Should You Have a Living Will Made? Here’s how
In a landmark judgement in March last year, the Supreme Court had recognised that a terminally ill patient or a person in a persistent vegetative state has the right to die with dignity. But in order to do so, the person will have to execute what is known as a ‘Living Will’.
 
Despite the name, a ‘living will’ is not at all like the wills that people use to bequeath property after their death. In fact, quite in contrast to a normal will, a Living Will has no power after death. It is essentially a document that sets out a patient’s wishes on how they want to be treated if they are seriously ill and become unable to communicate their decisions. 
 
Doctors often refer to a Living Will as an ‘advance directive’. Such a document becomes important to a person when their life reaches a point at which attempts to unnecessarily prolong it may only compromise dignity and quality of life. 
 
A Living Will respects the patient’s human rights and in particular their right to reject medical treatment. Even medical professionals benefit from having a Living Will, as it assists them in making difficult decisions with regards to their patient’s healthcare. Such a document also helps to take away the burden of making difficult decisions from family, friends and loved ones.
 
Although not officially categorised as such, there are six different types of Living Wills to consider. A document that instructs the concerned physician and family members that life prolonging treatments should not be used, thus allowing the person to die naturally, is known as a ‘Living Will Declaration’. 
 
In contrast a document that is the complete opposite of a Living Will, such that it allows the concerned person to ensure that all life-prolonging medical treatments are used to extend life, is called a ‘Life-Prolonging Procedures Declaration’. 
 
There is also a ‘Psychiatric Advance Directive’ that is written to direct the doctors in the treatment of incapacitating mental illness. 
 
Furthermore, patients can also direct healthcare providers not to resuscitate in case of cardiac arrest, with a ‘Do Not Resuscitate Declaration and Order’. 
 
The doctor can also issue an advance directive to indicate the regimen to be followed for a chronically ill patient, so that wherever the patient goes their treatment is not interrupted or changed; this is known as a ‘Physician Order for Scope of Treatment (POST)’. 
 
A document registering a person for organ and tissue donation, is also another type of Living Will. 
 
In all the above cases and wherever a Living Will is used, there has to be a medical power of attorney. This is to ensure that an individual is nominated by the patient to make certain that their wishes about health are carried out as per directions. The legal term for such an individual is ‘Attorney-in-Fact’. 
 
The attorney-in-fact does not have to be a lawyer and it can be any adult the patient trusts. Such an individual is granted the power to act for the person only in the ways clearly listed out in the document. More importantly, the person given the medical power of attorney is not required to accept the responsibility of the outcome. 
 
The document registering the attorney-in-fact should contain the name of the adult chosen, a list of situations in which the attorney-in-fact needs the power to act, a list of the powers granted and a list of powers that are not granted. 
 
A Living Will is an important legal document that has to be prepared in the right way. Although the use of a Living Will is a new concept in India, there are forms available at some hospitals that help you in drafting such a will. If such a form is not readily available, you can still draft a similar directive yourself. (At the bottom of this article is a sample form that you can use and modify as per your requirements.) 
 
Ensure that there are two eyewitnesses, who shall be required to sign the living will document. A doctor’s certificate is also required to ensure the authenticity of a Living Will, as it would help testify to the fact that the concerned person was of sound mind and capable of making their own decisions at the time of drafting the document. In order to make the Living Will a legally binding document, it should be prepared in the presence of a lawyer and all documents should be appropriately notarised. 
 
Once a Living Will document has been officially prepared, it can only be cancelled orally, in writing or by destruction of the declaration by the concerned patient themselves. The cancellation takes effect only when the concerned physician or hospital is informed of the same. 
 
But as the concept is fairly new in India, it still remains to be seen how effective it shall be. Nevertheless, it is a step in the right direction to end the pain and suffering of terminally ill patients. 
 
