'Dying With Dignity': Karnataka Approves Passive Euthanasia, State Health Minister Calls Move 'Progressive'
Karnataka approved passive euthanasia, aligning with the Supreme Court's directive for terminally ill patients. State Health Minister Dinesh Gundu Rao highlighted the "relief for families".
Based on feedback from several medical professionals and experts in palliative care, where patients have no hope of recovery, the Karnataka government has taken a landmark decision to approve passive euthanasia. This is in line with the Supreme Court’s directive allowing terminally ill patients to die with dignity.
Progressive move in line with SC guidelines: DGR
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“This is a progressive move, one that needs to be seen with a fair lens," said Karnataka Health Minister Dinesh Gundu Rao. Speaking to News18, he said this would bring relief to patients and their families. He added that since it is now legal, families of those who are terminally ill with no hope of recovery, or those in a persistent vegetative state, will be able to think more clearly about what appropriate decision to take.
“We have been told by care specialists and courts how heartbreaking it is to see patients lying in a state where they cannot communicate, while their families struggle to make a decision, watching their loved one suffer deeply, with medical care unable to help. Families of such patients are often guilt-ridden as the end becomes more difficult for the patient, and they have no idea what to do," explained Rao. He added that where the patient no longer benefits from life-sustaining treatment, this move will ease the decision-making process.
The health minister said that many countries worldwide have adopted this practice, and with the Supreme Court’s direction, Karnataka has set the path for the right to die with dignity.
The Supreme Court ruled that withholding or withdrawing life-sustaining treatment (WLST) may be appropriate for terminally ill patients undergoing prolonged treatment with no hope of recovery and lacking decision-making capacity, provided it follows the prescribed procedure.
“No other state in India has given such a detailed framework on how to go about this process," added the minister.
What the order says
The order copy states: “Any neurologist, neurosurgeon, surgeon, anaesthetist, or intensivist who has been approved by the Appropriate Authority under subsection 6 of section 3 of The Transplantation of Human Organs and Tissues Act, 1994, read with Amendment Act 2011, to form part of the Board of Medical Experts for the certification of brain-stem death, shall be deemed to be nominated by the District Health Officer of the district as registered medical practitioners who may serve as a member of the Secondary Medical Board."
“The hospital where the patient is being treated must set up primary and secondary medical boards, comprising three registered medical practitioners each, such as a neurologist, neurosurgeon, surgeon, anaesthetist, or intensivist who has been approved by the appropriate authority (under the Transplantation of Human Organs and Tissues Act, 1994). The secondary medical board must also have a registered medical practitioner nominated by the District Health Officer. The primary and secondary medical boards will take decisions regarding withholding treatment after obtaining the consent of the patient’s next of kin or the person nominated in the patient’s Advance Medical Directive," the Health Department’s order said.
Further, copies of the two boards’ decisions must be submitted to the Judicial Magistrate of the First Class (JMFC) before being implemented. The JMFC will send copies to the Registrar of the High Court for record-keeping, the order added.
‘Living Will’ Also Introduced
The department also introduced an Advance Medical Directive (AMD), or a ‘living will,’ in which patients can record their preferred medical treatment in case they fall severely ill and are unable to make decisions about their treatment.
“Any adult patient of sound mind can execute an AMD and should send a copy of the AMD to a competent officer who will 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 kept by the medical establishment," the circular said.
The patient can nominate two individuals to make decisions on their behalf if they lack decision-making capacity. A separate circular on AMD stated that it would guide healthcare providers on the patient’s preferred treatments or those they wish to avoid.
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