Concept of advanced medical directives in the Indian scenario

The right to physical integrity and self-determination are the basic fundamental rights in most countries. In cases of terminal disease, a person's decision to employ or refuse a life-sustaining treatment should be respected. Everybody has a right to decide the kind of treatment and its manner in advance if they are incapacitated to make an informed decision regarding the treatment choices. An individual can execute such decisions as an extension of patient autonomy. Supreme Court of India has, in one of its judgments, given specific directives known as advanced directives and has also laid down certain guiding principles relating to the execution of advance directives or 'living will'. It has spelt out guidelines along with safeguards to this effect. Proper execution and implementation of Advanced directives sometimes prevent unnecessary prolongation of life and deterioration in the quality of life and often reduce expanses of life-sustaining treatments for the relatives. Also, compelling the continuation of treatment, irrespective of the patient's condition, invariably puts financial stress on the executor's family. On the other hand, well-designed legislation on advance directives can prove to be beneficial for all. This paper discusses various types of Advanced Directives, who can issue them, the mode of preservation of Advanced directives, their pros and cons, and the legal implications of these directives.

Keywords: Supreme Court; incapacitation; living will; advanced directives; informed consent; autonomy.