India’s Supreme Court has recognised a right to die with dignity and allowed people to record treatment preferences through Advance Medical Directives, commonly called living wills. Yet the documents remain uncommon: a 2019 survey across seven cities found that 73 percent of urban Indians were unaware of the right, while only 6 percent of those who knew about it had drafted one.
The gap affects families facing advanced cancer, traumatic brain injuries and degenerative neurological conditions. An estimated seven to 10 million people in India require palliative care, but only about 4 percent receive it, according to a 2025 analysis cited in the source material.
What India’s courts have decided
In 2018, the Supreme Court ruled that the right to die with dignity formed part of the fundamental right to life under Article 21 of the Indian Constitution. It allowed patients to document whether they wanted life-sustaining treatment withdrawn if they later lost the capacity to decide.
A living will can also name someone to make decisions on the patient’s behalf. The ruling followed a petition by Common Cause, an organisation that sought a legal process for terminally ill people to refuse life-prolonging treatment. The recognition exists through judicial interpretation; the source material says Parliament has not passed a law governing the issue.
Why the process is difficult to use
The Supreme Court initially required a living will to be signed before two witnesses and countersigned by a magistrate. If the patient later became terminally ill, a medical board appointed by the treating doctor and a second board formed by a district magistrate had to agree before treatment could be withdrawn. Disagreement could send the matter to a regional High Court.
In 2023, a five-judge Supreme Court bench simplified the process after the Indian Society for Critical Care Medicine challenged the earlier guidelines. The changes removed the magistrate’s countersignature, reduced the minimum experience required for reviewing doctors from 20 years to five and allowed people to name multiple nominees instead of one.
Access remains limited. The source material identifies two living-will clinics in India: one in Mumbai and another in New Delhi, both operated by private hospitals.
The legal right does not answer every family’s needs
Harish Rana’s case showed how difficult end-of-life decisions can become without a living will. Rana had remained in a vegetative state for nearly 13 years when his family sought court permission. On March 11, the Supreme Court directed that his life support be withdrawn at the All India Institute of Medical Sciences in New Delhi; he died two weeks later. The case was the first in India in which the top court permitted passive euthanasia, meaning the withdrawal of life support.
Rana’s family had managed his feeding tube, tracheostomy and urine bag for 13 years. His lawyer said the absence of a living will made the case more complex. The source material says experts do not expect the case alone to create an immediate precedent for families across India.
The practical problem begins even before a legal decision. At AIIMS, families of patients with advanced cancer described receiving little guidance about how to manage pain and care at home once treatment options ended. A palliative-care specialist said patients and doctors may lack full awareness of palliative care, leaving relatives to make decisions during grief and uncertainty. India recorded an estimated 1.56 million new cancer cases in 2024, according to an Indian Council of Medical Research study cited in the source material.
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