(Dr Rekha Bhatkhande is a noted gastroenterologist and former Dean of Sushrusha Hospital, Mumbai)
 
A Sample of a Living Will (we can draw up our own wills as per our requirement or wishes)
 
Advance Medical Directive (LIVING WILL) and Medical Power of Attorney
This declaration is made by me:
 
Name:
Date of Birth:
Aadhaar no.
Full Address:
Date:
At (place):
 
I am an adult of sound mind and am making the Declaration of my own free will, voluntarily and after careful consideration.
If the time comes that I can no longer take part in the decision making about my medical treatment, this Declaration will comprise the final expression of my wishes. It is requested that all concerned should take these wishes into account before taking any medical decision regarding my life. If at any time:
 
  • I reach the stage of terminal illness and I lapse into a coma with no reasonable expectation of regaining consciousness or

 

  • I have a diseased state from which I have no reasonable chances of recovering with any acceptable quality of life or

 

  • I reach a persistent vegetative state from which I have no reasonable expectation of regaining any significant cognitive functioning
 
Then the following steps must be taken.
 
I request a panel of three very senior doctors not related to my medical treatment be appointed by the hospital to check out if my case falls in any one/all of the above states, once this is confirmed then I should be deemed to have declined any of the chosen life-sustaining measures listed below, and if any such treatment has been started it may be withdrawn:
     
  •  Multiple Blood Transfusions
  •  Artificial feeding by intravenous route or nasogastric tube, gastrostomy, or nasojejunal tube.
  •  Dialysis
  •  Artificial Respiration (tracheotomy, ventilator support)
  •  Cardio-pulmonary Resuscitation (DC shock, Cardiac Pacemaker, Ventilator)
  •  Chemotherapy
  •   Very high risk, last ditch surgical procedures
 
Other wishes: (written by hand)
 
I request that this Declaration be honoured by my family members and the hospital administration and doctors as a final expression of my legal right to refuse medical and surgical treatment accepting the consequences of such a refusal.
 
This document may be informed to my regular physician, Dr.______________________________
 
And to the Hospital_______________________________________________________________
 
A Medical Power of Attorney
 
This should be given to my Surrogate Decision Maker or Attorney in Fact to implement my Declaration from time to time on my behalf.
 
He/ she/they have consented to take this responsibility. My Attorney in Fact should be allowed access to all my medical files and treatment options to be able to take decisions on my behalf even if contrary views are expressed by others.
 
Name:
Date of Birth:
Aadhaar no.
Full Address:
Tel no:
Email address:
 
If the above mentioned person is not available then next two persons may be approached in the same order as listed
 
Name:
Date of Birth:
Aadhaar no.
Full Address:
Tel. No.
Email address
 
Name:
Date of Birth:
Aadhaar no.
Full Address:
Tel.no.
Email address
 
In the absence of all of the above authorized attorneys-in-fact, a member of my family or the hospital itself will have the authority to express the wishes on my behalf regarding my current treatment.
 
I submit that this Declaration and the Medical Power of Attorney shall remain in force during my lifetime and unless I revoke it at any time and until the notice of its revocation has been received by my Attorneys, and the Hospital.
 
I am fully competent to understand the Declaration and Medical Power of Attorney I have made, and I understand the importance of it.
 
SIGNATURE:
NAME OF SIGNATORY:
 
DATE:
PLACE:
  
Eye-Witnesses
 
I have signed this document in front of Witnesses who are required by law to validate this document containing the Declaration and the Medical Power of Attorney. I believe them to be competent enough to witness this procedure and sign on the document.
 
WITNESS SIGNATURE:
NAME:
AADHAR NO:
ADDRESS:
 
DATE:
PLACE
 
 
WITNESS SIGNATURE:
NAME:
AADHAR NO:
ADDRESS:
 
DATE
PLACE
 
 
SIGNED IN MY PRESENCE
 
 
APPROPRIATE AUTHORITY 
(Lawyer, Notary)
 
 
 STAMP
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    Crazy Mohan, King of One-Liners, No More
    ‘Crazy’ Mohan who passed away on 10 June 2019 after he suffered a cardiac arrest, was known as a playwright with a penchant for comic one-liners bereft of innuendoes. His friendship with Kamal Haasan was legendary and together the two created magic on screen.
     
