At the hearing, Chief Justice of India Dipak Misra said: “Should we not allow them to cross the door and meet death with dignity? For some, even their death could be a moment of celebration.”(Shutterstock)
At the hearing, Chief Justice of India Dipak Misra said: “Should we not allow them to cross the door and meet death with dignity? For some, even their death could be a moment of celebration.”(Shutterstock)

Passive euthanasia: How a living will can be made and executed in India

An explainer on how a living will, or advance medical directive, can be drafted and executed, after the Supreme Court in a landmark judgement allowed passive euthanasia in India.
By HT Correspondent | Hindustan Times, New Delhi
UPDATED ON MAR 09, 2018 09:07 PM IST

In a landmark judgement, the Supreme Court on Friday recognised that a terminally-ill patient or a person in persistent vegetative state can execute an “advance medical directive” or a “living will” to refuse medical treatment, saying the right to live with dignity also includes “smoothening” the process of dying.

The court laid down principles relating to the procedure for execution of advance directive or ‘living will’ and spelt out guidelines and safeguards to give effect to passive euthanasia in both circumstances — where there are advance directives and where there are none.

Here’s an explainer on how the process of drafting and implementing a living will works:

WHAT IS A LIVING WILL/ ADVANCE MEDICAL DIRECTIVE ?

Advance medical directives are instruments through which a person express their wishes at a time she is not capable of making an informed decision of how medical treatment should proceed, and how long it should continue, when she is not in a position to make an informed decision by reason of being unconscious or in a coma.

WHO CAN DRAW UP A LIVING WILL/ ADVANCE MEDICAL DIRECTIVE ?

* An adult who is of a sound and healthy mind and in a position to communicate, relate and comprehend the purpose and consequences of executing the document.

*It must be voluntary

* It should be in writing and should clearly state as to when medical treatment may be withdrawn or if specific medical treatment that will have the effect of delaying the process of death should be given

WHAT SHOULD THE LIVING WILL HAVE? / ESSENTIAL ELEMENTS OF A LIVING WILL

* It should clearly indicate the decision relating to the circumstances in which medical treatment can be withdrawn.

* Instructions must be absolutely clear and unambiguous.

* It should mention whether the patient may revoke the instructions/authority at any time

* It should say that the patient has understood the consequences of executing such a document.

* It should specify the name of a guardian or close relative who, in the event of the patient becoming incapable of taking decision at the relevant time, will be authorized to give consent to refuse or withdraw medical treatment

* If there is more than one valid Advance Directive, the most recently signed Advance Directive will be considered as the last expression of the patient‘s wishes and will be implemented.

HOW SHOULD THE LIVING WILL BE RECORDED AND PRESERVED ?

*It should be signed by the patient in the presence of two witnesses, preferably independent, and countersigned by a jurisdictional judicial magistrate, first class (JMFC), so designated by the concerned district judge

* The witnesses and the jurisdictional JMFC have to record their satisfaction that the document has been executed voluntarily and without any coercion or inducement or compulsion

* The JMFC has to preserve one copy of the document in his office and forward one copy of the document to the registry of the jurisdictional district court for being preserved.

*The JMFC has to inform the immediate family members of the patient and make them aware about the execution of the document.

* A copy has to be handed over to the municipal corporation or municipality or panchayat, as the case may be. The authorities shall nominate a competent official, who shall be the custodian of the said document

* The JMFC has to hand over a copy of the directive to the family physician

WHEN AND BY WHOM CAN IT BE IMPLEMENTED?

*The person becomes terminally ill and is undergoing prolonged medical treatment with no hope of recovery and cure of the ailment, the treating physician, when made aware about the Advance Directive, has to ascertain the genuineness and authenticity of the document from the jurisdictional JMFC before acting upon the same.

* The living will should be implemented only after being fully satisfied that the patient is terminally ill and is undergoing prolonged treatment or is surviving on life support and that the illness of the patient is incurable

* The hospital where the patient has been admitted for medical treatment has to constitute a medical Board consisting of the head of the treating department and at least three experts from the fields of general medicine, cardiology, neurology, nephrology, psychiatry or oncology of at least twenty years experience who, in turn, have to visit the patient in the presence of his guardian/close relative and form an opinion to certify, or not certify, the instructions in the living will. This decision shall be regarded as a preliminary opinion.

