Bengaluru, Karnataka - The Karnataka government has taken a historic step, implementing the Right to Die with Dignity policy for terminally ill patients, as directed by the Supreme Court's ruling earlier this year. This landmark decision signifies the state’s commitment to prioritizing compassionate care and preventing prolonged suffering for those with incurable illnesses.
This policy, introduced under the guidance of Health Minister Dinesh Gundu Rao, allows patients with no hope of recovery, or those who are stuck in persistent vegetative states and receive no benefit from life-sustaining treatments, to opt for the withdrawal of such therapies. It marks Karnataka as the first state to formalize this process, according to local health officials.
The Supreme Court’s decision, issued on January 24, 2023, affirmed the fundamental right to die with dignity under Article 21 of the Indian Constitution, which guarantees the right to life. The Court held the view, recognizing the patient's autonomy even when faced with terminal illness. The Court’s ruling followed years of advocacy from organizations such as the NGO Common Cause, which filed the original petition back in 2005.
At the core of this policy is a structured process involving medical boards. These boards, comprising registered medical practitioners, will be established at hospitals across the state to assess requests for the Withdrawal of Life-Sustaining Therapy (WLST). The process requires both primary and secondary medical boards — each consisting of three doctors — to evaluate conditions before life support can be withdrawn.
Health Minister Rao emphasized the significance of this measure, stating, "This will immensely benefit those who are terminally ill with no hope of recovery, or are in a persistent vegetative state, and where the patient no longer benefits from life-sustaining treatment." He underscored the introduction of the Advance Medical Directive (AMD) or living will, where patients can outline their preferences for medical treatment well before it's needed, allowing for greater dignity and control at life’s end.
The mere creation of medical boards tasked with evaluating life-ending requests is not enough; each decision must also undergo judicial scrutiny. Once medical boards approve the request, the cases will be submitted for final approval to the Judicial Magistrate First Class, enhancing the legal safeguard for these sensitive decisions.
According to the directives released by the Karnataka government, the process is initiated upon the request of the family. This request is evaluated first by the primary medical board followed by the secondary board, to confirm the patient is truly without hope of recovery. Harsh Gupta, Principal Secretary of the Health and Family Welfare Department, explained the framework, detailing the necessity for approval by the treating physician prior to any actions being taken.
The advance directive format published by the Karnataka government outlines how adults of sound mind can designate individuals to make healthcare decisions on their behalf, should they lose decision-making capacity. This allows individuals to maintain some control over their medical care until the very end.
Healthcare professionals involved will include neurologists, neurosurgeons, surgeons, anesthetists, and intensivists, who will be charged with the determination of eligibility for the protocol. Following the appropriate reviews and the completion of all necessary legal steps, patients who choose to do so will have life support withdrawn under medical supervision, ensuring they can pass peacefully.
This initiative aligns with prevailing attitudes toward end-of-life care and reflects societal shifts favoring patient autonomy and dignity. Many advocates believe this will serve as a model for other states, potentially prompting national discourse on euthanasia, passive euthanasia, and the rights of patients unable to speak for themselves.
The introduction of such policies is not without its controversies, as discussions surrounding euthanasia often ignite passionate debate about morality, ethical responsibilities, and the role of state authorities. Nonetheless, the Karnataka government's move is portrayed as progressive, aiming to balance the rights of patients against ethical concerns surrounding end-of-life care.
Overall, this comprehensive approach to the Right to Die with Dignity not only aligns with judicial guidance but also strives to protect vulnerable patients from undue suffering, providing them and their families with clarity and relief as they face the most difficult decisions of their lives.
For the people of Karnataka, this policy could mark the beginning of more compassionate legal frameworks surrounding end-of-life care, drawing more states to possibly reconsider and implement similar measures. The government articulates its vision clearly: Karnataka is determined to place humane healthcare at the center of its medical practices.