The Rise Of Living Wills In India Explained

TITLE: The Rise of Living Wills in India Explained | Kudrat Wadhwa | The Signal Brief | The Core CHANNEL: The Core DATE: 2026-05-08 ---TRANSCRIPT--- Sarita is 62. She spent decades in the corporate world, making high-stakes decisions every day. 2 years ago, she retired and now serves as an independent board director. In April 2026, she made what many would consider a deeply uncomfortable decision—deciding what should happen to her when she can no longer speak for herself. She got a living will made, essentially as a birthday gift to herself. A living will, also called an advanced medical directive, is a legal document that lets you decide in advance what kind of medical treatment you want or don’t want if you ever become seriously ill and unable to speak for yourself. It’s essentially your voice when you can no longer speak. When I asked Sarita what compelled her to take the plunge, her answer was straightforward. ‘Why not?’ You know, that was a thought that came to my mind. Why should I not do this? And I didn’t have any concrete reason for not doing it. So I said, let’s go ahead, find out more, and find out the process, procedure, and go ahead. There was never a question of why to do it. It was always a ‘why not’ that propelled me to go ahead for it. For years, this idea existed only in theory in India. And then in 2018, the Supreme Court of India, in its landmark Common Cause judgment, recognized the right to die with dignity as part of Article 21, the right to life. It legalized passive euthanasia and living wills for the first time. But the process was extremely cumbersome. It required a magistrate’s approval, multiple layers of verification, and sometimes involved long delays. As a result, very few people actually made a living will. Then in 2023, the Supreme Court stepped in again and simplified the guidelines. No more mandatory magistrate counter-signature. A notary or gazetted officer is now enough. The process became much more practical. Since then, there’s been a slow but noticeable rise in people, especially senior professionals and retirees like Sarita, getting their living wills made. States like Maharashtra and Goa are even creating digital registries to keep track of these documents. My name is Kudrat Badwa and you’re listening to The Signal Brief. We don’t do hot takes. Instead, we bring you deep dives into the how and why of consumer trends. In today’s episode, we look at living wills. How is a new generation of Indians choosing to plan for the end of life with clarity and dignity? Sarita told me that she first heard of living wills about a year ago when she read a newspaper article. That story planted a seed. Over the following months, she came across LinkedIn posts and then listened to a podcast episode by Founding Fuel titled Understanding the living will, clarity, autonomy, and care at the end of life. Doctors know how difficult these decisions are, and they’re rarely made in calm moments. They’re made in ICUs, in emergencies, when families are forced to decide quickly, often without knowing what the patient would have wanted. Sarita did not want her son Anmol finding himself in that position. Listening to the podcast sealed the deal. She discussed the idea of a living will with her son Anmol. Yeah, well, at that point, I immediately had a visceral reaction that I got a reality check that, okay, she is getting old. Something will happen to her in the future, and I must be mentally prepared, psychologically prepared, financially prepared. All of these thoughts were coming in, and she explained to me the advantage of the living will, and that was to give her peace of mind that in case she was not in control of her own body and her health, I would be the one responsible enough to give her the peace that she would have wanted. I asked Anmol if he had any resistance to the idea of a living will. No, I actually welcomed the idea without any apprehensions. I was pretty much in line with what my mother was thinking. I think what she did was a very mature and a good decision because nobody wants to live or exist in ambiguity. Once she got the go-ahead from her son, Sarita made an appointment at the Living Will Clinic at PDE Hinduja Hospital in Mumbai, one of few dedicated clinics of its kind in India. So it’s an OPD clinic, like any other clinic in the hospital at Hinduja Hospital, Mumbai. As I said, it’s only on Saturdays, I think between 10 to 11:30. So I had to take a prior appointment. And you pay the OPD fees at the reception, and the doctor is— Fortunately, there was no line, and the doctor saw me, and she had a printout of the form. She took me through each and everything of the form. She shared the Supreme Court judgment. I spoke to the doctor Sarita met there. Her name is Dr. Smriti Khanna. She’s a palliative care physician who runs a clinic. We are receiving anywhere from 20 to 40 enquiries every month. We also do outreach programs where we speak to members of, say, a club or a community, and we speak to a large group of people together to give them information about the living will and what it entails. Dr. Khanna told me that they use a carefully prepared template developed by the Vidhi Center for Legal Policy, the same think tank that played a key role in the Supreme Court case that made living wills feasible. Sarita took her form home and filled it out carefully. There were questions like, do you want CPR? Do you want chemotherapy or radiotherapy? Do you want aggressive treatment like chemo if recovery is unlikely? Where do you want to spend your end of life? Hospital, hospice, or home? And there was a whole section of doing end of life care, as they say, that whether you want to stay in a hospice or you want to be at home. Or do you want special attention towards alleviating mental distress or confusion so that you spend time with your loved ones? And would you want to be referred to any other people for anything else? As I said, you know, for me it was very clear that I just wanted to be very, very simple and easy to follow, the instructions to be very easy to follow. Sarita said that she made 5 copies of the form. One for her direct health representative, Hassan Anmol, one for the municipal health office, one for the Living Will Clinics doctor. She also organized two witnesses who would accompany her to the notary. Both are her neighbors. Sarita did not hire a lawyer, but many people do. I spoke to one such lawyer. I’m Shruti Svaika. I am an advocate practicing for over 15 years now. I’ve been deeply involved in advising clients with estate planning and succession planning for a larger part of the decade. What we also see in living wills is people will specify that they want sort of for pain relief medication to be given. For example, in an irreversible coma, there may not be any pain, but there could be other situations where there is pain