Karnataka Government Issues Circular Implementing Right to Die with Dignity

In line with the modified Supreme Court Judgment dated January 24, 2023, in Common Cause v. Union of India, (2018) 5 SCC 1 the Karnataka Government has issued a circular on January 30, 2025, to facilitate the right to die with dignity for terminally ill patients. While recognizing the right to life under Article 21, the guidelines govern the execution of advance medical directives (AMD) and withdrawal of life sustaining therapy (WLST).

WLST or passive euthanasia is deemed appropriate for a patient who is undergoing prolonged treatment with no hope of recovery or cure and no decision-making power or is in a persistent vegetative state with no benefit of medical treatment. However, a procedure has been laid down which includes approval from the treating doctor, consent of the patients next of kin and approval by Primary and Secondary Medical Boards. Boards are to be set up in the hospitals with three registered medical practitioners. Copies of the board’s decision must be sent to JMFC who will forward them to the Registrar of the High Court for record-keeping.

A living will or AMD can be made by a patient recording their wishes pertaining to their medical treatment in the future. It guides the healthcare professionals treating the patient on the kind of treatment the patient would have preferred. Two people are to be nominated to take healthcare decisions for when a patient loses decision making capacity. AMD can be executed by an adult of sound mind and a copy must be sent to a competent officer appointed for the purpose by the local government. It can also be maintained in the paper/digital health records of the patient by the hospital.

In Sep 2024, the ministry of health and family welfare had issued Draft Guidelines for Withdrawal Of Life Support In Terminally Ill Patients for stakeholder comments laying down four conditions for passive euthanasia taking into account the medical, ethical and legal concerns around it.