Mr Varma
I am not your P A to present precision; you cannot afford to view the
youtube nor afford to read and digest because of inability then you have to
feel the consequences if so called for at any point of time in life So
wait for the serpent to become worm oneday and start OK? KR IRS 311025
On Fri, 31 Oct 2025 at 17:21, Surendra Varma <[email protected]> wrote:
> Sir,
>
> What is the essence of this long, serpentine post?
>
> Suren
>
> On Fri, Oct 31, 2025, 07:22 Rajaram Krishnamurthy <[email protected]>
> wrote:
>
>> A living will, formally known as an Advance Medical Directive, is a legal
>> document that allows individuals to specify their preferences for medical
>> treatment in situations where they may become incapacitated, vegetative
>> state, or unable to communicate their decisions. This directive ensures
>> that a person’s wishes regarding life-sustaining treatments are respected,
>> even when they cannot express them due to medical conditions. The concept
>> of a living will in India has evolved through a series of landmark judicial
>> pronouncements that have shaped the legal discourse on the right to die
>> with dignity as a fundamental right under Article 211 of the Constitution
>> of India2. This journey began with the judgment P. Rathinam v. Union of
>> India3, wherein the constitutional validity of Section 3094 of the Penal
>> Code, 18605 was challenged and the Supreme Court was pleased to struck down
>> Section 309 of the Penal Code, 1860 (IPC) which criminalised attempt to
>> suicide and hold that right to life under Article 21 of the Constitution of
>> India shall also include right to die as a fundamental right. This judgment
>> initiated legal discussions on personal autonomy and the right to end one’s
>> life in particular circumstances. However, in Gian Kaur v. State of
>> Punjab6, the Supreme Court overruled the judgment in P. Rathinam case7 and
>> upheld the validity of Section 3068 IPC, which penalises the abetment of
>> suicide, thereby distinguishing between passive euthanasia and assisted
>> suicide. This judgment left room for the possibility of passive euthanasia
>> while the Supreme Court affirmed that the right to life does not include
>> the right to die. A significant step forward came with Aruna Ramachandra
>> Shanbaug v. Union of India9, whereby the Supreme Court, permitted a woman
>> in a persistent vegetative state for decades, and recognised passive
>> euthanasia under strict medical and judicial guidelines after taking
>> approval from the High Court of Bombay. This judgment acknowledged that in
>> specific circumstances, withdrawing life-sustaining treatment could be
>> legally permissible. The most definitive ruling came in Common Cause v.
>> Union of India10, where a five-Judge Constitution Bench of the Supreme
>> Court of India held that the right to die with dignity is a fundamental
>> right under Article 21 of the Constitution of India. This judgment not only
>> legalised passive euthanasia but also laid down comprehensive guidelines
>> for executing living wills, ensuring that individuals could make advance
>> medical directives regarding their end-of-life care. Together, these cases
>> have contributed to a nuanced legal framework that balances personal
>> autonomy with ethical and medical considerations in end-of-life decisions.
>> In Common Cause v. Union of India (2018)11, the Supreme Court of India
>> outlined procedures, guidelines and a structured framework for the
>> execution of living wills to ensure that individuals could exercise their
>> right to die with dignity in a legally recognised manner. (a) Executor
>> requirements: The executor of a living will must be an adult of sound mind,
>> capable of making informed decisions about their medical care. (b)
>> Witnesses and authentication: To authenticate the living will, it should be
>> signed in the presence of two independent witnesses and further
>> countersigned by a Judicial Magistrate, First Class (JMFC) designated by
>> the District Judge. As per the Supreme Court’s guidelines, the witnesses
>> and the JMFC must record their satisfaction that the document has been
>> executed voluntarily, without any coercion, inducement or compulsion.
