Indian SC recognizes 'living will' of terminally ill patients


Health experts on Friday hailed the apex court's verdict permitting passive euthanasia and "living will" by patients on withdrawing medical support if they slip into irreversible coma, saying it would give "salvageable patients" the opportunity to avail ventilator support.

The bench, also comprising justices A K Sikri, A M Khanwilkar, D Y Chandrachud and Ashok Bhushan said that a person with no will to live shouldn't suffer in a comatose state. While passive euthanasia, described by the Supreme Court as "withdrawing medical treatment with a deliberate intention of causing the patient's death" is permitted, provided guidelines and conditions are followed, active euthanasia, "ending life through use of lethal substance" is not permitted in any circumstance.

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It said that in cases where a patient is terminally-ill and undergoing prolonged treatment for an ailment which is incurable or where there is no hope of being cured, the doctor may inform the hospital which would set up a medical board. A Constitution Bench headed by Chief Justice of India, Dipak Misra said that passive euthanasia is permissible as also advance directive of a person refusing life support treatment in case it is determined that s/he couldn't be revived.

The Centre had also told the court that the government had in principle chose to decriminalise attempt to suicide, which at present is an offence punishable under Section 309 of the Indian Penal Code. The government had opposed the concept of Living Will and the Medical Power of Attorney in case of terminally ill patients because according to the Centre, persons who opt for it may not be aware of future medical advancements.

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Private hospitals that are increasingly at the receiving end of allegations of inflated medical bills through extended ICU admissions of terminally ill and clinically dead patients will now get a reprieve if the person has signed such a "living will". However, the bench had then hinted that it could allow the execution of "living will" in cases of passive euthanasia under Article 21 of the Indian Constitution. Additional solicitor general P.S. Narasimha, representing the centre, told the court that consent for removal of artificial support may not be an informed one and could be misused in cases of the elderly. Their decision would serve as preliminary opinion on whether or not to certify carrying out the instructions in the living will.

"Life and death are inseparable".

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Recognising the right to die with dignity, the apex court said, "Human beings have the right to die with dignity".