When You Are ‘Dead’, while Still Alive
Dad collapsed at lunch. We were at home and rushed him to hospital. One of Bombay’s best doctors, son of mom’s friend, immediately examined dad, on the lobby floor. ‘Khotto sikko chey,’ he said. A ‘counterfeit coin’. He gave us two days, to make ‘preparations’. Did dad have a Will? No. Was he going to make one? No. Frankly, his love for us was worth more than the billions he could not give. We simply did not care. 
 
Should our family have been worried? A definite ‘Yes’. A big ‘YES’. We have had a lot of seminars at Moneylife, dealing with Wills. The one thing we learn from them is that we cannot foresee everything. We have to do the best we can.
 
Dad, being dad, came home a month later. But we knew better. A wooden nickel. Did we do anything then? No. A month later, we were back in hospital. This time, we knew for sure. The doctor asked us to forego all artificial resuscitation. It may then last for years, he explained. Mom agreed. No suffering.           
 
We kept vigil. Day and night. One night, while I was sleeping on the bench in the corridor, a junior doctor, uninformed, started resuscitation. By then, dad was in a coma. When I awoke, I panicked. Dad was entombed in equipment, cylinders, pipes and meters. I called our doctor. We had agreed on letting him pass silently into the night.
 
You be the judge. What should the doctor have done? He refused to withdraw the tubes. Tantamount to murder, he explained. No matter what, it could not be done.
 
This is where a ‘Living Will’ comes handy. A bit of a misnomer, the Will is not alive. It is a set of instructions drawn up, in case of an emergency, usually a medical situation. Means and methods to be set in motion when the ‘testator’ is not able to care for himself. While a Will ‘speaks from the grave’, a Living Will speaks when the deponent, while still alive, is unable to speak for himself.
 
A Living Will must be carefully drawn up. Think of everything possible. Where is the money to come from? How much is to be spent? Who will have access to it and how is it to be allocated? What of Mediclaim? Will the insurer play ball? Is your doctor in the know and has he been consulted on the medical costs and possibilities of care? Most importantly, does the Will specify, if so desired, that artificial means must not be used under any circumstance? Have you indemnified the person whom you have entrusted to ‘execute’ the Living Will? He could face a lot of flak just by following your instructions. Is there more than one agent to do your bidding? Always wiser to appoint a second line of defence, an arm’s length person. A close relative may be involved in the same accident as the deponent. 
 
Then there are religious rituals that one may need, when close to death. These need be detailed, priests named. If one has donated one’s organs, someone needs to inform the hospital or agency when the end arrives. Eyes, especially, have to be recovered immediately, to gift their sight to others.
 
There is always the possibility that the hospital, fearing legal reprisals, may not follow your instructions. Make sure that the matter is cleared beforehand with the hospital and its lawyers. Maybe leave a copy with the doctors or the hospital management.
 
Above all, consult your lawyer, especially one who understands the special and specific implications. Have you signed the document? The law is silent on the need for witnesses, but it is best to get the attestation done. Take due care. Dad was put off the ventilator when he stabilised. He passed away one night, two months later, peacefully in his sleep. 
 
For those who may want to prepare a Living Will, let us pray that it is never put to use. Also remember, it has no legal sanctity as yet, but it acts as a guide for your loved ones and your doctors on what to do, if you are no longer capable of spelling it out yourself.
 
Bapoo Malcolm is a practising lawyer in Mumbai. Please email your comments to [email protected]
Comments
Sunil Rebello
6 years ago
YES.. I understand..the Law is not on our side.
it is only the love of our loved ones who can take decisions for us when we are not capable to do so.
we had 2 cases in the Hospital near by.. a poor patient.. who was admitted late evening - brain dead, after a massive heart attack. the NGO who she was under wrote a letter to the Hospital management, the next morning informing them that she was a person in need and cannot afford to pay any Hospital Bills. FYG she was kept 3 days more on the ventilator and she passed away peacefully. No Doctor or Family could take the decision to take her out of the support system. No Bill yet from the Hospital.
the next case was a high ranking person admitted to the same Hospital in the same situation. He also was kept in the same situation for around 12-15 days. His hands and feet started swelling, but no Doctor or family could take a decision the man passed away and they were hit with a Hospital bill running in Lakhs.
It is a very hard decision but we as family of our near and dear ones should take difficult decision with much empathy and prayer. Looking at the best interest of the patient.
Lastly there was the case of the raped nurse at KEM who was kept under similar situation for 16 years by interested parties. But who to blame?
YOGEESH RAO V
6 years ago
can you give me a draft of a Living Will and how to go about it...
Sunil Rebello
6 years ago
Dear Money Life,
can you give us a draft of a Living Will and how to go about it..
Best Regards
Bapoo Malcolm
Replied to Sunil Rebello comment 6 years ago
No. That's not possible. Have clearly written that you need to consult a lawyer. The matter is too dicey. The article shows you a possibility, an introduction. We do understand that "everything" is available on the net. And it's FREE ! But as my father-in-law used to say,"Whatever is free is always very expensive". Please think of the possibilities, the permutations and the combinations.

The day this article was published, a newspaper article talked of doctors refusing to acknowledge Living Wills. You may try with a 'draft', yourself; most of the points are given, but, if you fortunately survive, you may face loads of troubles. Litigation, too, maybe.

Even I, who is making his own living will, am facing problems of compliance. Maybe, I could then circulate it. But it can never be copied as each will be so different.

Sorry!
S A Narayan
Replied to Bapoo Malcolm comment 6 years ago
Currently in the absence of acceptability of living wills, doctors and hospitals are ever ready to put patients on ventilator or other intrusive and aggressive intervention as long as they are assured that the bills will be paid. People are seeking legitimacy of living wills more to state what they dont want doctors to do just to keep a body alive at any cost. Therefore medical costs etc issues and insurance complications etc for medicare may not arise. I presume that access to money etc during course of treatment and thereafter would be be available to jt./ac holder to discharge obligations of payment.
In anycase thwe maker of the living will must take a few near and close relatives, spouse into confidence and seek commitment to comply at the right time. But the draft bill expressly says that the living will will not be binding on doctors. that must be made to change.
Bapoo Malcolm
6 years ago
Moneylife has been bringing, to its readers, legal topics much ahead of their becoming important. The latest issue talks of the very problem that is in the Times this morning. That of euthanasia. Moneylife readers should take this opportunity to put forward their views on living wills and their mandatory implementation just as normal wills. Will try and get the agency and its address to whom one may write.
S A Narayan
Replied to Bapoo Malcolm comment 6 years ago
The address is [email protected]
If more and more people submit suggestions re legalising 'living will' govt will have to listen.
The address to send suggestions is [email protected]l.com
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