Euthanasia and beyond: on the Supreme Court's verdict

Passive euthanasia verdict: It will be the doctors’ call

Guidelines prescribed by the Supreme Court on Friday while upholding passive euthanasia and ‘Living Will’, place a huge burden on the treating physician and hospital.

For one, the responsibility is on the treating doctor to ascertain the “genuineness and authenticity” of a Living Will of a terminally ill patient from the Judicial Magistrate in whose custody the document is kept.

Once satisfied that there is no cure, the doctor should give due weight to the instructions left by the patient in his or her Living Will. After the doctor decides that the Living Will needs to be “acted upon”, it is his responsibility to convey to the guardian or close relative the medical condition, the availability of care and consequences of alternative forms of treatment and the consequences of remaining untreated. It is again up to to the doctor to ascertain that the relative or the guardian has understood the situation and come to the “firm view” that withdrawal of medical treatment is the “best choice.”

The physician or the hospital concerned has to then constitute a Medical Board consisting of the head of the treating department and at least three experts from the fields of general medicine, cardiology, neurology, nephrology, psychiatry or oncology with experience in critical care and a standing of 20 years in the profession. They will have to visit the patient and release a preliminary opinion on whether or not to withdraw treatment as per the Living Will.

In case the Medical Board decides not to follow a Living Will, it can apply to the District Collector concerned. In case it supports the Living Will, the doctor or the hospital has to “forthwith” inform the District Collector, who will also form a Medical Board with the Chief District Medical Officer as Chairman for endorsement of the decision.

They too shall visit the hospital and would have to endorse the endorse the Living Will. The Chairman of this Medical Board would then convey their decision to the jurisdictional JMFC before giving effect to the decision to withdraw the medical treatment. The Magistrate shall also visit the patient and finally authorise the implementation of the decision of the Board. The procedure is the same even for those who do not have a Living Will.

The court gives the treating doctor even a right to move the High Court, along with the dying person's relatives or guardian, in case the Medical Board revokes permission for passive euthanasia.

In such a case, the high court is free to form an independent committee of doctors to re-look the case and take a decision. Once the treatment is withdrawn, the Magistrate has to inform the high court.

The court also gives an individual the right to withdraw or alter his Living Will, but only in writing.

The court held that a Living Will shall not be applicable to the treatment in question if there are “reasonable grounds for believing that circumstances exist which the person making the directive did not anticipate at the time of the advance directive and which would have affected his decision had he anticipated them”.

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Printable version | Feb 24, 2020 1:54:51 PM |

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