SC to frame norms for drafting ‘living wills’:& The will to die: 

SC to frame norms for drafting ‘living wills’:& The will to die: 

Context

• If the medical board will affirm that the patient’s condition is beyond cure and irreversible only then advance directive to withdraw medical care to allow him to die with dignity should take effect, Chief Justice of India, Dipak Misra made a statement on allowing Euthanasia.

What is the debate?

• The Chief Justice, heading a five-judge Constitution Bench, was responding to a debate on when exactly a person’s “living will” or advance directive for end-of-life medical care should take effect.
• The court was hearing a petition by an NGO, Common Cause, to legalise euthanasia and the concept of living will.

What is the final verdict and suggestions?

• Guidelines for drafting living wills and how it could be authenticated will be laid down. The Supreme Court has reserved the case for judgement.
• Advance directives may be approved by a Magistrate. The Magistrate has to examine that the person executing the living will is of sound mind or not.
• A certificate from a statutory medical board that a patient’s condition was beyond cure and irreversible would take care of apprehensions of relatives and doctors about withdrawing life support.
• The medical board will be taking this decision impartially and on the touchstone of modern technology.
• The Constitution Bench suggested framing guidelines for setting up medical boards in every district. The decision of the board would be final and an advance directive should yield to the board’s decision.
• A two-fold test is also suggested as to when living will would come into effect. One, when the medical condition of the patient has become irreversible. Two, when the prolongation of his life can be done only at the cost of pain and suffering which is at a level inconsistent with his advance directive.

Government’s rebuttal

• The government maintains that the legalization of “advance directives” would amount to the waiving of the paramount fundamental right to life enshrined under Article 21 of the Constitution.
• Allowing passive euthanasia opposes the concept of living will as a principle of public policy. It said the State’s primary obligation was to sustain life and not legalize a person’s wish to die.
• The government is rightly concerned that the idea may be misused and result in the neglect of the elderly.
• The government is finalizing a draft law on passive euthanasia called ‘The Management of Patients With Terminal Illness – Withdrawal of Medical Life Support Bill.
• This bill comes under the light of the Law Commission of India which recommends that life support can be withdrawn for patients in persistent vegetative state (PVS) or suffering an irreversible medical condition.

What is euthanasia? What is Passive euthanasia?

• Euthanasia is the practice of intentionally ending a life to relieve pain and suffering. There are different euthanasia laws in each country.
• Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary.
• Voluntary euthanasia is conducted with the consent of the patient.
• Non-voluntary euthanasia is conducted when the consent of the patient is unavailable. It is illegal worldwide.
• Involuntary euthanasia is conducted against the will of the patient. This is also illegal.
• Passive euthanasia is the subdivision of Voluntary, non-voluntary and involuntary euthanasia.
• Passive euthanasia involves the withdrawing of treatment or food that would allow the patient to live.

What is a living will?

• A living will is a concept associated with passive euthanasia. It is a legal document that allows one to express their wishes to doctors in case you become incapacitated.
• In a living will, one can outline whether or not you want your life to be artificially prolonged in the event of a devastating illness or injury.
• It can give invaluable guidance to family members and healthcare professionals if a person can’t express his or her wishes.

Passive euthanasia in Indian constitution:

• In March 2011, the Supreme Court of India passed a historic judgement-law permitting Passive Euthanasia in the country.
• The Supreme Court specified two irreversible conditions to permit Passive Euthanasia Law in its 2011 Law:
• The brain-dead for whom the ventilator can be switched off and
• Those in a Persistent Vegetative State (PVS) for whom the feed can be tapered out and pain-managing palliatives are added.
• After the case of Aruna Shanbaug’s euthanasia, the Supreme Court laid the following guidelines:
• A decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend.
• Even if a decision is taken by the near relatives or doctors or next friend to withdraw life support, such a decision requires approval from the High Court concerned.
• When such an application is filled the Chief Justice of the High Court should forthwith constitute a Bench of at least two Judges who should decide to grant approval or not.