A living will is a legal document that empowers terminally-ill patients, who have no prospect of recovery, to refuse or discontinue treatment, allowing them to die with dignity. This document enables individuals to make informed choices regarding their future medical care.
Living wills have been legally recognized in India since 2018, following a landmark ruling by the Supreme Court of India. This ruling established a structured process for the execution of living wills.
To create a living will, individuals must follow a streamlined process. The living will must be signed in the presence of two witnesses, attested by a notary or a gazetted officer, and then submitted to a "competent officer" at the local government, who will act as the custodian of the document.
In the event that a patient becomes terminally ill and lacks decision-making capacity, the treating doctor is responsible for verifying the living will against the copy held by the custodian or any available digital health records.
The implementation of living wills faces several challenges. Guidelines stipulate that decisions regarding the withholding or withdrawal of treatment must first be certified by a primary medical board and then confirmed by a secondary medical board. This secondary board must include a doctor appointed by the chief medical officer, which can complicate the process in hospitals lacking such nominations. As a result, terminally-ill patients, even those with living wills, may find it difficult to make critical decisions regarding their medical care.
In cases where a patient does not have a living will, the Supreme Court mandates that the primary medical board must seek written consent from the 'next of kin' before proceeding with the withdrawal or withholding of treatment. However, Indian law lacks a clear definition of 'next of kin', leading to potential conflicts when family members disagree on the appropriate course of action.
Some state governments have issued directives to comply with the Supreme Court's judgment but have not provided essential guidance or protocols for effective implementation. States like Odisha are taking a more proactive approach by forming expert committees to draft detailed orders for this purpose. To further facilitate the process, the central government could play a vital role by developing and disseminating model orders and protocols, thereby instilling confidence in state governments to implement the ruling effectively.
Kutos : AI Assistant!
