Karnataka High Court Issues Notice On Plea Seeking Implementation Of SC's Modified Guidelines On Advance Medical Directives, Living Wills

The Karnataka High Court on Wednesday issued notice to the State government on a petition filed seeking enforcement of direction issued by the Supreme Court in its modified judgment in the case of Common Cause (a registered society) V Union of India and another, in regards to advance medical directives, or living wills.

A division bench of Chief Justice N V Anjaria and Justice K V Aravind issued notice on the public interest litigation filed by one Advocate Shiv Kumar. The court said, “Notice returnable on October 29, respondents shall take instruction on the matter.”

The petition had sought a direction to the respondents to forthwith appoint a competent officer of the local government or the municipal corporation or municipality or panchayat, as the case may be. Further, direct the respondents to ensure that the appointed competent officer/custodian is vested with the authority and responsibility to collect, maintain, and preserve copies of advanced medical directives.

Also direct the respondents to formulate and implement necessary rules, regulations, or guidelines to facilitate the effective functioning of the appointed competent officer/custodian in discharging their duties with respect to advanced medical directives, as envisaged by the Supreme Court.

The Supreme Court had in January 2023 modified the directions issued by it in 2018, acknowledging that its earlier order resulted in 'insurmountable' obstacles that prevented the directions from being implemented.

The modified guidelines prescribe that more than one guardian or close relative can be named in the document, all of whom have to be informed of the nature of the illness, the availability of medical care, the consequences of alternative forms of treatment, and the consequences of remaining untreated by the treating physician at the time of the execution of the directive.

Before a final opinion was formulated by the secondary medical board, and if the executor was incapacitated, the consent of all the nominees would be taken, it was proscribed.

It was further added that the executor has to hand over a copy of the advance directive to the designated decision maker(s) and the family physician, if any. A copy shall be handed over to the competent officer of the local Government or the Municipal Corporation or Municipality or Panchayat, as the case may be. The aforesaid authorities shall nominate a competent official in that regard who shall be the custodian of the said document. The executor may also choose to incorporate their Advance Directive as a part of the digital health records, if any.

Advance directives are legal documents that extend a person's autonomy and control over their healthcare decisions in the event they become incapacitated. These directives enable individuals to communicate preferences regarding medical treatment, end-of-life care and other aspects of care, as well as designate a surrogate decision-maker ahead of time, before being incapacitated.

In simpler terms, an advance directive ensures that the wishes of the executor are honoured, even when they are incapable of making a decision or their decision-making capacity is severely impaired.

Case Title: Shiv Kumar AND State of Karnataka & Others

Case No: WP 22674/2024