Everything you need to know about living wills

With PD Hinduja Hospital amp Medical Research Centre in Mahim launching a firstofitskind living will clinic to help patients retain control over future healthcare decisions midday spoke to Dr Nikhil Datar a renowned gynaecologist and health rights activist whose public interest litigation PIL in the Bombay High Court highlighted the Maharashtra governmentrsquos failure to implement February 2022 Supreme Court directives on living willsThe state government has to set up a web portal for living wills in the larger interest of the public good by August 16 the day when the four monthsrsquo time granted by the court comes to an end Meanwhile P D Hinduja Hospital amp Medical Research Centre in Mahim launched a firstofitskind living will clinic to help patients retain control over future healthcare decisionsThe flashbackOn April 17 2025 the high court in response to Dr Datarrsquos PIL ordered the state government to create a public web portal so as to ease out the process of living will The state was given a deadline until August 16 2025 to implement itDr Nikhil Datar gynaecologist and health rights activistDr Datar urged in his PIL that the state government be directed to implement Supreme Court guidelines on endoflife care which remained unaddressed The petition criticised the outdated medical code of ethics in terms of the current SC judgment which doesnrsquot permit withdrawal of life support otherwiseIn response within six weeks from the date of filing the PIL the state issued a GR appointing 413 officers as custodians for living wills mdash becoming the first in India to do so The petitioner also became the first to prepare and submit his own living will under the SC frameworkInitially only two custodians were assigned to Mumbai but later health officers were included in every municipal ward Despite this citizens struggled to access custodians or the system raising concerns about transparency and hence the directivesExcerpts from the interviewWhat is a living will or advance directiveIt is a legal document where a person states their wishes about medical treatment in case they become seriously ill or unconscious and cannot make decisions for themselves It guides doctors and family members on whether to continue or stop treatment especially if there is no hope of meaningful recovery This helps avoid confusion or disagreement and ensures the personrsquos wishes are respectedHow is a living will different from a will and testamentA will and testament outline how a personrsquos assets and property should be distributed after their death In contrast a living will provides instructions about a personrsquos medical care if they become incapacitated and unable to communicate their wishes It typically addresses situations such as whether to continue lifesustaining treatmentWhy would someone need a living willIn todayrsquos world where medical technology can sometimes prolong life artificially it can be difficult to know whether treatment is truly helping or simply delaying death This can lead to unnecessary suffering loss of dignity emotional distress for loved ones and high medical costsWho should have a living willIdeally every human being should have a living will regardless of age However it becomes especially important for middleaged and older adults including those who are retired Starting to think about and prepare a living will during middle age can ensure that your medical care preferences are known and respected well before any serious health issues arise for instance if Irsquom over 70 and have terminal illnesses like cancer or Alzheimerrsquos In such cases individuals can specify which treatments they want or refuse such as ventilators dialysis or feeding tubes If I have a living will I consent to feeding tubes and saline but refuse others I also requested pain relief measures and included organ donation details My draft is available at wwwdrnikhildatarcom for reference Since this is personal changes should be made as needed If conscious individuals decide for themselves but if unconscious who informs doctors about the advance directive Therefore the names of relatives or friends executors whorsquoll decide on the personrsquos behalf must be clearly stated and informed of their dutiesHow can I update or cancel my living willYou can update or cancel your living will by creating a new one which will cancel the previous one The state government after my PIL has appointed 413 custodians of the living will across Maharashtra In Mumbai they had initially appointed two BMC doctors but seeing the population of the city the government has decided to make each health official medical health officer in BMC ward offices a custodian The state government is still in the process of making the web portal which can be used for uploading and for verification of living wills when required by treating doctorsWho should have a copy of my living willThe person who creates the living will should keep the original Additionally copies should be given to close family members or executors mdash preferably someone younger or trusted by the maker This could include the family doctor or any individual appointed by the maker as the executor of the living will The chosen custodian should be reliable and able to verify the documentrsquos authenticity when requiredShould I carry a card or note indicating I have a living willAlthough the Supreme Court has not mentioned anything about such cards it is always a good idea to carry a medical card which mentions important details and whether a living will was made and the executors contact number Itrsquos important to clearly name the people authorised to act on your living will executors in the document Those people should know how to follow your advance directives If therersquos any confusion doctors will refer to the latest living will to decide which instructions to follow and hence the web portal is very important