In early March this year, 30 people in Thrissur in Kerala executed living wills. Living wills have been legal since 2018, when the Supreme Court of India created a process to allow terminally-ill patients, with no hope of a cure, to withhold or withdraw treatment and die with dignity. Since patients may not be able to communicate their wishes for a variety of reasons, including being unconscious or suffering from dementia, living wills allow them to make choices about future medical care. Six years after the judgment, however, the Court’s process is unavailable in most of India. Officials remain unlikely to implement the procedure without direct orders and guidance from State governments.
The Court’s procedure
When the Court created the process, it was unworkably complex. As the Court worried that “unscrupulous persons who wish to inherit or otherwise grab the property of the patient” might abuse the process, it created elaborate bureaucratic procedures as safeguards. One particular requirement — that living wills must be countersigned by a judicial magistrate — was too much of a burden. Predictably, few living wills were executed in the first five years after the judgment. In January 2023, the Court recognised that requiring a judge to countersign each living will ‘impaired, if not completely defeat’ the objective of its judgment, and streamlined the procedure.
