Health Department proposes to seek inclusion of ‘living will’ under digital health records of patients

Karnataka introduces Advance Medical Directive (AMD) allowing patients to record desired treatment preferences for the future.

Citizens in Karnataka can now record their desired medical treatment in the future in an Advance Medical Directive (AMD) or a ‘living will’. The State Health Department, which has come out with a circular on AMD, is now contemplating getting the ‘living will’ included under digital health records of patients.

For the AMD, the patient can also nominate two persons to decide on his/her behalf if the patient does not have decision-making capabilities. The AMD would indicate to healthcare providers the kind of treatment the patient wants or prefers to avoid.

“Any adult patient of sound mind can execute an AMD and should send a copy of the AMD to a competent officer who is to be appointed for this purpose by the local government. AMDs can also be maintained in the paper/digital health records of the patient which are maintained by the medical establishment,” stated a separate circular issued in this regard on January 30.

Harsh Gupta, Principal Secretary (Health and Family Welfare), told The Hindu that the department was now contemplating getting the AMD included under the patients’ digital health records.

“The AMD should be stored safely and be available for verification. To avoid its misuse, we are planning to write to the Centre to come up with a common mechanism with a unique ID such as Aadhaar number or Ayushman Bharat Health Account (ABHA) number for the AMDs. This unique ID will help even if the person migrates to some other State. We will submit a proposal in this regard to our Chief Secretary as a common policy should be put in place for the unique ID,”  he said.

Meanwhile, welcoming the move Sundar Sankaran, nephrologist and director of Aster Institute of Renal Transplantation in Bengaluru, said as a doctor he always wanted this ruling to be effective. “Most of the time, the family members are reluctant to let go especially if the children are abroad and if they are doctors. I am in the same predicament with my children being abroad and are doctors. Hence, I have already mentioned in my joint will with my spouse that no active invasive intervention should be done. No one should die alone in the ICU without family and friends, if possible,” he said.

Nagesh Simha, medical director of Karunashraya Hospice Trust in Bengaluru, who has been working closely with the Health Department seeking dignified death for the terminally ill, said the move is a huge relief for people in critical care.