NEW DELHI: The Supreme Court on Tuesday modified its 2018 order on passive euthanasia to make the procedure of removal of (or withholding) life support from terminally ill patients less cumbersome for the patients, their families and the doctors by limiting the role played by government officials. While the requirement of setting up two medical boards — one primary and other review — to examine the medical condition of the patient has been retained, the SC has done away with the rule mandating that the district collector set up the review board. The court said both boards will be constituted by the hospital and there would be one nominee doctor of the district medical officer in the review board. The medical boards must take a decision on such cases preferably within 48 hours, it added.
While the current rules state that the consent of the judicial magistrate is required for conducting passive euthanasia, the new order by a five-judge bench of justices K M Joseph, Ajay Rastogi, Aniruddha Bose, Hrishikesh Roy and C T Ravikumar says the magistrate just needs to be informed. While making the procedure for passive euthanasia less cumbersome, the Supreme Court on Tuesday also simplified the process of making a “living will”, an advance directive by a person wishing not to be put on artificial life support. While the earlier rule stipulated that a living will had to be made in the presence of two attesting witnesses and countersigned by the jurisdictional JMFC, the new order says such a will can be attested by notary or a gazetted rank officer. The process prescribed in2018 was onerous as it not only involved family members and doctors but also a judicial magistrate and collector as well as setting up of two medical boards before removal of life support systems and there was no prescribed time period for medical boards to give their opinion. As per 2018 guidelines, in the event a person became terminally ill with no hope of recovery, the treating physician had to ascertain the authenticity of the case from the JMFC. If the physician was satisfied, the hospital then constituted a medical board consisting of the head of the treating department and at least three expert doctors with 20 years of experience.
If the medical board certified that life support system could be removed, the hospital had to inform the collector who then had to constitute another medical board comprising the chief district medical officer and three expert doctors. If the review board allowed withdrawal of treatment, it had to convey the decision to the JMFC. The JMFC then had to visit the patient and, after examining all aspects, decide on whether the euthanasia directive could be implemented. Modifying the order, the bench said that medical practitioners with five year of experience can be part of the medical board. The court also agreed with the petition that there was no need to involve JMFC in the process of preparation of the living will. Times View: The new guidelines have been issued because the earlier guidelines were proving to be unworkable. It is good that the apex court has taken a relook on the subject. It is entirely possible that even these new guidelines may need to be revised in future. But the principle must be about making things easier for consent-givers without increasing the risk of misuse.