Living Will in India: How Seniors Can Document Their Medical Preferences Legally

What Is a Living Will?

A living will — also known as an advance directive or advance medical directive — is a legal document in which a person records their wishes regarding medical treatment in circumstances where they are unable to communicate those wishes due to illness, incapacity, or unconsciousness. It is distinct from a testamentary will, which deals with property distribution after death. A living will deals with medical decisions during life.

Legal Status in India: The Supreme Court Ruling

The Supreme Court of India, in the landmark judgment Common Cause v. Union of India (2018) 5 SCC 1, unanimously recognised the legal validity of advance directives and living wills in India. The court held that the right to die with dignity is a fundamental right under Article 21 of the Constitution, and that a person has the right to refuse medical treatment, including life-sustaining treatment, in advance.

The court also laid down detailed guidelines for the execution and implementation of advance directives, which have since been modified in subsequent orders to make the process more accessible.

What a Living Will Can Cover

• Refusal of specific medical interventions such as mechanical ventilation, resuscitation (CPR), tube feeding, or dialysis in defined circumstances
• Consent to palliative care and comfort measures even where curative treatment is declined
• Designation of a healthcare proxy — a person authorised to make medical decisions on behalf of the patient when the patient cannot
• Specific instructions about organ donation
• Preferences regarding place of care (home, hospital, hospice)

How to Execute a Valid Living Will in India

Following the Supreme Court's guidelines (as updated), the process for executing a valid living will involves:

• The document must be signed by the executor in the presence of two witnesses
• It must be attested before a Notary Public or a Gazetted Officer
• A copy must be provided to the executor's physician, the Judicial Magistrate of First Class of the relevant area, and the family physician
• A copy should be preserved with the executor's family
• The healthcare proxy named in the document should be someone who understands and accepts the responsibility

What a Living Will Does Not Cover

A living will does not authorise anyone to take actions contrary to Indian law. It cannot instruct active euthanasia, which remains illegal. It operates within the framework of passive euthanasia and the withdrawal of futile treatment — which the Supreme Court has recognised as lawful under defined conditions.

How Varasa Can Help

Varasa assists seniors and their families in preparing advance medical directives with appropriate sensitivity, ensuring the document is correctly executed, properly filed with the relevant authorities, and understood by both the family and the designated healthcare proxy.