You Can Choose To Die With Dignity

Dying with dignity, even when we are physically or mentally not in a position to communicate our wish to our near and dear ones, is an option that many senior people like me will eagerly look forward to, irrespective of our faith or belief system. Now you can choose to do that since the right to die with dignity is considered as a fundamental human right as per a landmark judgement passed by Supreme Court of India in March 2018. 

Individuals can make use of this law by creating a legal document called a Living Will, which empowers people to express their desire, in advance, on how they want to spend the last days of their life. It is essentially a document that sets out a patient’s wishes regarding how they want to be treated if they are seriously ill. A living will is one form of Advance Directive to the healthcare provider, leaving instructions for treatment. 

Why The Living Will

We have often felt helpless and disgusted when hospitals put terminally ill people in ICUs and on ventilators to prolong their life. They load the whole body with drugs, needles, and tubes. If you are unable to breathe, an opening is created at the front of the neck for a tube to be inserted into the windpipe to enable breathing. If you are unable to take food then a tube is inserted into the nose and liquid food is supplied through it to feed the person. 

As per medical science, giving food and fluids by artificial means (intravenously) does not usually prolong life or improve its quality. Most dying people do not experience thirst or hunger as death approaches. Decreasing food and fluid intake is a common, natural part of the dying process. As the end of life nears, the body gradually loses its ability to digest and process foods and liquids. As organs and bodily functions shut down, minimal amounts of nutrition or hydration might be needed, if at all.

Some people die unexpectedly in seconds while others decline slowly over time feeling immense pain for hours and days. Whether you die at home or in a hospital, human life should get the dignity it deserves.

How To Prepare One 

There are detailed procedures to write and execute a Living Will. The requirements for drawing up a Living Will and the elements that must be a part of it are provided below:

• The person drawing up the ‘living will’ must be an adult, who is of sound mind and is capable of communicating his/her decision clearly.
  
  
•  This is a voluntary process and the ‘living will’ cannot be obtained under duress or coercion.
  
  
• The ‘living will’ must be in writing and the contents of it must clearly state that treatment may be withdrawn.
  
  
• A declaration stating that the person drawing up the ‘living will’ has understood the consequences of executing the will must be mentioned.
  
  
• The ability to revoke any instructions made in the ‘living will’ must also be mentioned clearly.
  
  
• The name of a guardian or relative authorized to decide on behalf of the patient in adverse situations must also be clearly mentioned.
  
  
• The ‘living will’ must be signed by the person making it in the presence of two witnesses, countersigned by a jurisdictional judicial magistrate first class.
  
  
• The witnesses and the judicial magistrate must record their satisfaction that the document has been drawn up and executed voluntarily without any coercion.
  
  
• One copy of the ‘living will’ shall be preserved in the office of the judicial magistrate, and one copy shall be forwarded to the registry of the district court.
  
  
• The onus of informing the immediate family members of this ‘living will’ be on the judicial magistrate.
  
  
• One copy also must be handed over to the municipal corporation for their record.
  
  
• One copy of the directive must be handed over to the family physician.
  
  

Link With ABDM

Ayushman Bharat Digital Mission (ABDM) provides the digital health infrastructure of the country. It provides for each citizen a Health ID called ABHA (Ayushman Bharat Health Account) Number, a 14 digit number, used to standardize the process of identification of an individual across healthcare providers. You can generate your ABHA Number from the National Digital Health Mission website using your Aadhaar number or Driving License number.

Presently, the preparation of a Living Will is a rather complicated process and so many parties are also involved in its administration. In my opinion, the Living Will should be made an integral part of one's digital health records of National Digital Health Mission. This will help in simplifying the procedure of creating and maintaining the Living Will by linking it to the person's Aadhaar. Finally, the Living Will should be made available as a valid digital document on the Digi-locker platform.  This will allow all concerned parties to download it from a central repository in case of an emergency.