    Born in 1952, Mohan Rangachari completed his engineering from Guindy College of Engineering. But in Chennai no one knows him as Mohan Rangachari. He is known more by his epithet “Crazy”. A Tamil Iyengar, his Tamil diction was impeccable. He himself was amazed at his transition from an engineer to a writer.
     
    He worked in TVS Motors for a while before writing lured him. Along with his younger brother Balaji, he formed a winning combination staging one successful play after another.  Remarkably, unlike most Tamil Brahmins (TamBrahms), Crazy Mohan stayed in a joint family until death snatched him away. 
     
    His first film appearance seems to have been in Apoorva Sahodarargal (remade in Hindi as Appu Raja) wherein Kamal Haasan played a midget. His dialogue writing was laced with pulsating and rib-tickling humour, something that the audiences remembered years after the film’s release.
     
     
    Crazy Mohan’s friendship with Kamal Haasan resulted in memorable films like Sathi Leelavathi, Michael Madana Kama Rajan, Avvai Shanmughi, Tenali, Pammal K Sambandham and Panchathanthiram. In all these films, the comedy track was superlative – thanks to Crazy Mohan.  
     
    Sathi Leelavathi was remade as Biwi No 1 that starred Salman Khan, Anil Kapoor, Tabu, Karishma Kapoor and Sushmita Sen. Avvai Shanmughi was remade in Hindi as Chachi 420 and starred Kamal Haasan and Tabu in pivotal roles.  Crazy was considered adept in screenplay writing and Kamal Haasan’s comic timing only added to the allure of these movies. He played an important role in Vasool Raja MBBS which was a remake of Sanjay Dutt’s Munnabhai MBBS.
     
    He had a knack for writing in Madras Tamizh – the kind of slang used by slum dwellers in Chennai. Of course, there were critics who felt that his comedy was getting repetitive over the years. Not everyone fancied the slapstick comedy.
     
    Mohan loved chewing betel leaves and tobacco. He wrote the dialogues for Rajinikanth’s super hit film Arunachalamthat starred Ramba and Soundarya along with Rajinikanth. The film was loosely inspired by the Naseeruddin Shah-Aditya Pancholi-Mandakini-Poonam Dhillon starrer Malamal (the plot in both the movies was completely different). Mohan was terribly scared of stray dogs; so much so that he would comment that he left his job because of this fear of stray dogs. Tamil fans proudly call him “the King of Twitter” for his punch dialogues.
     
    Crazy Mohan would be sorely missed by Tamil audiences who loved slapstick comedy and gentle humour.
     
    (After working in the corporate world for close to two decades, Bhagyalakshmi Seshachalam started her second career innings as a head-hunter. She is passionate about Hindi movies and loves retro music. When her family shifted to Chennai in the 80s, Bhagya had a taste of Tamil cinema too. In the long term, she plans a book on two of her favourite directors – Guru Dutt and K Balachander. She travels across the country on work and is based in Mysore.)
     
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    COMMENTS

    Vydehi

    2 months ago

    Crazy Mohan's brand of comedy was good in the beginning but became jaded later on.

    V ganesan

    2 months ago

    The two characters maadu and seenu created by crazy Mohan remembered by tamil audience. They will not forget these two characters

    Girish Karnad No More
    Girish Karnad who passed away on 10 June 2019 at the age of 81, will be remembered as a multi-lingual actor who was known for his bohemian views and who often courted controversies for the same.
     
