HC pulls up state govt for not establishing medical board to enforce living wills

Bombay HC criticizes state govt for lacking proper medical board to enforce living wills, questions delays in appointing registered practitioner.

MUMBAI: The Bombay high court (HC) on Thursday pulled up the state government for not having a proper secondary medical board in place for enforcing living wills or advanced medical directives for terminally ill patients.

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During the hearing, the bench of chief justices DK Upadhyay and Amit Borkar expressed dissatisfaction with the state government’s compliance with Supreme Court directives issued in 2023, aimed at streamlining the execution of living wills.

Living wills are legal documents that outline a person’s preferences regarding medical treatments and life-sustaining measures in case they become incapacitated and unable to communicate their wishes.

“Why can’t we have a permanent secondary board? Every doctor is registered. You nominate one permanent doctor? Why can’t you do this? Why is it that you always seek instructions?” remarked the bench, questioning the state’s delay in nominating a registered practitioner for registering living wills.

The court’s remarks were made in response to a petition filed by Dr Nikhil Datar, seeking enforcement of the Supreme Court’s guidelines on living wills. He pointed out that despite the directives, the state had failed to appoint a registered medical practitioner for the secondary medical board, crucial for executing the directives.

Under the Supreme Court’s 2023 order, a living will, or advanced healthcare directive allows individuals to specify their preferences regarding medical treatment in advance. The protocol involves a primary medical board promptly assessing whether to proceed with the patient’s advance directive within 48 hours of referral.

If endorsed, a secondary medical board, including a nominated registered medical practitioner and additional specialists, validates this decision within the same time frame. However, delays in nominating a registered practitioner for the purpose have hindered the execution of living wills, practically making the mechanism defunct, Dr Datar contended.

He also highlighted that the state government had appointed custodians for living wills across 29 municipal corporations and 388 municipal councils in Maharashtra. However, he raised concerns about the functionality of these custodians, noting issues faced by individuals, including uncertainty about how to retrieve their wills after several years.

Reacting to these issues, the bench emphasised the need for infrastructure to support the effective execution of living wills, stating, “It is unfortunate that a person has to file a petition to comply with directions of the Supreme Court.”

Furthermore, the court allowed Dr Datar to involve the National Medical Commission and the Union Minister of Health and Family Welfare in the case, seeking their input on improving the implementation framework for living wills.