PANAJI
On Friday, Justice M S Sonak, of the Bombay High Court at Goa, became the first Goan to register a “living will” at the event organised by the Indian Medical Association's Goa branch, also making this tiny State the first in the country to put in operation the regime that permits registering such wills.
What then is a 'living will' and how does it help both patients and doctors?
According to the IMA, it is a legal document which can be executed by people whose health is declining or those with terminal diseases, by which they make a choice in advance to permit doctors take the decision to discontinue life support rather than continue to remain in vegetative state.
In effect the living will permits passive Euthanasia, a decision endorsed by the Supreme Court of India in 2018 when it issued the directive to governments to implement the advance medical directives (living will) and also issued guidelines.
On admission to a hospital patients who have executed a 'living will' or their family members must present it to the hospital authorities so doctors are aware and can take appropriate decision in the event their health worsens to a point where nothing more can be done medically.
In the case of Sonak registering his living will, the Registrar of Births and Deaths, Dinesh Shetty was one of the witnesses while IMA State president, Sandesh Chodkanar was the second witness. The will was also handed over to his family doctor Shekhar Salkar.
According to Salkar, for now these 'living wills' are physically handed over but efforts are on for these to be digitally available.
Currently the Deputy Collector (Sub-Divisional Magistrate) is the repository of these living wills. But in the near future the records of these wills could move to the digital mode and be available in the public domain.
Confirmed knowledge of the existence of a living will suffices for doctors to take a decision on behalf of patients to discontinue life support and let fate take its course.
"These usually will come in play with patients inflicted with terminal diseases like cancer or renal failure where no treatment can hope give the patient any quality of life," Salkar said.
However there is an elaborate procedure that doctors must ensure when taking decisions on the basis of a patient's living will.
"A panel of two other doctors from the same hospital and a second panel of doctors from outside the hospital must endorse the decision that the patient's condition is fit to invoke the living will and remove life support," Dr Salkar said.
As for patients and their families, it will help in terms of saving unnecessary expenditure on continuing life support when it is medically evident that there is no scope for betterment.
In Goa, the procedure to be followed for executing a living will involves the concerned person writing down their “wishes” and sign in the presence of two witnesses. The document has to then be attested either by a gazetted officer or by a notary public and it must then be deposited with the Deputy Collector's office who will then collect all these wills and keep them with the office of the designated Additional District Collectors.
