A Living Will, also known as an Advance Medical Directive (AMD), is a legal document through which a competent adult voluntarily records his or her wishes regarding future medical treatment in the event of becoming terminally ill or permanently incapacitated and incapable of communicating or making informed decisions. It enables an individual to exercise autonomy over end-of-life medical care by specifying the circumstances in which life-sustaining treatment may be withheld or withdrawn, subject to applicable law and judicial guidelines.
In India, the concept of a Living Will has been recognized by the Hon'ble Supreme Court in Common Cause (A Regd. Society) v. Union of India, (2018) 5 SCC 1, and the procedural guidelines were subsequently simplified in Common Cause v. Union of India, 2023 SCC OnLine SC 373. These judgments recognize the right to die with dignity as an integral facet of the right to life and personal liberty guaranteed under Article 21 of the Constitution of India, while prescribing safeguards for the execution and implementation of Advance Medical Directives.
A Living Will generally includes:
- The personal details and identification of the person executing the directive.
- A declaration that the directive is made voluntarily, while the person is of sound mind and free from coercion, fraud, or undue influence.
- Clear instructions regarding refusal or withdrawal of artificial life-sustaining treatment in specified medical circumstances.
- Appointment of one or more authorised representatives or healthcare proxies to communicate and implement the individual's wishes.
- The date, signatures of the executant and witnesses, and compliance with the procedural requirements prescribed by law.
The principal objectives of a Living Will are:
- To preserve the individual's dignity and autonomy in making healthcare decisions.
- To provide clear directions regarding end-of-life medical treatment.
- To reduce uncertainty and emotional burden on family members and healthcare providers.
- To prevent unnecessary prolongation of suffering through invasive medical interventions where recovery is medically improbable.
- To ensure that medical decisions are implemented in accordance with the individual's expressed wishes and the applicable legal framework.
A Living Will becomes operative only upon the occurrence of the circumstances specified therein and is subject to compliance with the legal procedures and medical safeguards prescribed by the Hon'ble Supreme Court of India and other applicable laws. It may be revoked or modified by the executant at any time while he or she remains competent and capable of making informed decisions.