Supreme Court Simplifies Living Will Rules: No Magistrate Countersignature, Hospital Medical Boards to Decide Within 48 Hours

The 2018 Constitution Bench judgment in Common Cause v. Union of India recognised the right to die with dignity and laid down directions for Advance Directives and for withdrawal of treatment where none exists (paras 1-2). The Indian Society of Critical Care Medicine applied for clarification, saying the directions, such as countersignature by a Judicial Magistrate, had created insurmountable obstacles and nearly defeated their object (para 3). The Union first opposed the application but later took part in discussions on changes (paras 4-5).

Although a clarification application would ordinarily not be entertained, the Court revisited the directions because of the subsequent development of discussions with the Union, including medical experts, and the difficulties doctors reported (para 5). It modified or deleted parts of the 2018 directions on Advance Directives and on cases without one (para 6). The executor may name more than one guardian or relative; the document is attested by a notary or Gazetted Officer, and the Magistrate's duties of keeping and forwarding copies are deleted (para 6). The executor hands copies to the named persons and family physician, and a local-body official is the custodian; the directive may also be kept in digital health records (para 6). The hospital, not the Collector, constitutes a Primary Medical Board of the treating physician and two experts with five years' experience, and then a Secondary Medical Board including a nominee of the Chief Medical Officer, each giving an opinion preferably within 48 hours (para 6). The Magistrate is informed before the decision is given effect; if the Secondary Board refuses, the High Court may be approached under Article 226 (para 6).