When Government Medical College Hospital (GMCH), Kollam, opened a ‘Living Will Information Counter’ in the OP registration block, the major objective was to spread awareness and offer assistance.
Though the living will registration is not any novel concept, a large section of society remains unaware of the practice and that’s where the GMCH made a difference.
Within three months, hundreds of people, most of them commoners, obtained soft copies of the living will form the hospital as the counter empowered them to create a legal document outlining their end-of-life medical preferences and priorities.
“The GMCH, Kollam, is the first hospital in the country to establish a counter to popularise the concept. A living will is a legal document that allows individuals to specify their health care preferences should they become incapacitated and unable to make decisions due to a terminal illness or life-threatening condition,” said hospital superintendent Rajendran C.V.
The process
Writing a living will involves two or more health care attorneys and then a gazetted officer or notary to certify the document in the presence of two witnesses. “The health care attorneys can be family members or friends as the will comes into effect when the individual is incapacitated but alive. Before executing the will, two medical boards will be convened to certify that the individual has terminal illness and zero chance of survival. Every government or private hospital in the country is obliged to follow this procedure when a living will is presented,” said I.P. Yadav, nodal officer.
While many staff members of the hospital made their will recently, the counter gets a lot of enquiries each day. “People often confuse living will with euthanasia, which is not legal in India. Also, the will only specifies your choices, which need not always be refusal of life-sustaining treatments. There are people who prefer ventilator support. A person who visited the counter said that he wants to be put on life support till his only son arrives from abroad. He was willing to suffer any degree of pain for that,” Dr. Yadav added.
R.M .Shibu, who lives near the hospital in Paripally, said he made the will after collecting details from the counter. “It’s a crucial document, but people are not aware of it,” he said.
Reducing burden
Another highlight of the will is that it reduces the burden of family as a patient in the last stage of cancer or someone who suffered a massive stroke with no hope of survival can decide if they want CPR, ventilator support or ICU.
Many who made their living will prefer only palliative care and specify that they want to be with their loved one
“In our country, most people, even those living in rural parts, die in ICUs which is not the case in European countries. With the help of the will an individual can choose if he wants to be in an ICU or his home or hospital ward where he can be with his family during the last days. ICU care is extremely important in many cases, but it’s a matter of debate if a 99-year-old person should be taken to ICU,” said Dr. Yadav.
