Abstract

A Living Will, introduced by Luis Kutner in 1967, enables individuals to specify medical treatment preferences in case they lose decision-making capacity. Landmark cases, such as Karen Ann Quinlan in the U.S. and Aruna Shanbaug in India, significantly influenced legal frameworks on end-of-life decisions. Advanced Directives has gained momentum in hospital set-ups after the decision of the Courts of India in its favour in 2018. Evidence on its use is limited. Advance Directives, including Living Wills and Lasting Power of Attorney, safeguard patient autonomy in terminal care. Legal and medical frameworks, guided by ICMR regulations and Supreme Court rulings, ensure due process through physician validation and Medical Board reviews before execution. Courts may intervene in disputed cases. However, directives may be deemed inapplicable in situations involving potential recovery or ambiguity. Advance Directives play a crucial role in guiding medical decisions for patients in rreversible conditions such as coma, persistent vegetative state, severe brain injury, and advanced dementia.

• 1.   Susan J., Nnaovic, Living Will: Preservation of the Right to Die demands Clarity and Consistency, Dick L Rev 95(1990): 209-234, at pp. 211-212. Ishita Manral, Dipankar Ojha, et al. Curious Case of Living Will: Medicolegal Aspects of Advanced Directives in India. 40 Journal of Social Welfare and Management JSWM / Volume 17 Number 1 / January – April 2025
• 2.   Alexander Morgan Capron, “Advanced Directive” in a companion to Bioethics, Ed Helga Kuhse and Peter Singer, 2nd Ed (West Sussex: John Wiley and Sons, 2009, 299-3111, at p. 300.
• 3.   Supreme Court of India. Common Cause v Union of India (2018): SCC OnLine, SC, 208. [cited 2018 Mar 10] Available from: http://supremecourtofindia.nic. in/supremecourt/2005/9123/9123_2005_ Judgement_09-Mar-2018.pdf
• 4.   Yadav KN, Gabler NB, Cooney E., Kent S., Kim J., Herst N., et al. Approximately one in three US adults completes any type of advanced directive for end-of-life-care. Health Aff (Millwood). 2017; 36(7).
• 5.   Ratnam A., Rudra A., Chatterjee K. and Das R.C., 2015. Psychiatric Advance Directives in India: What will the future hold? Asian Journal of Psychiatry, 16, pp. 36-40.
• 6.   Philip S., Rangarajan S.K., Moirangthem S., Kumar C.N., Gowda M.R., Gowda G.S., Math S.B. Advance directives and nominated representatives: A critique. Indian Journal of psychotary. 2019 Apr; 61: S680.
• 7.   Kristina Stern, Advanced Directive, Medical Law Review 2 (1994): 57-76 at p. 57.
• 8.   Andoro, Biller Andoro and Brauer Advance Health Care Derivatives: Towards a Coordinated European Policy, 208.
• 9.   Dogra T.D., Rudra A. Lyon’s Medical Jurisprudence and Toxicology: The First Indian Book of Forensic Medicine and Toxicology,
• 10.   Indian Council of Medical Research. Definition of terms used in limitation of treatment and providing palliative care at the end of life. ICMR; 2018. Available from: http://www. ncdirindia.org/Download/EOLC.pdf, accessed on February 4, 2020.
• 11.   Salins N.S., Pai S.G., Vidyasagar M., Sobhana M. Ethics and medico legal aspects of “not for resuscitation”. Indian J Palliat Care 2010; 16: 66.