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In a landmark judgement by the Supreme court of India, it stated that the human race has the freedom to choose to die with dignity. With this statement, the court sealed the case granting permission for passive euthanasia. At the same time, the court also laid down some strict rules that will regulate the situation when it’s permitted.
With the implementation of the judgement, one can also create a “living will” pleading to remove him/her from the life support in case of incurable coma in the future.
What’s a Living Will?
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It’s a documented statement of the individual where he/she can request to be removed from life support like ventilator or life support system and plead for dignified death.
Challenges Faced by The Doctor in Charge
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While the verdict makes a mark in the history, the “living will” will also prove a huge burden on the treating doctors and the hospital. This is considering that it’s the physician’s obligation to get the authenticity and validity of a living will of a patient suffering from terminal illness to be verified from the Judicial Magistrate who has the custody of the document.
Once the “living will” is validated, no treatments should be carried out and the medical practitioner must pay required importance to the plea of the patient left in his/her living will. It’s time for the doctor to execute the “living will” and even inform the close ones of the patient about the medical condition.
It’s the responsibility of the doctor to let them know what care is available, the outcomes of the optional treatment methods, and the outcome of not getting treated of the remaining condition. the doctor will also have to ensure that the patient’s relatives have understood the situation and must give a firm consent to the fact that the revocation of the medical treatment is the ultimate choice.
Followed by this, the concerned physician or the hospital has to form a Medical Board with the head of the concerned department involved in the treatment, and a minimum of three experts from general medicine, oncology, nephrology, cardiology, psychiatry, and neurology departments. They must possess have been in the profession for a minimum of 20 years and extensive experience in critical are in their respective fields.
This Medical Board will then have to visit the patient and offer their basic opinion on if they should or should not withdraw the treatment based on the “living will”. If the medical board decides not to execute the Living Will, the matter may be handed over to the concerned District Collector.
But, if the board allows the Living Will, the matter has to be informed to the District Collector with immediate effect. He is then supposed to notify the Chief District Medical Officer acting as the Chairman in favour of the decision.
Even they will have to first visit the hospital and sanction the Living Will. The medical board chairman will then pass on their judgement to the jurisdictional JMFC prior to executing the decision to revoke the medical treatment. The Magistrate is also supposed to visit the patient to permit the execution of the Living Will as decided by the board. The process remains same for even those patients without a Living Will.
However, if the Medical Board does not allow the execution of the Living Will, the treating physician has the right to move to the High Court in unison with the patient’s relatives, or guardian. Under these circumstances, the high court has the rights to form an independent board of doctors to look into the matter again and take a call. In case the treatment is revoked, the Magistrate has to notify the high court. The court, on the other hand, also offers the patient the right to revoke or modify the Living Will, however, only in writing.
Supporting the Court’s judgement, even the Centre has said that the government had taken a call to legitimize attempt to suicide which is currently a punishable offence with a jail term upto one year under section 309 of the Indian Penal Code.