* After the hospital medical board certifies that the instructions contained in the advance directive ought to be carried out, the hospital has to inform the jurisdictional collector about the proposal.

*The collector shall constitute another medical board comprising the chief district medical officer as the chairman and three expert doctors from the fields of general medicine, cardiology, neurology, nephrology, psychiatry or oncology

*The chairman of the medical board nominated by the Collector, that is, the Chief District Medical Officer, has to convey the decision of the board to the jurisdictional JMFC before withdrawing the medical treatment administered to the patient. The JMFC shall visit the patient at the earliest and, after examining all aspects, authorise the implementation of the decision of the Board

WHAT IF THE PERMISSION IS REFUSED BY THE MEDICAL BOARD?

*If permission to withdraw medical treatment is refused by the Medical Board, it would be open to the patient or his family members or even the treating doctor or the hospital staff to approach the high court.

* The chief justice of the high court will have to constitute a division bench to decide upon case.

SHARE THIS ARTICLE ON
Close
Policemen outside the house in Batla House where inspector Mohan Chand Shama was killed during a shootout. HT Archive
Policemen outside the house in Batla House where inspector Mohan Chand Shama was killed during a shootout. HT Archive

Batla House: Ariz Khan held guilty of killing inspector

By Richa Banka, New Delhi
PUBLISHED ON MAR 09, 2021 03:26 AM IST
  • Additional sessions judge Sandeep Yadav convicted 35-year-old Khan, also known as Junaid, Salim and Anna
Close
Farm subsidies worth thousands of crores — including cheap insurance, fertilisers, credit and income transfers — still suffer from leakages because very little information about individual farmers is centrally available.(Bloomberg file photo)
Farm subsidies worth thousands of crores — including cheap insurance, fertilisers, credit and income transfers — still suffer from leakages because very little information about individual farmers is centrally available.(Bloomberg file photo)

National farmers’ database on anvil

By Zia Haq, New Delhi
PUBLISHED ON MAR 09, 2021 02:38 AM IST
  • The database uses Aadhaar-based data generated from key farm sector programmes such as PM-KISAN.
Close
Passengers queue to get their documents verified before entering the IGI Airport amid the lockdown in New Delhi on May 30, 2020.(Sanjeev Verma/HT Photo)
Passengers queue to get their documents verified before entering the IGI Airport amid the lockdown in New Delhi on May 30, 2020.(Sanjeev Verma/HT Photo)

Prominent warnings at IGI against carrying bullets soon

By Anvit Srivastava, New Delhi
PUBLISHED ON MAR 09, 2021 02:33 AM IST
  • Police data shows that some of the 522 passengers nabbed in last 5 years while carrying live bullets in their bags claimed they had done so unknowingly
Close
The Act mandates all private establishments in Haryana to provide 75% of new jobs to local candidates.(Representational photo)
The Act mandates all private establishments in Haryana to provide 75% of new jobs to local candidates.(Representational photo)

Is the Haryana Act legal?

By Utkarsh Anand, New Delhi
UPDATED ON MAR 09, 2021 02:23 AM IST
  • Private firms will likely claim that the law interferes with their constitutional rights to carry on trade freely
Close
The apex court has agreed to re-examine the 50% ceiling on reservations in India while hearing a case on the validity of 10% separate reservations for Marathas(Amal KS/HT PHOTO)
The apex court has agreed to re-examine the 50% ceiling on reservations in India while hearing a case on the validity of 10% separate reservations for Marathas(Amal KS/HT PHOTO)

Why reservation may fail in levelling the field

By Roshan Kishore, Abhishek Jha
PUBLISHED ON MAR 09, 2021 01:58 AM IST
  • From SC-ST social groups, reservations have expanded to OBCs, economically weaker sections
Close
The recovery in GST collections reflects the larger revival in the economy.(PTI)
The recovery in GST collections reflects the larger revival in the economy.(PTI)

Record GST collections expected in March

By Rajeev Jayaswal, New Delhi
PUBLISHED ON MAR 09, 2021 01:23 AM IST
  • The revenue in March may cross the record Rs.1,19,875 crore collected in January by at least Rs.10,000 crore.
Close
DU officials said that Tyagi was the first V-C in the university’s 100-year history to be suspended.(HT file)
DU officials said that Tyagi was the first V-C in the university’s 100-year history to be suspended.(HT file)

