Following the footsteps of Kerala Government,Karnataka ensures that terminally ill patients have the right to a dignified death as it set up medical boards in hospitals to process living wills. Following a Supreme Court ruling that recognized the right to die with dignity as part of the right to life under Article 21, the state has become the second in India, after Kerala, to implement this measure.
Announcing the decision on 31 January, State Health Minister Dinesh Gundu Rao called it “a historic order” that aligns with the Supreme Court’s directive. The initiative, he explained, would provide relief to individuals who have no hope of recovery or are in a persistent vegetative state, where life-sustaining treatment serves no benefit.
A circular issued by the health department on 30 January mandates the formation of primary and secondary medical boards in government hospitals to review requests from a patient’s closest relatives for the Withdrawal of Life-Sustaining Therapy (WLST) based on a living will. The report further noted, “We have also come out with an Advance Medical Directive (AMD), or a living will, in which a patient can record their wishes about their medical treatment in the future. This important step will bring great relief and a dignified sense of closure to many families and individuals.”
A living will, or advance directive, is a legal document allowing terminally ill individuals to express their wish to forego life support when they are no longer able to communicate. Once submitted, hospitals will be required to act on it as per medical board recommendations.
The Supreme Court first recognized and sanctioned passive euthanasia and living wills in a landmark 2018 judgment, ruling that the right to life includes the right to live with dignity and, in cases of terminal illness or irreversible vegetative states, extends to allowing a smooth and dignified end. The ruling also directed the formation of medical boards in hospitals to assess and execute such directives.
In January 2023, the Supreme Court modified its earlier judgment, simplifying the process by removing the need for a Judicial Magistrate First Class (JMFC) to validate living wills. Instead, the directive can now be attested by a notary or a gazetted officer, ensuring it was signed voluntarily. The Court also revised the composition and operational guidelines for medical boards.
With Karnataka’s latest directive, all government hospitals in the state will now be required to establish these boards, ensuring that individuals who have expressed their wishes through a living will receive the legal and medical support they need for a dignified end-of-life process.
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