.The Indian Society of Critical Care Medicine (ISCCM) had got itself impleaded in this long-pending case in favour of allowing patients this right. The Supreme Court had referred the matter to the government for opinion with inputs from all state governments.“The state has no right to intrude into that space which is intimate or personal. Autonomy in medical decisions is implicit in the mandatory requirement of consent. This right is further affirmed by the establishment of the right to privacy as a fundamental inalienable right. Towards the end of life thus, the patient would have the right to refuse either initiation or continuation of life support,” said Dr R K Mani, former ISCCM president, who spearheaded the creation of the multi-professional medical association called End of Life Care in India Task Force (ELICIT).He pointed out Justice DY Chandrachud’s observation that the right to privacy stems from the principle of autonomy.“The state cannot take the plea of state interest in preserving life. This principle exists whether or not the patient retains competency when in terminal illness. In the absence of competency, this right can be exercised through instruments such as advance will or durable power of attorney conferred on a representative. In its absence, it can be exercised by surrogates who are next of kin,” said Dr Mani.In June 2016, after the Supreme Court referred the matter of advance will, the health ministry uploaded a draft bill on “Medical treatment of terminally ill patients for the protection of patients and medical practitioners”, which was dubbed the “passive euthanasia bill”.The bill drew heavily from the controversial Aruna Shanbaug judgement. Noting several anomalies in the document, ELICIT, along with legal experts, sent an alternative draft to the health ministry. This matter is also pending and it would now have to ensure that any proposed bill for end-of-life care ( EOLC ) and dignity in death is privacy-compliant.