Sunset Literacy: living wills
Living wills: your wishes about treatment, written down in advance
A living will, also called an advance medical directive, is a written record, made by an adult while they can still decide, of the circumstances in which medical treatment may be withheld or withdrawn. It is used only if they later become terminally ill, under prolonged treatment with no hope of recovery or cure, and unable to decide for themselves. Since 2023 it is signed before two witnesses and attested before a notary or Gazetted Officer, and two medical boards look at the case before it is acted on. It is not a will about property.
Whose situation this covers. Any adult in India thinking about their wishes for medical treatment, and families caring for someone who can no longer decide. These rules come from the Supreme Court and are not tied to any personal law. The judgments, orders and official notices on this page were read in the official texts on 21 October 2026. The one rule about wills comes from our note Making a valid will in India, read on India Code on 9 October 2026. Not medical or legal advice. This page explains a legal process in general. It is not medical advice, and not legal advice about your situation. For medical questions, talk to your doctors. Waseeyat™ is not a law firm.
A right the Supreme Court recognised
In March 2026, the Supreme Court recorded that Parliament had still not made a law on living wills. The rules are the Court's own directions.
Dignity, and the right to refuse treatment
Directions of the Court, not an Act
Not tied to any personal law
A living will is not a will
One word to watch
What Waseeyat does not do
Who can make one, and what it must say
The 2018 judgment sets out who may make a directive and what it must contain. The 2023 order kept these rules, and now lets you name more than one person.
An adult of sound mind
Only an adult of sound and healthy state of mind can make one: someone able to communicate, and to understand its purpose and consequences. Supreme Court, Common Cause v. Union of India, 2018.
Freely, and fully informed
It must be made voluntarily, without coercion, inducement or compulsion, with full knowledge or information, and with informed consent, free of undue influence or constraint. In plain words, the decision must be your own, made freely, knowing what it means. Supreme Court, Common Cause v. Union of India, 2018.
In writing, in clear words
It must be in writing. It must set out, in specific, clear and unambiguous terms, the circumstances in which treatment may be withheld or withdrawn. Supreme Court, Common Cause v. Union of India, 2018.
Two statements it must make
It must say that you may revoke (cancel) it at any time, and that you have understood its consequences. Supreme Court, Common Cause v. Union of India, 2018.
Someone to give consent for you
It must name a guardian or close relative who will give consent if you become unable to decide. Since 2023, you may name more than one person, and no minimum number is set. Supreme Court, Common Cause v. Union of India, 2018 and order of 2023.
If there is more than one
If you have made more than one valid directive and have revoked none of them, the one signed most recently counts. Supreme Court, Common Cause v. Union of India, 2018.
How a living will is made since 2023
In January 2023, a bench of five Supreme Court judges changed how a directive is made. It now works like this.
1. Sign before two witnesses
You sign it in the presence of two attesting witnesses, preferably independent ones. Supreme Court, Common Cause v. Union of India, order of 2023.
2. Attested before a notary or Gazetted Officer
It is also attested before a notary or a Gazetted Officer. The two witnesses and that official record that they are satisfied you made it voluntarily, without coercion, inducement or compulsion, and with full understanding of the relevant information and its consequences. Supreme Court, Common Cause v. Union of India, order of 2023.
3. Copies to the people you named
You tell the person or people named in it, and your family doctor if you have one, and give each of them a copy. Supreme Court, Common Cause v. Union of India, order of 2023.
4. A copy to your local body
A copy is handed to the competent officer of the local government, municipal corporation, municipality or panchayat. That body nominates an official as the custodian, the person who keeps the document. Supreme Court, Common Cause v. Union of India, 2018 and order of 2023.
5. Your digital health records, if you wish
You may also choose to make the directive part of your digital health records, if you have any. This is optional. Supreme Court, Common Cause v. Union of India, order of 2023.
What changed in 2023
A magistrate no longer countersigns the directive, and neither the magistrate nor the District Court keeps a copy. The 2023 order does not say what happens to a directive made under the earlier procedure. If you made one before 2023, you may wish to ask a lawyer whether to make a fresh one; that is our suggestion, not a rule of law. Supreme Court, Common Cause v. Union of India, order of 2023.
Ask your local body who its custodian is
The Supreme Court left it to each local body to nominate its custodian. Here is what the directions say, and the two official arrangements we have read.
No registry, fee or form in the directions
The Supreme Court's directions name the local body and its custodian, but they do not set up a registry, a fee or a form. Supreme Court, Common Cause v. Union of India, order of 2023.
Ask before you go
Ask your municipal corporation, municipality or panchayat who its custodian is, how to hand over a copy, and whether there is a fee. This is our advice, not a rule of law.