Report on probe against DU V-C Tyagi likely today

By HT Correspondent, New Delhi
PUBLISHED ON MAR 09, 2021 01:18 AM IST
  • Officials said that an inquiry committee, constituted by the Visitor of Delhi University (DU), the President of India, held its final meeting.
Close
Home minister Narottam Mishra tabled the bill in the legislative assembly.(PTI)
Home minister Narottam Mishra tabled the bill in the legislative assembly.(PTI)

MP assembly nod to anti-conversion bill

By Shruti Tomar, Bhopal
PUBLISHED ON MAR 09, 2021 01:13 AM IST
  • BJP MLAs supported the bill and called it a gift for women on the occasion of Women’s Day
Close
According to BloombergQuint, in the case of one prominent private bank, only 25-30% of the OTPs were being delivered.
According to BloombergQuint, in the case of one prominent private bank, only 25-30% of the OTPs were being delivered.

Anti-spam tech halts OTP texts for some

PUBLISHED ON MAR 09, 2021 12:46 AM IST
  • The technology requires telecoms companies to scrub messages to verify if the text being sent has been approved and it is only being sent to someone who has consented to receive such a message.
Close
At Tikri, women farmers dubbed the three laws “death warrants”.(PTI Photo)(PTI)
At Tikri, women farmers dubbed the three laws “death warrants”.(PTI Photo)(PTI)

On their day, women farmers helm the stir at all sites on Delhi borders

By HT Correspondent, New Delhi
UPDATED ON MAR 09, 2021 12:34 AM IST
  • Throughout the day, women protesters organised marches at the sites while wearing yellow, green scarves
Close
Activists said waste was being dumped late at night from the site of the new Parliament building. The mound has become so high now that it has reached the height of the main road. Arvind Yadav/HT(Arvind Yadav/HT)
Activists said waste was being dumped late at night from the site of the new Parliament building. The mound has become so high now that it has reached the height of the main road. Arvind Yadav/HT(Arvind Yadav/HT)

Activists flag concerns over debris dumping on Yamuna floodplains

By Soumya Pillai, New Delhi
PUBLISHED ON MAR 09, 2021 12:28 AM IST
  • Responding to HT on Monday, CPWD denied all allegations that the waste from the Central Vista construction site was being dumped on the floodplains.
Close
Indian Navy ships in the Andaman Sea.(Representational image/ANI)
Indian Navy ships in the Andaman Sea.(Representational image/ANI)

After almost 25 years, women deployed aboard Indian warships

PUBLISHED ON MAR 08, 2021 11:48 PM IST
  • Two women officers each have been assigned duties aboard INS Vikramaditya and INS Shakti.
Close
Fire fighters trying to control the blaze at a multi-storeyed building in Kolkata on Monday,
Fire fighters trying to control the blaze at a multi-storeyed building in Kolkata on Monday,

9 killed in blaze at multi-storeyed building in Kolkata

UPDATED ON MAR 09, 2021 01:47 AM IST
  • The fire had broken out at the 13th floor of the Eastern Railway’s office in the evening.
Close
Union Education Minister Ramesh Pokhriyal ‘Nishank’(PTI)
Union Education Minister Ramesh Pokhriyal ‘Nishank’(PTI)

Best role played by anyone during pandemic that of mothers: Education Minister

ANI
PUBLISHED ON MAR 08, 2021 10:47 PM IST
The Minister also said that women are performing exceedingly well in science, technology, research, literature and social services showcasing the highest quality of leadership potential.
Close
File photo: Supreme Court of India.(Sonu Mehta/HT PHOTO)
File photo: Supreme Court of India.(Sonu Mehta/HT PHOTO)

'Does 50% reservation limit need a relook?' SC asks states after 29 years

By Abraham Thomas, New Delhi
UPDATED ON MAR 08, 2021 10:47 PM IST
  • The apex court framed this as one among the several questions to be decided while considering the constitutional validity of a 2018 Maharashtra law.
Close
SHARE
Story Saved
OPEN APP