To Our Readers: Road Ahead

LIVING WILL: THE ROAD AHEAD

It Is All About Human Dignity and Meaningful Life

Dear readers,

The cover theme this time is Living Will but let me first recap the society’s main activities since the last quarter. Our Status of Policing in India Report (SPIR) released in May last continues to get extensive and noteworthy coverage in the media. Among the prominent experts who have commended its findings are French political scientist Christopher Jefferlot, former Planning Commission Member Syeda Hameed and human rights activist Maja Daruwala. It is a subject of discussion among activists, bureaucrats, cops, criminologists and political scientists which is heartening and which was one of the reasons why an enterprise like this was undertaken.

Lately, our PILs have also evoked a good response. The petitions to watch in the coming months are the ones about the non-appointment of the Lokpal and the introduction of opaque Electoral Bonds, never mind if the pace of their progress is agonisingly slow. We hope these modest attempts will contribute to India’s fight against political corruption, non-transparent electoral funding and black money.

In the Lokpal matter, the Supreme Court nudged the government once again to come up with a roadmap for the appointment. Last year, the Court had observed while disposing of our earlier petition that the Lokpal and Lokayuktas Act 2013 was a perfectly workable piece of legislation. Common Cause later filed a contempt petition for the compliance of this judgment. After several postponements and circuitous submissions, the Court asked for a proper time frame for the appointment. In the other matter challenging the introduction of the Electoral Bonds (filed with the Association for Democratic Reforms), notices have been issued and one can only hope that some action will be taken before the next and crucial round of elections. The bonds have unlocked Indian elections for foreign lobbyists, removed funding limits for big corporates and made the process a lot more opaque, without a minute’s discussion in Parliament.

In the meantime, a group of Gandhian activists brought to our notice an environmental catastrophe called the Chardham Road Project in Uttarakhand where 900 km of road-widening is wreaking havoc with the ecology. The project is hurtling through rivers and forests at breakneck speed and without conducting the mandatory Environmental Impact Assessment (EIA). Thousands of trees have been felled in ecologically sensitive zones including in the core forest areas around the glaciers which feed the Ganga. A group of citizens did file a PIL but the National Green Tribunal (NGT) reserved its judgment to the activists’ utter frustration. Common Cause also intervened by filing an Original Application in the NGT against the indiscriminate dumping of debris and muck directly into the Bhagirathi river and along the slopes. The petition has submitted photographic evidence to point out that this would excessively pollute the river and alter its course. The NGT has issued notices to the concerned authorities. (for details of the PILs, see the Case Updates section and also commoncause.in)

Living Will: The Road Ahead

This issue of Common Cause journal is dedicated to Living Will. As shared earlier, it was in response to our PIL that the Supreme Court gave a historical Judgment in March 2018 on an individual’s right to die with dignity as part of her Right to Life and Personal Liberty enshrined in Article 21 of the Constitution. The judgment was very well covered in the national media and was a subject of many debates on TV. As a petitioner, we are gratified but we are equally aware that it is one thing to get a favourable order and quite another to get it implemented in the true spirit.

If one reads between the lines, the Apex Court, while recognising and upholding the citizens’ right to die with dignity, is clearly concerned about its possible misuse. It is precisely for this reason that in many countries it is a serious criminal offence to fake or misusing someone else’s Living Will or Advance Medical Directive (AMD). We can also consider making it a part of the package in the legislation which will eventually replace the Court’s directive. Clearly, our laws and ethics will have to catch up with rapid advancements in medical sciences. It also means that every stakeholder, from courts to hospitals and from doctors to patients and their caregivers, will have to be better-informed and better-prepared for the new realities surrounding us. The private sector can also help by redesigning insurance policies and hospitals to cover the end of life care.

It is well-known that ageing influences our decisions. And that is why the idea of the Living Will or the AMD is to write it much in advance and at a time when the individual is of sound mind and is in command of her faculties. We have attempted to draw a Living Will or AMD in this issue of Common Cause on the basis of the court judgment. The idea is to provide a first draft for more discussion and deliberation on the subject. If you have any comments, criticism or suggestions, please share them with us.

Although the Living Will judgment is about patient autonomy and old age, it opens up a significant debate on several interrelated concepts like palliative care and hospices which are beginning to be followed globally. Palliative care is a medical speciality which provides quality of life to patients and their families besides relief from pain and stress, while a hospice is a specialised care meant for those patients who are terminally ill or facing life-limiting diseases. Internationally, these are being included in medical insurance covers. The articles in this issue have tried to answer some of the moot questions surrounding the debate. They also talk about an immediate need for all Indian states to factor ageing and palliative care in their health policies.

The real scope of the Living Will or the patient autonomy goes much beyond the legal provisions because it is about human dignity and meaningful life. The courts can only fill a legislative void or set the ground rules. In the end, it is our society which should be able to provide constant and compassionate care for people nearing the end of their lives. Our primary objective should be to allow old people to live (and die) as they wish. They need social and emotional security, comfort and care, besides freedom from unnecessary medical intrusions. It takes a lot more than a court order for a society to be kind and compassionate to its ageing population. Like always we will wait for your comments or suggestions, please write to us at commoncauseindia@gmail.com.

-Vipul Mudgal
Editor