>> Further, they must also ensure that the executor possesses a clear
>> understanding of all relevant medical and legal consequences before signing
>> the living will. This safeguard is crucial in preventing misuse or undue
>> influence, thereby upholding the integrity of the individual’s autonomy in
>> making end-of-life decisions. (c) Preservation and distribution: The JMFC
>> is required to retain one copy of the document in their office, both in
>> physical and digital formats. Additionally, the JMFC must forward another
>> copy to the Registry of the District Court concerned, where it will also be
>> maintained in both formats for record-keeping. To ensure that the
>> executor’s family is informed, the JMFC must notify the immediate family
>> members if they were not present at the time of execution, making them
>> aware of the document’s existence and implications. Furthermore, a copy of
>> the living will must be handed over to a designated Competent Officer of
>> the local Government, whether it be the Municipal Corporation, Municipality
>> or Panchayat, ensuring that an official custodian is responsible for
>> maintaining the document. Lastly, if the executor has a family physician,
>> the JMFC must also provide them with a copy. (d) Medical Board Evaluation:
>> In the event that the executor becomes terminally ill or enters a
>> vegetative state, the treating physician must inform a Medical Board, which
>> will assess the patient’s condition and determine whether to honour the
>> living will. Implementation of a living will A living will comes into
>> effect when the executor becomes terminally ill and is undergoing prolonged
>> medical treatment with no hope of recovery. Once the treating physician is
>> informed of the living will, they must verify its authenticity with the
>> jurisdictional JMFC before proceeding. The physician must give due
>> consideration to the document but can only act upon it after confirming
>> that the executor’s condition is incurable and that they are dependent on
>> life support or prolonged treatment. If the physician determines that the
>> instructions should be followed, they must inform the executor (if
>> conscious) or their guardian/close relative about the nature of the
>> illness, available treatments and possible outcomes. The hospital must
>> constitute a Medical Board comprising the Head of the Treating Department
>> and at least three senior medical experts. This Board will assess the
>> patient’s condition and issue a preliminary opinion. If the hospital’s
>> Medical Board certifies that the living will should be implemented, the
>> jurisdictional Collector must be notified. The Collector will then form a
>> second Medical Board, chaired by the Chief District Medical Officer and
>> three independent senior doctors, to review the case. If this Board concurs
>> with the hospital’s findings, they will endorse the decision. Before
>> implementing the living will, the second Medical Board must confirm the
>> wishes of the executor if they are capable of communicating. If the
>> executor is unable to decide, the consent of their nominated guardian must
>> be obtained, ensuring adherence to the Advance Directive’s instructions.
>> Finally, the Chief District Medical Officer must convey the Board’s
>> decision to the jurisdictional JMFC, who will visit the patient, review all
>> aspects, and countersign the withdrawal of medical treatment. Importantly,
>> the executor retains the right to revoke the living will at any time before
>> its implementation. However, recognising that these procedures were complex
>> and difficult to implement, the Supreme Court revisited its earlier
>> guidelines in January 2023 to simplify the process. Under the revised
>> framework, the requirement for countersignature by a JMFC was removed, and
>> instead, the living will could be attested by two witnesses along with a
>> notary or a gazetted officer, making the procedure more accessible.
>> Furthermore, to expedite decision-making, the Court mandated that the
>> Medical Board must reach and communicate its decision within 48 hours of
>> the case being referred to them whether to allow withholding or withdrawing
>> life support. The necessity for approval from a Judicial Magistrate has
>> been removed and simplified the procedure for withholding or withdrawing
>> life support. In cases where the executor becomes terminally ill or
>> undergoing prolonged medical treatment with no hope of recovery, and lacks
>> decision-making capacity, the treating physician must take necessary steps
>> to verify the authenticity of the Advance Directive of the living will
>> before acting upon it. Upon being informed of the living will’s existence,
>> the physician must cross-check its genuineness by referring to the
>> patient’s existing digital health records, if available. If such records
>> are not accessible, then the physician must obtain confirmation from the
>> designated custodian named in the living will. Despite the legal
>> recognition of living wills in India, their implementation continues to
>> face several challenges. One of the primary obstacles is the lack of public
>> awareness, as many individuals remain unfamiliar with the concept and the
>> legal provisions governing living wills. This limited awareness has
>> resulted in the underutilisation of living wills, preventing them from
>> becoming a widely accepted tool for end-of-life decision-making.
>> Additionally, cultural sensitivities play a significant role in shaping
>> societal attitudes toward death. In a country where familial
>> decision-making is deeply valued, discussions surrounding living wills are
>> often met with reluctance, making it difficult for individuals to assert
>> their right to refuse life-sustaining treatment in advance. Administrative
>> inefficiencies further complicate the process, with bureaucratic delays
>> hindering the effective execution of living wills. A notable example
>> occurred in June 2024, when the Bombay High Court criticised the
>> Maharashtra Government for its sluggish implementation of the Supreme
>> Court’s directives on the matter. In a progressive move, Justice M.S. Sonak
>> of the Bombay High Court became the first person in Goa to register a
>> living will, setting a precedent for others to follow. While these
>> challenges persist, such developments indicate a gradual shift towards
>> greater acceptance and recognition of living wills in Indian society. To
>> ensure that individuals can effectively exercise this right, increased
>> public awareness and administrative efficiency are essential. By
>> streamlining procedures and fostering informed discussions, society can
>> move closer to a legal and social environment where living wills are both
>> accessible and respected. *Advocate, Supreme Court of India. Author can be
>> reached at: [email protected]. 1. Constitution of India, Art.
