End-of-life care presents complex challenges that span medical judgment, ethical responsibility, and legal accountability. Recent jurisprudence in India particularly the Supreme Court rulings in 2018 and 2023 has clarified the legal status of advance directives , including living wills and Do Not Resuscitate (DNR) orders, providing essential guidance for intensivists and treating teams in critical care settings. A legally valid advanced directive enables a competent adult to outline their preferences regarding the continuation or withdrawal of life-sustaining treatment, in scenarios of irreversible illness or permanent incapacity.
The updated 2023 framework streamlines the process: such directives must be signed before two witnesses and countersigned by a Judicial Magistrate of First Class (JMFC) . Implementation now requires a two-tier approval system first by the hospital medical…
