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October 13, 2017

What are Advance Medical Directives? Discuss the pros and cons of legalising it.

Refer - The Indian Express

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IAS Parliament 7 years

KEY POINTS

Advance Medical Directives (or) Living Will

·         It refers to an advance written directive of the concerned person to physicians for end-of-life medical care (i.e.) not to provide life support.

·         The Supreme Court has indicated that it may lay down comprehensive guidelines on operationalizing the idea of living wills.

·         However, the Union government has opposed the concept of an advance directive and opposes permitting people to make a ‘living will’.

Pros

·         Allowing it would acknowledge the patient’s autonomy and self-determination to the point of legalizing a wish to die.

·         Allowing it would relieve the close family members, of a terminally ill patient, of the moral burden of making a life-ending decision.

·         A living will would also rule out the possibility of doubting the life terminating decision as a murder.

·         In India, where most medical expenses are out of pocket, such directives may ease the financial strain on the incurable patient’s family due to mounting medical bills.

Cons

·         An earlier verdict from the judiciary has noted that right to life under Article 21 does not include the right to die.

·         Allowing making a living will would contravene this legal stand.

·         There are chances of misusing the provision and leading to the abuse and neglect of the elderly, particularly in countries with large socioeconomic inequalities and a high rate of illiteracy.

·         It may be hard to translate the words of the living will into actual medical action.

Suggestions

·         Given the mixed benefits, living will could be provided for with the necessary safeguards.

·         The guidelines should ensure that it was really the will of the concerned person.

·         Also, an independent medical board can examine the health of the person to establish the validity of the decision.

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