Supreme court reviews 2018 judgement on end-of-life care

Categories: Featured and Policy.

Courtesy of Pallium India

On a matter of supreme importance that concerns you, me and every single citizen of India, in response to a petition from the NGO ‘Common Cause’, the Supreme Court of India had validated the importance of advance medical directives (AMD) and of withholding/withdrawing (WH/WD) artificial life support in the context of futility of treatment. The judgment was a moral victory emphasising the importance of human dignity at the end-of-life; but the procedures laid out by the court were so complex that we are not aware of a single person who went through WH/WD following that process in the last five years.

In response to a review petition, the Supreme Court has now simplified some of the processes:

  1. AMDs no longer need to be countersigned by a magistrate. Attestation by a notary public or a gazetted officer would be enough. And the magistrate is no longer required to keep a copy; it is to go into a central repository.
  2. For WH/WD, it is no longer needed to involve the district collector; nevertheless it is still necessary to form two committees of specialist doctors one after the other. The first one has to take a decision in two days; it is not clear how long the second committee will take.
  3. The court continues to refer to WH/WD as ‘passive euthanasia‘. For one thing, the word euthanasia involves ‘killing’ however noble be the objective. WH/WD is allowing natural death. The use of the phrase ‘passive euthanasia’ is likely to cause an enormous burden of guilt on families and professionals. It would also invite religious objections.

The final detailed judgement is yet to be published, though. It is important to remember that the legal position is not necessarily the most critical factor affecting end-of-life care. We believe that the doctor’s knowledge of duty of care, the family’s awareness and the social perception are even more important.

Please find the main article HERE.

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