Dr Haroon Hussain delivers talk on 'Living Will and Pathways to making advance Medical Directive'
National GSI Conference in Bhubaneswar
Bhubaneswar: Dr Haroon Hussain, senior physician at the Department of Medicine, KMC Hospital, Mangaluru, addressed an important session on Medical Law and Ethics at the National Midterm Conference of the Geriatric Society of India (GSI) held recently in Bhubaneswar between 20-22 June, 2025.
The Geriatric Society of India is a professional organisation working towards improving the health and care of elderly people across the country. The midterm conference served as a platform for medical professionals and experts from different parts of India to discuss and deliberate on challenges and advancements in geriatric care.
During his address, Dr Haroon shed light on the sensitive yet significant topic of end-of-life care. He began by highlighting the complex socio-cultural landscape in India, where even initiating conversations around death is often considered taboo or viewed as apa-shagun (inauspicious).
“While death is an event, dying is a process that takes place while one is still alive. The experiences of patients in this phase, and the emotional journey of their family members, can have long-lasting psychological and social impacts,” he noted.
Dr Haroon stressed the importance of advance care planning, explaining that it is not just a matter of signing a document, but rather an ongoing dialogue. “It is a process involving multiple discussions between the patient, family members, and healthcare professionals to empower patients to make informed decisions about their future medical care,” he said.
He also highlighted the ethical principles that guide end-of-life decisions, including autonomy (the patient's right to make informed choices), beneficence (acting in the patient’s best interest), non-maleficence (doing no harm), and justice (fair and equal treatment).
Touching on the legal aspects, Dr Haroon referred to the landmark 2018 Supreme Court judgement in the Common Cause vs Union of India case, which legally recognised the concept of a ‘Living Will’ or Advance Medical Directive (AMD). This judgment laid the foundation for patients to express their wishes in advance about the kind of medical treatment they would want, or refuse, in case they become terminally ill or unable tox communicate.
The Supreme Court’s guidelines were further simplified through procedural amendments in 2023. As per the law, hospitals are required to set up a Primary Medical Board (PMB) comprising the treating doctor and two senior medical experts to review any case where life-sustaining treatment may be withheld or withdrawn.
A Secondary Medical Board, including three medical experts (one of whom is appointed by the District Medical Officer), must also evaluate the patient’s condition and give its decision within 48 hours. Once both boards and the patient’s surrogate decision-maker reach a consensus, the decision is documented and communicated to the local Judicial Magistrate First Class (JMFC).
Dr Haroon emphasised that during this process, it is essential to respect the wishes mentioned in the Advance Medical Directive. “Treatments that are explicitly refused must not be forced upon the patient. Instead, the focus should shift to symptom control, comfort, and providing holistic palliative care,” he said.
Palliative care, according to him, should aim to relieve suffering while upholding the patient’s dignity, and must also address the psychological, social, emotional, and spiritual needs of both the patient and their caregivers. Grief counselling and family support form an important part of this care.
He concluded by stating that all of this is rooted in Article 21 of the Indian Constitution, which guarantees the right to life with dignity. “Respect for cultural and religious values is also vital in this journey,” he added.
It is worth noting that Karnataka became the first state in India to bring a structured legal mechanism into place for the implementation of Advance Directives.
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AIITA welcomes Karnataka’s ban on obscene songs in school events
Bhatkal: The Karnataka unit of the All India Ideal Teachers Association (AIITA) has welcomed the Karnataka government’s decision to strictly ban school children from dancing to obscene songs during educational and cultural programmes in government, aided, and private schools across the state.
AIITA Karnataka State President M. R. Manvi congratulated the government for taking what he termed an important step to preserve the sanctity of education.
“Such decisions to safeguard the dignity of school children and uphold the values of education are the need of the hour. This rule should not be limited to government schools alone but must be strictly implemented in all private educational institutions as well,” he said.
He further urged the government to address other concerns within school programmes.
“The government should not only prohibit obscene dances in the name of school anniversaries, but also ensure that plays and dialogues that incite religious hatred are avoided. Schools should be centres of harmony, not platforms for spreading hatred,” he added.
According to a recent circular issued by the Department of School Education and Literacy, obscene dances are adversely affecting the mental health and moral values of students.
In this regard, schools have been advised to use songs that promote nationalism, positive thinking, the greatness of Kannada culture, and value-based traditions instead of inappropriate content during programmes.
The circular also emphasises that students should be dressed in decent attire.
AIITA also backed the department’s warning that disciplinary action would be taken against head teachers if such guidelines are violated. The association has further demanded that district Deputy Directors of Public Instruction strictly monitor the implementation of these rules.
