Euthanasia – Andhra Pradesh Sets Framework for Passive Euthanasia Procedures
Euthanasia – The Andhra Pradesh government has approved a formal framework for passive euthanasia, creating a regulated process for withdrawing or withholding life-sustaining treatment in cases where a terminally ill patient has no reasonable prospect of recovery.
Health Minister Y. Satya Kumar Yadav approved the guidelines on Wednesday, bringing the State’s procedures in line with directions issued by the Supreme Court on the right to die with dignity. The rules are intended to guide hospitals, doctors and families through decisions involving patients who are dependent on life support and are unlikely to regain meaningful health.
Guidelines Based on Supreme Court Directions
The State’s decision follows the Supreme Court’s rulings on passive euthanasia, including the 2018 judgment in the Common Cause case. In that ruling, the court held that the right to die with dignity forms part of the fundamental right to life under Article 21 of the Constitution.
The Supreme Court later revised certain procedural requirements in January 2023 to make the process more practical for medical institutions and families. The updated directions sought to reduce delays and uncertainty in cases involving withdrawal of life support, while retaining safeguards against misuse.
According to the Andhra Pradesh government, the new guidelines aim to ensure that decisions are taken only after detailed medical assessment, documented consent and independent review.
Health Officials Assigned Oversight Role
The Director of Medical Education, the Director of Secondary Health and District Medical and Health Officers will oversee implementation of the procedures across the State.
The Health Minister has instructed senior health officials to closely monitor every stage of the process. The government said the framework is designed to protect patients’ rights while also offering legal clarity to family members and medical professionals involved in difficult end-of-life decisions.
Hospitals will be required to maintain detailed records and follow the prescribed sequence of medical and legal steps before any life-support system is withdrawn.
Living Wills to Guide Future Medical Decisions
Under the guidelines, an adult who is mentally capable and acting voluntarily can prepare an Advance Directive, commonly known as a living will. The document can state the person’s wishes regarding medical treatment if they later become unable to communicate or make decisions.
The Advance Directive must be signed in the presence of two witnesses and counter-attested by either a notary or a gazetted officer. It can also name a guardian or surrogate who will represent the patient if the person becomes incapacitated.
If a treating doctor believes that further treatment is medically futile, the doctor must review the living will, inform the nominated guardian about the patient’s condition and record a recommendation on whether treatment should continue.
Two Medical Boards Required Before Withdrawal
A hospital must establish a Primary Medical Board when a passive euthanasia request is considered. The board will include the treating doctor and two independent medical experts with at least five years of professional experience.
The Primary Medical Board must examine the patient and provide its opinion within 48 hours. If it concludes that continued treatment is futile, the hospital must then form a Secondary Medical Board.
The second board will include the treating doctor, the regional District Medical and Health Officer and two medical specialists who have no connection with the patient’s treatment. This panel will independently review the case before a final decision is made.
Judicial Process and Family Rights
Before life support is withdrawn, the hospital must obtain consent from the patient’s nominated guardian. The findings of both medical boards must then be communicated to a First Class Judicial Magistrate.
If the Secondary Medical Board does not approve withdrawal of life support, the guardian can approach the High Court. The court may appoint an independent panel of senior specialists with more than 20 years of experience to examine the case and issue a final decision.
For patients without a living will, the treating doctor may still initiate the process. In such cases, immediate family members must be informed about the prognosis and provide written consent before the matter is referred to the Secondary Medical Board.
After life support is withdrawn, the Judicial Magistrate must notify the High Court. Hospitals must preserve all medical records, board opinions and related documents for at least three years.