A five-judge Constitution bench of the Supreme Court of India headed by CJI Dipak Misra hinted on October 11, 2017 on devising a mechanism to legitimise a ‘living will’, says a report by Dhananjay Mahapatra in 'The Times of India'.
The bench, also comprising A K Sikri, A M Khanwilkar, D Y Chandrachud and Ashok Bhushan, said: "We recognise that every individual has a right to die with dignity, i.e. the process of end of life must be dignified."
The bench reserved order after concluding the hearing of a petition by NGO Common Cause seeking to legalise living will, referred to by the court as "advance directive" that allows a person in a sane state of mind to decide that in the event of his/her slipping into a vegetative state or coma, certified by medical experts to be irreversible, life should not be prolonged with artificial life support system.
The bench said whatever be the living will, it would come into play only if a statutory medical board, after thorough examination of the patient, declares that s/he has slipped into a condition that would inevitably and irreversibly lead to end of life. If the board says that she could be revived from an apparent hopeless medical condition, the living will would not be taken into account, it added. "This would save the relatives of the patient from the moral dilemma of consenting to withdrawal of ventilator and the doctors of medical negligence charge in future," the CJI said.
Pointing out that the conditions prescribed for the same should be more liberal, the bench said conscious persons who are old and bedridden, suffering from bed sours and other infections also deserve a decent death.
The bench asked additional solicitor general P S Narasimha to inform the court within a week the medical experts from different fields who, in the Centre's view, should be included in the statutory medical board.
"The pro forma of the advance directive document must be left to the department of health to draft. Once we pronounce the judgment, the legislature and executive will take a decision," it said.
(The Indian Society of Critical Care Medicine (ISCCM), Indian Academy of Neurology (IAN) and Indian Association of Palliative Care (IAPC) came together to form an end-of-life care in India task-force (ELICIT) to develop an alternative draft bill to the one proposed by the health ministry. The ministry made public the draft Medical Treatment of Terminally-Ill Patients (Protection of Patients and Medical Practitioners) Bill, 2016 in May. ELICIT drafted an alternative Bill on legalising Living Wills in 2016, and came out with a “Mathura Declaration”, emphasising the need to discuss end-of-life care in India.)
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