Karnataka
A Health and Family Welfare Department circular of 30 January 2025 states that the Supreme Court's guidelines, as changed in 2023, govern advance medical directives and decisions to withhold or withdraw life-sustaining treatment. It was sent to, among others, Deputy Commissioners, District Health Officers, medical colleges, heads of municipal bodies and panchayats, and registered private medical establishments. Its own summary differs from the Supreme Court's text in places: for example, it says a directive should name at least two people, where the Supreme Court sets no minimum. This page follows the Supreme Court's text. Karnataka Health and Family Welfare Department, circular of 30 January 2025; Supreme Court, Common Cause v. Union of India, order of 2023.
Nashik, Maharashtra
A notice of the Nashik Municipal Corporation records that its Commissioner's order of 18 March 2024 named an Assistant Medical Officer of its Medical Health Department as the corporation's custodian of advance medical directives. Nashik Municipal Corporation notice.
Elsewhere
We have not yet confirmed arrangements in other states, cities or panchayats from official texts, so this page does not describe them. Ask your own local body.
When a living will is used, and what the hospital must do
A directive matters only when you can no longer decide for yourself. Before it is acted on, two medical boards look at the case, and a magistrate is told.
Only when you cannot decide
A directive comes into play when the person who made it is terminally ill, is undergoing prolonged treatment with no hope of recovery or cure, and cannot make decisions. In 2026 the Court remarked that while a patient can decide, there is no need to look at a directive at all; Harish Rana had made no directive, so this remark was not needed to decide his case. Supreme Court, Common Cause v. Union of India, order of 2023; Harish Rana v. Union of India, 2026.
Three conditions
In 2026, the Court read the 2018 judgment to mean that, for a patient who cannot decide, a directive refusing treatment can be acted on only when all three are true: a terminal illness, a persistent vegetative state or a like condition; prolonged treatment; and a condition that cannot be reversed. The Court said this applies even to a directive that names the situation outright. Harish Rana had made no directive, so these remarks were not needed to decide his case. Your doctors can explain these medical terms. Supreme Court, Harish Rana v. Union of India, 2026.
The doctor checks it first
The treating doctor checks that the directive is genuine, against the patient's digital health records if there are any, or with the custodian. Supreme Court, Common Cause v. Union of India, order of 2023.
The first medical board
The hospital forms a Primary Medical Board: the treating doctor and at least two experts in the relevant specialty, each with at least five years' experience. It visits the patient with the guardian or close relative present, and gives its first opinion, preferably within 48 hours of the case being referred. The treating doctor informs the people named in the directive. Supreme Court, Common Cause v. Union of India, order of 2023.
The second medical board
If the first board certifies (formally confirms) that treatment may be withdrawn, the hospital immediately forms a Secondary Medical Board: one registered medical practitioner nominated by the district's Chief Medical Officer, and at least two experts in the specialty, each with at least five years' experience, who were not on the first board. It first finds out the patient's wishes or, if the patient cannot decide, gets the consent of the people named in the directive. It gives its opinion, preferably within 48 hours. Supreme Court, Common Cause v. Union of India, order of 2023; Harish Rana v. Union of India, 2026.
The Chief Medical Officer's nominee
Only the Chief Medical Officer may choose that nominee; the hospital only forms the board. Each Chief Medical Officer must keep a standing panel and nominate from it, preferably within 48 hours of a hospital's request. The panel is to be reviewed at least once every 12 months. Supreme Court, Harish Rana v. Union of India, 2026.
The magistrate is told
Before acting, the hospital tells the local magistrate (the Judicial Magistrate First Class) about both boards' decisions and the consent of the people named. Since 2023, the magistrate no longer visits the patient or authorises the decision. In 2026 the Court directed every High Court to direct magistrates to receive these notices from hospitals when both boards agree. Supreme Court, Common Cause v. Union of India, order of 2023; Harish Rana v. Union of India, 2026.
A record with the High Court
When life support is withdrawn, the magistrate informs the High Court. The High Court keeps the record in digital form, and the paper copy is destroyed three years after the patient's death. Supreme Court, Common Cause v. Union of India, 2018, unchanged in 2023.
If a board says no, or the directive is unclear
The guidelines also say what happens when a board does not agree with the directive, or when the hospital does not begin.
If the first board says no
If the Primary Medical Board decides not to follow the directive, the people named in it may ask the hospital to refer the case to the Secondary Medical Board. Supreme Court, Common Cause v. Union of India, order of 2023.
If the second board refuses
The people named in the directive, the treating doctor or the hospital staff may ask the High Court to decide, by a writ petition under Article 226 of the Constitution. Supreme Court, Common Cause v. Union of India, order of 2023.
If the hospital does not begin
If the treating doctor or hospital does not start the process although the conditions are met, the next of kin (the patient's closest relatives) may ask the High Court for directions under Article 226. Supreme Court, Harish Rana v. Union of India, 2026.
If the wording is unclear
A directive that is unclear or ambiguous is not given effect. The guidelines for patients with no directive apply instead. Supreme Court, Common Cause v. Union of India, 2018.
