Karnataka's Implementation of Supreme Court Directive on End-of-Life Decisions

In a historic move, the Karnataka Health Department implemented the Supreme Court's ruling, allowing terminally ill patients to die with dignity. This makes Karnataka the second state after Kerala to execute this directive.

Supreme Court Ruling

• On January 24, 2023, the Supreme Court declared that the right to life under Article 21 of the Constitution includes the right to die with dignity.
• The court ruled that life-sustaining treatment might be withheld or withdrawn for terminally ill patients with no hope of recovery or those in a persistent vegetative state.

Implementation Process

The Karnataka Health Department outlined specific procedures to follow the Supreme Court's directive:

• Hospitals must establish primary and secondary medical boards, each with three registered medical practitioners, including specialists like neurologists and anaesthetists.
• The secondary medical board must include a practitioner nominated by the District Health Officer.
• Decisions to withhold treatment require consent from the patient's next of kin or the person nominated in the patient's advance medical directive.
• These decisions must be submitted to the Judicial Magistrate of the First Class (JMFC) and recorded by the Registrar of the High Court.

Advance Medical Directive (AMD)

The department introduced an Advance Medical Directive or 'living will' where patients can specify their preferred medical treatment:

• Any adult of sound mind can create an AMD, indicating treatment preferences or refusals.
• Patients can nominate two individuals to decide on their behalf if they lose decision-making capacity.
• AMDs should be submitted to a designated local government officer and can be stored in the patient's medical records.

This initiative aims to bring relief and closure to families and uphold the dignity of terminally ill patients.