The new Supreme Court guidelines on Advance Directives are welcome


The Supreme Court of India revised the guidelines for putting in place an Advance Directive (AD) or a Living Will and executing it. The earlier process was extremely onerous and not a single person could actually get this done. The new process has removed the main impediments and made the process much simpler.

I had blogged about this just a few weeks back and pointed out how some NGOs were working to get the process simplified through Parliament. Thankfully, the Supreme Court acted and solved some of the problems.

One of the most important problems with the earlier process was that the AD had to be countersigned by the jurisdictional Judicial Magistrate of First Class (JMFC). What does that even mean? Do you know who the JMFC of your area of residence is? Where do they operate from? How do you reach out to them?

An AD is usually prepared by someone with a chronic condition who wants a death with dignity whenever the time comes. You think in that situation, they will have the energy and inclination to find out all this?

Thankfully, the new process only requires that the AD be signed by a Gazetted Officer or a notary. Both of these are much simpler to do.

The second major problem with the earlier process was that when the time came, before the AD could be acted upon, the process to ascertain the need for such action involved the constitution of two Medical Boards, the second of which was to be done by the District Collector! Then the JMFC had to be looped in. All this involved visits by the Boards and the JMFC to see the patient and there was no outer limit for the process to be concluded. Imagine the agony of the patient and the family.

The new process, while retaining the requirement of two Boards, has simplified the process by removing the involvement of the Collector, simplifying the constitution of the Boards and adding that the process should ideally be completed in 48 hours (not mandatory though). The last step still involves the JMFC.

While there still can be some more tweaks, it is at least a step in the right direction. Any such process needs to balance ease of use with misuse. We must understand that. Hopefully, over the years, some more changes will be made based on the experience accumulated and make the process simple and effective.

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