involved. So in a living will, they would talk about that irrespective of treatment being withdrawn, they would want to be given palliative care or pain management. The other thing that we see which people are now looking at doing is organ donation through living wills. Shruti says that she’s noticed that one of the biggest areas of confusion for consumers is between what a regular will and a living will is. Less than 10% of Indians even have a regular will. A living will is completely different. It’s not about property. It’s about your body and medical choices while you’re still alive. Overall, Shruti says that especially since 2023, getting a living will made has become a pretty smooth process. She has noticed that it helps out sort out conflict in the future too. In fact, it gives them clarity In case there isn’t such a directive, then sometimes family members, especially if there are elder siblings, they could be having disagreeing views on how they want a parent’s treatment to continue. These can resolve those disagreements. We don’t see any issue with implementing these. Doctors are respectful of these documents. They are giving effect to it. They are following protocols and then giving effect to it. Essentially, this document does something crucial. It removes the heavy responsibility of guessing what your loved one might have wanted. I just wanted it very simple and easy to be followed. I’m a single parent. I didn’t want my son to be burdened with this whole thing. Okay, do this, now do that. And, you know, I just wanted it very simple. The idea is to make it easy, not just for me but also for him. I also have a trust built up for my son where financially it goes through a trust, my investments, and he gets a way of life. So I’m doing all that I can to make life easy for my loved one. This was one step in it. If I come to know tomorrow of any other process that makes it easy, you know, like I’m clearing up my papers, my documents, trying to dispose of clothes I don’t use. He’s trying to make life easy. Because, you know, I’ve seen— I lost my elder sister a couple of years ago. And I saw the mammoth task of cleaning the house, disposing her clothes and her stuff and everything. It just took so much of time, you know. So my question is, how can I make it easy for my loved one? Can I do it? And if the answer is yes, why not? Living wills are meant to make these decisions easier, but they don’t make them easy. In her living will, Sarita was clear. She said that, quote, in situations where my treating physician or team has determined that there is no scope of recovery, I have instructed that any life-prolonging medical procedure or treatment be withheld or withdrawn and the course of natural death be permitted. These may include CPR, dialysis, chemotherapy, ventilator, etc. She also has refused any specific place or hospice or home for the duration of end-of-life care, nor has she named any specific physician to take care of her health. She appointed Anmol as her designated healthcare representative, giving him the power to act on her behalf. But she made one thing clear: her documented wishes in the living will should take priority over her son’s personal feelings too. And yet, when I asked Anmol how he would actually handle that moment, his answer revealed how complicated these situations remain, even with a living will in place. If that situation arises, I will be taking some time. You know, a lot of success stories come up on newspapers that a coma patient, you know, gets fully healed, comes back after years. So I definitely would want to wait for at least a year before I decide to pull the plug in such a scenario, because one may never know when miraculous things happen. And with the living will, I have the authority to take care of somebody after their condition, like coma dose or accidents where they’re neurologically impaired. I would still prefer to give some time, 6 months or a year, just because it’s also a taxing decision even for me. So I would not rush into it, but the living will allows me to take a calculated decision on behalf of the person. And that is a real human tension at the heart of living wills. Sarita has drawn a line. Her wishes should supersede everything else. But for Anmol, love and hope still pull in the other direction. The living will, of course, doesn’t erase emotion. It simply gives families a clear anchor and legal protection when the hardest moments arrive. The taboo around death, or the difficulty in talking about death. So even if a person We want to have a very quiet, rational discussion about what is to be done if I’m at the end of life. It is very distressing for many family members to think about it, to sit down and talk about it, and to be able to complete the discussion also. So some of the resistance that I have noticed has come from this area where families find it very difficult to even discuss this topic. And if one person from the family does want to discuss it It’s either, you know, let’s be positive, let’s stay positive and not talk about death, or it gets overwhelmingly difficult for the rest of their family to discuss. But see, if this is going to happen, then it’s going to be also difficult for them to handle this situation and to be able to think about what are the options we have and what we can get done in a terminally ill situation also. So even though it is a tough conversation, I would encourage people, I would encourage families to have it because it’s always better to have it early rather than late. If family members who find it very distressing, if at least we are able to start having the conversation at the beginning, they may find it lesser and lesser distressing as time goes by or as more conversations around it happen. And I think that the Living Will is an excellent way to just normalize the entire discussion around death and dying, around dignity of life and how dignity of life should extend right till the end of life. So if you would like to have a dignified life, you should have a dignified end of life too. Living wills represent a shift from reactive, guilt-filled decisions in hospital corridors to planned endings made with clarity and intention. Of course, India is still far from the widespread adoption of living wills, Most people in this country don’t even have a regular will. But as healthcare becomes more complex and lifespans get longer, that shift may not remain optional for long. That’s all for today. You just heard The Signal Brief. We don’t do hot takes. Instead, we bring you deep dives into the how and why of consumer trends. The Core produces The Signal Brief. Follow us wherever you get your favourite podcasts. To check out the rest of our work, go to www.thecore.in. If you have feedback, we’d love to hear from you. Write to us at feedback@thecore.in, or you can write to me personally at kudrat@thecore.in. Thank you for listening.