Maharashtra Launches Digital Portal for Living Wills, a National First
In a landmark move, Maharashtra has become the first state in India to establish a digitized registry for living wills, two years after the initial appointment of custodians in 2024. A Government Resolution (GR) issued on Tuesday announced the integration of a dedicated portal into the mahaulb.in website, enabling urban residents across all municipal corporations and nagar panchayats to permanently store their living wills online.
Understanding Living Wills and Legal Framework
A living will is a critical legal document that allows individuals to outline their medical treatment preferences in advance, particularly regarding the refusal of artificial life-sustaining measures if they become incapacitated. This document serves as a form of passive euthanasia through an "advance directive". According to the GR, any person aged 18 or older can create a living will, requiring signatures from two witnesses and a notary for validation.
The Urban Development Department's resolution aligns with Supreme Court guidelines, designating municipal commissioners and chief officers of municipal councils and nagar panchayats as custodians of these wills. Initially, the state appointed 417 custodians across these institutions, and these appointments are now undergoing a revalidation process to ensure compliance and efficiency.
Challenges and Advocacy for Further Reforms
Dr. Nikhil Datar, a Mumbai-based gynaecologist who filed a public interest litigation to push for the implementation of Supreme Court guidelines, commented on the development, stating, "One mad person can still make some changes in the system." However, he emphasized that significant hurdles remain.
While the state health department has established primary and secondary medical boards at the district level to oversee cases involving living wills, Dr. Datar argues for greater decentralisation. He advocates for every hospital in Maharashtra to have its own primary and secondary boards to streamline decision-making and accessibility. The next crucial step, according to Dr. Datar, is for the public health department to issue directives for establishing these boards at the hospital level.
Additionally, Dr. Datar highlighted the need for the Rural Development Department to release a similar GR to appoint custodians at the gram panchayat level, ensuring rural residents have equal access to the living will registry. He warned that if there are severe delays on both fronts—board establishment and rural implementation—he may have to approach the court again to seek further action.
Implications and Future Outlook
This initiative marks a significant advancement in healthcare and legal rights in India, providing a structured, digital framework for individuals to exercise control over their end-of-life decisions. By digitizing records, Maharashtra aims to enhance transparency, reduce paperwork, and ensure that living wills are securely preserved and easily accessible when needed.
The move is expected to set a precedent for other states to follow, potentially leading to nationwide adoption of similar systems. As the state continues to refine its processes, stakeholders like Dr. Datar will play a key role in advocating for broader reforms to make the system more inclusive and efficient for all citizens, both urban and rural.
