Karnataka issues circular to facilitate ‘right to die with dignity’ based on 2023 Supreme Court order
The health department circular has directed the setting up of medical boards in hospitals across Karnataka to look at requests by patients’ relatives for Withdrawal of Life-Sustaining Therapy.
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A post on X, Health and Family Welfare Minister Dinesh Gundu Rao said the Department is seriously taking into account the 18 cases of cardiac arrest reported in Hassan district over the past month. The Karnataka Government has issued an order directing to set up medical boards in the state’s hospitals to facilitate requests for dignified deaths. The move is based on a Supreme Court ruling of 2023 which stated that the Right to Life under Article 21 of the Constitution encompasses the right to die with dignity.
State Health Minister Dinesh Gundu Rao announced Friday that the department has issued “a historic order” to implement the Supreme Court’s directive. “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 said.
A health department circular dated January 30, 2025, has directed the setting up of primary and secondary medical boards in hospitals to look at requests by the nearest relatives of patients for Withdrawal of Life-Sustaining Therapy (WLST) based on living wills.
“We have also come out with an Advance Medical Directive (AMD), or a living will, in which a patient can record their wishes about their medical treatment in the future. This important step will bring great relief and a dignified sense of closure to many families and individuals,” the minister said.
The circular is based on the Supreme Court order of January 24, 2023, in a miscellaneous application linked to a special leave petition filed in 2005 by the NGO Common Cause on the subject of WLST in hospitals.
“The Hon’ble Supreme Court has held that if a patient is terminally ill and is undergoing prolonged medical treatment with no hope of recovery and cure of the ailment, and does not have decision-making capacity, then WLST may be appropriate, in accordance with the prescribed procedure,” says the circular.
According to the procedure laid down by the apex court for WLST, the first step involves approval by the treating doctor for the implementation of advanced medical directives or the living will of the patient. Following this, the request from the patient’s family must pass muster with two medical boards in the hospital.
“The hospital where the patient is being treated must also set up the Primary and Secondary Medical Boards, comprising three registered medical practitioners each. The Secondary Medical Board must also have a registered medical practitioner nominated by the District Health Officer,” says the circular.
“The Primary and Secondary Medical Boards will take decisions regarding WLST, after obtaining the consent of the patient’s next of kin or the person nominated in the patient’s advance medical directive. Copies of the decisions of the Boards regarding WLST are to be submitted to the Judicial Magistrate of the First Class (JMFC) before giving effect to them, and the JMFC will send copies to the Registrar of the High Court for record-keeping,” the government circular states.
The advanced medical directive (AMD) format issued by the Karnataka government requires the patient to nominate at least two people “to take healthcare decisions on their behalf in case the patient has lost their decision-making capacity”.
“Any adult person of sound mind can execute an AMD and should send a copy of the AMD to a competent officer who is to be appointed for this purpose by the local government. AMDs can also be maintained in the paper/digital health records of the patient which are maintained by the Medical Establishment,” the circular states.
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