New Delhi: The Apex Court has laid down clear guidelines for advance direction for passive euthanasia, so that it is not misused in any manner. First and foremost, the last wish shall be in writing clearly stating as to when medical treatment may be withdrawn.
This last wish can be executed only by an adult in sound state of mind and who is in a position to communicate and comprehend the consequences of executing such a direction. The guidelines say the ‘living will’ document much clearly indicate the circumstances in which withholding or withdrawing medical treatment can be resorted to, mentioning that the executor may revoke the instructions at any time.
The document should also specify the name of the guardian or close relative, who in the event of the person becoming incapable of taking a decision, will be authorised give consent to withdrawal of medical treatment. If there are more than one valid advance directives, the latest one signed by the person will be considered as his last wish. In case a person becomes terminally ill while he is undergoing prolonged medical treatment, the treating physician shall ascertain authenticity of the document before acting upon it. The person authorising passive euthanasia has to sign the document in the presence of two witnesses, preferably independent; it has to be countersigned by a Judicial Magistrate of First Class (JMFC), who shall preserve one copy in his office besides sending it to the registry of the district judge to retain it in digital format.
The guidelines also require that the withdrawal of the life support shall be intimated by the concerned magistrate to the High Court which will keep the report in a digital format as also in hard copy that will be destroyed after three years of the patient’s death.
But what about cases where there is no advance directive? The court says in such instances adopt the same safeguards as applied in cases where the directive is available. Doctors have to give due weight to the instructions in the document but only after fully satisfying themselves that the person is terminally ill with no hope of being cured. The concerned hospital has to then set up a 4-member medical board which shall certify or deny the last wish.
If the medical board refuses permission, the person or his family members or even the treating doctor or the hospital staff can approach the High Court whose division bench shall decide on grant or refusal of the approval, with liberty to set up a 3-member independent panel of doctors. The High Court can also set up a medical board to examine the patient and submit its report.