Karnataka Approves Passive Euthanasia, Grants Terminally Ill Patients Right To 'Die With Dignity'

Following consultations with numerous medical professionals and palliative care specialists, the Karnataka government has made a landmark decision to permit passive euthanasia.

This aligns with the Supreme Court's directive, which upholds the right of terminally ill patients to die with dignity.

"This is a progressive move, one that needs to be seen with a fair lens," stated Karnataka Health Minister Dinesh Gundu Rao. Speaking to News18, he explained that the decision would provide relief to both patients and their families.

He further emphasised that, now that it is legally recognised, families of those who are terminally ill, with no hope of recovery, or in a persistent vegetative state, will be able to consider their options more clearly.

"We have been informed by care specialists and the courts how heartbreaking it is to witness patients in a state where they cannot communicate, while their families struggle with the difficult decision of seeing their loved ones suffer, with no medical intervention offering relief. Families of such patients are often overcome with guilt as their condition deteriorates, unsure of what to do," Rao explained.

He added that when a patient no longer benefits from life-sustaining treatment, this legislation will simplify the decision-making process.

The health minister noted that several countries have already adopted this practice, and, with the Supreme Court's guidance, Karnataka has taken the lead in recognising 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 who have undergone prolonged treatment without hope of recovery and who lack decision-making capacity, provided the procedure follows the prescribed legal framework.

"No other state in India has provided such a detailed framework on how to go about this process," the minister added.

What the Order States

The order specifies: "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 directive further states: "The hospital where the patient is being treated must establish primary and secondary medical boards, each comprising three registered medical practitioners, 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 include a registered medical practitioner nominated by the District Health Officer. The primary and secondary medical boards will make decisions regarding the withdrawal of treatment after obtaining consent from the patient's next of kin or the individual nominated in the patient's Advance Medical Directive."

Additionally, copies of the decisions made by the two boards must be submitted to the Judicial Magistrate of the First Class (JMFC) before implementation. The JMFC will then forward copies to the Registrar of the High Court for official records, the order further states.

'Living Will' Also Introduced

The department has also introduced an Advance Medical Directive (AMD), commonly known as a 'living will,' which allows patients to document their preferred medical treatment in case they become critically ill and are unable to make decisions regarding their care.

"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 or digital health records of the patient, which are held by the medical establishment," the circular states.

The patient can also nominate two individuals to make decisions on their behalf should they lose decision-making capacity.

A separate circular on AMD specifies that it will serve as a guideline for healthcare providers, ensuring that the patient's treatment preferences are upheld.