Karnataka Orders Establishment of Medical Boards for Dignified Deaths Under Living Wills
Maheshpriya · 3 February 2025 · 2 min read
The Karnataka government has mandated the creation of medical boards in state hospitals to review and process requests for dignified deaths through the execution of living wills for terminally ill patients. This development follows a significant 2023 ruling by the Supreme Court of India, which recognized the right to die with dignity as part of the right to life under Article 21 of the Indian Constitution. Karnataka becomes the second state in India to implement this directive, following Kerala's lead.
Government's Directive and Implementation
On January 31, Karnataka’s Health Minister Dinesh Gundu Rao announced the issuance of what he called a “historic order” to comply with the Supreme Court’s decision. The move is aimed at offering relief to individuals who are terminally ill, with no hope of recovery, or in a persistent vegetative state where life-sustaining treatments no longer provide any benefit.
The directive, issued via a circular on January 30, mandates that primary and secondary medical boards be established in hospitals. These boards will assess requests for Withdrawal of Life-Sustaining Therapy (WLST), based on a living will or advance directive executed by the patient, with decisions to be made in consultation with the patient’s nearest relatives.
Living Will/Advance Directive
A living will, also known as an advance medical directive (AMD), is a legal document that allows terminally ill patients to express their wishes regarding medical treatment in advance. This enables individuals to opt-out of life support if they enter a state where they can no longer express their wishes. The document can be presented to hospitals for action when a patient’s condition worsens and they become unable to communicate their preferences.
Legal Precedents and Supreme Court Rulings
The 2018 Supreme Court ruling laid the foundation for passive euthanasia and the recognition of living wills. The Court held that the right to life under Article 21 includes the right to live with dignity, which extends to the process of dying for individuals in a terminally ill state or a persistent vegetative state with no hope of recovery.
In 2023, the Court modified its earlier judgment, removing the need for judicial magistrates to validate living wills, and instead requiring attestation by a notary or a gazetted officer. Additionally, the 2023 ruling clarified the composition and operational guidelines for medical boards, ensuring that they follow a clear, structured process in evaluating living wills.
