[Answered] Critically examine the Supreme Court’s guidelines on living wills in India. Discuss the challenges in implementing these guidelines and suggest measures to streamline the process for the benefit of terminally ill patients.
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Red Book

Introduction: Contextual Introduction

Body: Analyse SC guidelines on living wills and challenges and measures for the benefit of patients.

Conclusion: Way forward

A living will is a document in written form that enables individuals to provide clear instructions in advance regarding the medical treatments they wish to receive if they become terminally ill or incapacitated and are unable to communicate their consent. In 2018, the Supreme Court of India recognized the right to die with dignity by allowing terminally ill patients to create living wills, also known as Advance Medical Directives (AMD).

Supreme Court’s Guidelines on Living Wills in India

  • Autonomy and Dignity: The recommendations acknowledge that competent persons have the right, even in the latter stages of their lives, to make decisions regarding their medical treatment. This upholds the dignity of the patient and encourages their autonomy.
  • Transparency: During difficult times, patients can avoid confusion by using the described approach to express their wishes to family members and healthcare professionals clearly and concisely.

Challenges in implementing the guidelines

  • Strict Formalities: According to the standards, a living will must be seen during execution and attested by a gazetted officer or notary public. This can be difficult, particularly for individuals who live far away or have restricted movement.
  • Doctor’s Dilemma: When respecting living wills, physicians may have moral and legal dilemmas because they worry about being sued or accused of carelessness.
  • Family Discord: Families may disagree, with some members not agreeing with the patient’s wishes. Counseling and open communication can assist in reducing this.
  • Awareness: Public awareness about living wills remains low. Many patients and healthcare professionals are unfamiliar with the process, leading to underutilization.

Measures to Streamline the Process

  • Public education campaigns: Disseminating information through media, healthcare facilities, and community outreach can raise awareness about living wills.
  • Simplified Forms: The process of drafting a living will can be made easier by standardizing and simplifying the forms.
  • Physician Education: Providing physicians with information regarding living wills and their legal ramifications can promote greater comprehension and application.
  • Online Register System: By creating a national online register, accessibility and record-keeping for living wills can be enhanced.
  • Ethical Committees: Hospitals can set up ethical committees to handle issues resulting from living wills and make sure that choices are made fairly and intelligently.

Conclusion

The Supreme Court’s guidelines on living wills are a significant step towards ensuring patient autonomy and dignified death. However, addressing the challenges and implementing the suggested measures can make the process more accessible and beneficial for terminally ill patients in India. By promoting awareness, simplifying procedures, and fostering better communication, the right to die with dignity can be truly realized.

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