Published: Thu, October 12, 2017
Medicine | By Earnest Bishop

Supreme Court reserves judgement on right to 'living will'

Supreme Court reserves judgement on right to 'living will'

India has taken the stance of not allowing active euthanasia (where a life ends through the administration of lethal substances).

The Supreme Court on Wednesday reserved its verdict on whether "living will" authorising stoppage of medical treatment to the person suffering from an ailment with no chance of survival can be allowed in India. In a living will, you can outline whether or not you want your life to be artificially prolonged in the event of a devastating illness or injury.

Living will is a written document that allows a patient to give explicit instructions in advance about the medical treatment to be administered when he or she is terminally ill or no longer able to express informed consent.

Mr Narasimha said a draft bill, based on the guidelines framed by the top court in Aruna Shaunbag's case, is under the government's consideration. For example, a person in a coma or a vegetative state can not physically communicate with the doctors, so the living will represents his choice. "Safeguards have to be there and nothing more could be done".

The top court declined the plea for Shanbaug's mercy-killing but approved the concept of passive euthanasia under exceptional circumstances. Such a request would be vetted by a board of medical experts and thereafter the high court would grant or refuse permission for passive euthanasia.

Justice Chandrachud suggested a two-pronged test on when a living will take effect.

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Advocate Prashant Bhushan, appearing for the NGO, had said since a patient under coma can't express his/her wish, law should allow him/her to put it down in writing in advance that he/she should not be tortured.

The bench, also comprising Justices AK Sikri, AM Khanwilkar, DY Chandrachud and Ashok Bhushan, said that Right to Life does not mean right to die but a dignified life would certainly include right to die with dignity, as advance directive would take effect once a medical board affirms that the patient comatose state is irreversible.

The Supreme Court, however, said there should be adequate safeguards and implementation of living will would be subject to medical board's certifying that the patient's comatose state is irreversible.

The NGO had prayed for declaring the right to die with dignity as a Fundamental Right and sought a direction to the government to adopt suitable procedures to ensure that those with deteriorating health or the terminally ill should be able to execute a living will and attorney authorisation for termination of life. But one can not commit suicide. In the absence of a law authorizing doctors to do so, they keep incurable patients on life support, he said. The matter to be decided was whether the law should allow it (euthanasia). This is followed by passive euthanasia. When the patient decides to end life and is assisted by a doctor, it is assisted suicide. Euthanasia, on the other hand, refers to the call taken by the family and friends of a patient, who is presumably on life support. "Can one decide today what would be the state of medical advancement in the future to specify a medical condition when s/he should not be given treatment?" he asked.

The Bill protects the medical practitioner, as well as the patient, from any criminal or civil liability.

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