>> 21. 2. Constitution of India. 3. (1994) 3 SCC 394. 4. Penal Code, 1860, S.
>> 309. 5. Penal Code, 1860. 6. (1996) 2 SCC 648. 7. (1994) 3 SCC 394. 8.
>> Penal Code, 1860, S. 306. 9. (2011) 4 SCC 454. 10. (2018) 5 SCC 1. 11.
>> Common Cause v. Union of India, (2018) 5 SCC 1....
>>
>> K Rajaram IRS 311025
>>
>> On Fri, 31 Oct 2025 at 14:34, Surendra Varma <[email protected]>
>> wrote:
>>
>>> I too would llke to read a transcript. I had difficulty understanding
>>> their English.
>>>
>>> This reminded me of an incident in the White House. An Indian journalist
>>> once asked a question to Trump. Trump said:
>>>
>>> "Sorry, I did not understand what you said. Here we use English to
>>> communicate".
>>>
>>> Suren
>>>
>>> On Fri, Oct 31, 2025, 01:47 R V Rao <[email protected]> wrote:
>>>
>>>> I am giving my response after listening to the speakers on Living will
>>>> etc
>>>> While I appreciate the views expressed by both, I am of the view that
>>>> it was not clear. Hence a transcript of both speakers would be helpful.
>>>> Is it possible through the technology in our mobiles
>>>> Basics are understood
>>>> Thanks for sharing
>>>> .
>>>>
>>>> On Fri, 31 Oct, 2025, 9:13 am Padmanabha Vyasamoorthy, <
>>>> [email protected]> wrote:
>>>>
>>>>> Don't miss this recording of *Webinar - Living Will - A Medical and
>>>>> Legal Overview*
>>>>>
>>>>>
>>>>> Centre for Lifelong Learning, Tata Institute of Social Sciences in
>>>>> association JAC (Joint Action Committee of Senior Citizen Organisation)
>>>>> with Silver Innings and Happy2Age had organised a webinar on 26th July
>>>>> 2025
>>>>> for Senior Citizens, 50 Plus and Family members.
>>>>>
>>>>> Expert Resource person were Advocate Joby Matthew and Dr. Rekha
>>>>> Bhaktkande and moderator by Dr. Saigita Chitturu, Assistant Professor &
>>>>> Programme Coordinator of TISS CLL.
>>>>>
>>>>> https://youtu.be/L8qYr4nqsYk?si=59zP96lad47ONbj5
>>>>>
>>>>>
>>>>> *Please do share* this to all Seniors, your family and friends to take
>>>>> advantage of this excellent information.
>>>>>
>>>>> Dr P Vyasamoorthy / 9490804278
>>>>>
>>>>> --
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>>>>> an email to [email protected].
>>>>> To view this discussion, visit
>>>>> https://groups.google.com/d/msgid/society4servingseniors/CANDiLvfoPh%3DtaZR43v_o-70%2B07hfh2pE1uw%2BgUrxZ-ztwE%3DPOA%40mail.gmail.com
>>>>> <https://groups.google.com/d/msgid/society4servingseniors/CANDiLvfoPh%3DtaZR43v_o-70%2B07hfh2pE1uw%2BgUrxZ-ztwE%3DPOA%40mail.gmail.com?utm_medium=email&utm_source=footer>
>>>>> .
>>>>>
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>>>> To view this discussion, visit
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>>>> <https://groups.google.com/d/msgid/society4servingseniors/CAPVuisXe-cEZJsRYMpkXjqxWUXB0noX2dTPH8ppTPmPONhizVw%40mail.gmail.com?utm_medium=email&utm_source=footer>
>>>> .
>>>>
>>> --
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>>> To view this discussion, visit
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>>> <https://groups.google.com/d/msgid/society4servingseniors/CACgBxSpGUpX2Nano4hitce44nhNC3UJMhQ09XsgWftvnPOqzZw%40mail.gmail.com?utm_medium=email&utm_source=footer>
>>> .
>>>
>>
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