Final Choice

The concept of an advanced medical directive where you can state whether or not you should be kept on life support if you were to be in a state when you can’t express your opinion has been a legal one since 2018. You can draw up such a directive, often called a living will in India, and the hospitals and your closest relatives are legally bound to follow what is written on it.

But go ahead and try to register such a will, and you will know just how tedious and near impossible such a task is. That is because while the Supreme Court gave this concept legal sanctity in 2018, while also allowing for ‘passive euthanasia’ (the withdrawing and withholding of life support in individuals), and simplified the processes of registering and executing such wills in subsequent judgments, most governments simply did not pay any attention in putting these processes together.

Many lauded the concept of such an idea where an individual, through a will prepared in advance, had a say in his or her death, since withdrawing life support was considered illegal before 2018. (It is another matter that life support is often withdrawn quietly in hospital after consultations between doctors and family members and the cause of death shown as something else.) This will however existed only on paper.

This is now beginning to change.

The Maharashtra government, under some pressure by a public interest litigation (PIL) filed in the Bombay High Court, recently told the court that it is developing an online portal through which people can apply and register such wills. The state, through its government pleader Neha Bhide, also told the court that the state will soon issue government resolutions on Standard Operating Procedures (SOPs) for its officers for implementation of the Supreme Court’s directions on euthanasia and living wills, and on the portal for registering living wills. The state had earlier also appointed over 400 officials from various local bodies in the state to serve as custodians of these living wills, something that was mandated by the Supreme Court and which the Bombay High Court had admonished it over not putting in place. The Bombay High Court has directed the government to put these mechanisms in place within three months.

Dr Nikhil Datar, a gynaecologist and obstetrician in Mumbai, who had filed this PIL in the Bombay High Court after experiencing difficulties in drafting his living will, told Open earlier how putting in place these mechanisms in place is the need of the hour. “As a doctor, I understand the limitations and scope of existing medical treatments and what they will probably be like for the next 20 or so years. There is already now, and there will increasingly be, the need to answer the question whether a given treatment is prolonging someone’s life or meaninglessly delaying death,” he had told  Open.

Since the 2018 Supreme Court judgment, many individuals, especially activists who argue for an individual’s right to have a say in his or her death, have drawn up and tried to register such living wills. Their numbers however have been relatively small, and the state has had little incentive to follow up on the Supreme Court’s guidelines.

Maharashtra, through some prodding by the Bombay High Court, now appears to be putting some of the processes in place. Whatever is put together will probably not be perfect and will need more work, but it will be a start, and hopefully more states will follow.

Bombay High CourtDr Nikhil DatareuthanasiaMaharashtra governmentSupreme Court of IndiaWeb Exclusive