    As late as 2016, he was seen in the movie Chalk-N-Duster that also starred Shabana Azmi and Juhi Chawla. He was seen in Salman Khan starrer Ek Tha Tiger too. He also acted with Hema Malini in the film Ratnadeep (1979) that was directed by Basu Chatterjee. Among all his Hindi film roles, he is still remembered for his role as the kind hearted Ghanshyam in Basu Chatterjee’s Swami (1977) and Shyam Benegal's Manthan (1976) that was based on Dr Verghese Kurien's valiant attempts to establish a milk co-operative in Anand. Swami was based on a novel by Bengali writer Sarat Chandra Chatterjee and the film won rave reviews.
     
    The film was produced by Jaya Chakravarthy, Hema Malini’s mother. The songs "Pal Bhar Mein Yeh Kya" and "Ka Karoon Sajni Aaye Na Balam" are still popular among cine goers.
     
    Born on 19 May 1938, Karnad’s oeuvre was vast. He was an actor, film director, writer, playwright and a Rhodes scholar. His villainous roles in Tamil movies like Naan adimai Illai (1986) and Kadalan (1995) are still remembered. 
     
     
    He received the Jnanpith award in 1998. He is considered to be a modern playwright in Kannada on the lines of Vijay Tendulkar (Marathi), Badal Sarkar (Bengali) and Mohan Rakesh (Hindi). He was also conferred the Padma Shri and Padma Bhushan by the government of India and won four Filmfare Awards for Kannada films.
     
    Karnad was born in Matheran and his father Dr Raghunath Karnad was a medical practitioner. His family moved to Dharwad in Karnataka in 1952. He worked briefly for Oxford University Press and then got involved in theatre. He was the director of FTII between 1974 and 1975 and served as the Chairman of the Sangeet Natak Akademi from 1988 to 1993.
     
    Karnad’s foray into Kannada literature was marked by a story in the Mahabharata called Yayati. It was published in 1961 and won rave reviews. His play Tughlaq (1964) won critical acclaim. His other plays like Hayavadana (1971) and Naga Mandala (1988) added more fame to his repertoire.
     
    His Kannada debut was in the movie Samskara (1970) that won the President’s Golden Lotus award. He directed a movie Vamsha Vriksha (1971) which won him a national award. Among the Hindi films that he was seen in, Nishaant (1975), Manthan (1976) and Swami (1977) remain notable. Winner of several national and state awards, Karnad proved that he was a man to watch out for.
     
     
    Intrepid as he was, Karnad was one who was blunt and always called a spade a spade. In 2012 at an awards function, he made a scathing attack on VS Naipaul for his hatred towards Indian Muslims. Later he commented that Rabindranath Tagore was someone who had got more than what he deserved and condemned him for his plays of “poor quality”. He also carried a torch for Tipu Sultan and his comments that the Bangalore airport should have been named after Tipu Sultan created uproar in Bangalore.
     
    Karnad is survived by his wife Saraswathi (who hails from Coorg) and son Raghu.
     
    (After working in the corporate world for close to two decades, Bhagyalakshmi Seshachalam started her second career innings as a head-hunter. She is passionate about Hindi movies and loves retro music. When her family shifted to Chennai in the 80s, Bhagya had a taste of Tamil cinema too. In the long term, she plans a book on two of her favourite directors – Guru Dutt and K Balachander. She travels across the country on work and is based in Mysore.)
     
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    COMMENTS

    Vydehi

    2 months ago

    Oh my god this man was unbelievable - a maverick to the core! His controversial life apart, I think he was a good actor. Among all his films, I liked him in "Swami" and "Teri Kasam" where he was cast opposite Ranjeeta Kaur.

    Ramesh Poapt

    2 months ago

    mam, this is fast track article indeed but good. lots off missed. he was in Asha,a good
    role! in Godhuli? he was excellent in 'manthan'. yes in 'sur sangam' as well.was in a film
    of kumar gaurav/poonam d. he was in dev anand's 'manpasand', not a good one.
    . i will request to write about 'tughlag' and 'hayavadan'.

    murugu selvan

    2 months ago

    world is better off

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