If something unforeseen happens
A directive does not apply if circumstances arise that you did not foresee and that would have affected your decision. Supreme Court, Common Cause v. Union of India, 2018.
You can change or cancel it
A directive stays yours to change while you can decide.
At any time
In writing
Until it is acted on
Tell everyone who has a copy
When there is no living will
The Supreme Court's guidelines also cover a patient who has made no directive. The family and the same two medical boards take part.
The family and the first board
The Primary Medical Board discusses the case with the family doctor, if there is one, and with the next of kin (the closest relatives), next friend or guardian (a person who acts for the patient). With their written consent, it may certify that treatment may be withdrawn, preferably within 48 hours of the case being referred. Supreme Court, Common Cause v. Union of India, order of 2023; Harish Rana v. Union of India, 2026.
The second board and the magistrate
The hospital then forms the Secondary Medical Board. If that board agrees, the hospital tells the magistrate and the next of kin, next friend or guardian, preferably within 48 hours. The magistrate no longer visits or endorses the decision, and the route to the High Court remains open. Supreme Court, Common Cause v. Union of India, order of 2023.
The patient's best interests
In 2026 the Court explained the test for a patient who cannot decide. The question is whether prolonging life by the treatment is in the patient's best interests, not whether it is in their best interests to die. There is a strong presumption in favour of life, though it can be displaced. Medical and other factors are weighed together, including what the patient would have wanted, but that alone does not decide it. Supreme Court, Harish Rana v. Union of India, 2026.
Tube feeding is treatment
Clinically assisted nutrition and hydration, including tube feeding at home, is medical treatment, not basic care. So the two boards may decide whether to continue, withdraw or withhold it, as with any other treatment. Supreme Court, Harish Rana v. Union of India, 2026.
Cared for at home
If the patient is cared for at home, the next of kin may admit them to any hospital, which must then follow the guidelines. Or they may ask a hospital to designate a primary treating doctor, who starts the process. Supreme Court, Harish Rana v. Union of India, 2026.
Thirty days to reconsider
Once both boards agree, the decision is carried out only after a 30-day period for reconsideration. During it, a person who shows they are entitled to object may challenge the boards' opinions in court, and courts must use restraint. The judgment does not say whether this period also applies where there is a valid directive. The period was set in 2026 by a bench of two judges, drawing on one judge's separate opinion in 2018; it is not in the Court's 2018 directions or its 2023 order, both made by five judges. Supreme Court, Harish Rana v. Union of India, 2026.
What the Supreme Court decided in Harish Rana (2026)
Harish Rana v. Union of India was decided on 11 March 2026. It applied the guidelines for a patient with no directive, and added steps that the two judges called “streamlining” the guidelines.
There was no directive
Harish Rana had not made an advance directive. He was in a persistent vegetative state and was fed through a tube. His parents applied to the Supreme Court after the hospital did not start the process. Supreme Court, Harish Rana v. Union of India, 2026.
The first full application
The Court described the case as the first substantive application of the guidelines, and the first to reach it in which they were applied in their full measure. Supreme Court, Harish Rana v. Union of India, 2026.
What it ordered for the patient
Tube feeding was to be withdrawn, the 30-day period was waived, and AIIMS, New Delhi was to admit him to palliative care and carry out the withdrawal under an end-of-life care plan. Supreme Court, Harish Rana v. Union of India, 2026.
For every High Court
All High Courts are to direct magistrates to receive hospitals' notices when both boards agree. Supreme Court, Harish Rana v. Union of India, 2026.
For every district
The Union Government, with State and Union Territory Health Secretaries, is to ensure that Chief Medical Officers prepare their panels without delay, reviewed at least once every 12 months. Supreme Court, Harish Rana v. Union of India, 2026.
A call for a law
The Court urged the Union Government to consider a comprehensive law on the subject. It recorded that draft government guidelines released for consultation in June 2024 had reached no fruitful conclusion. Supreme Court, Harish Rana v. Union of India, 2026.
Palliative care, not discharge
The Court strongly disapproved of patients being discharged “against medical advice” in place of palliative care. Supreme Court, Harish Rana v. Union of India, 2026.
Medical questions belong with your doctors
This page explains a legal process. It does not give medical advice, and Waseeyat cannot tell you what to write in a directive.
Talk to your doctors
Palliative-care professionals
Talk to the people you will name
Write it down, and share it
If you decide to make a living will, the steps on this page show how it is signed, attested and shared since 2023. Then look at the rest of your plans with our free readiness check.
Your will is separate A will deals with your property after your death. Our guide to will basics explains how one is made. Read: will basics
The full note The note in our law library gives every rule on this page with its paragraph number. Read: living wills
General information General information about Indian law, not legal or medical advice. Waseeyat™ is not a law firm.