Source: Indian Express 

Introduction 

The Ministry of Health and Family Welfare has released draft guidelines for withdrawing life support in terminally ill patients. These guidelines aim to turn the Supreme Court's 2018 and 2023 orders about the right to die with dignity into practical rules for hospitals. 

What Makes Someone "Terminally Ill"? 

• According to the guidelines, terminal illness means an irreversible or incurable condition where death is inevitable in the near future.  
• This includes severe brain injuries showing no recovery after 72 hours or more. 

The Four Essential Conditions for Withdrawing Life Support 

• Doctors confirm brain stem death 
• Medical experts agree that advanced treatment won't help the patient recover 
• The patient or their family (after understanding the situation) refuses further life support 
• All Supreme Court procedures are followed correctly 

What Treatments Can Be Stopped? 

Life-sustaining treatments (LST) that can be withdrawn include: 

• Mechanical ventilation (breathing machines) 
• Vasopressors (blood pressure medications) 
• Dialysis 
• Surgical procedures 
• Blood transfusions 
• Parenteral nutrition (artificial feeding) 
• ECMO (heart-lung bypass machine) 

The Decision-Making Process 

Two medical boards must be involved: 

• Primary Medical Board: At least three doctors who first evaluate the case 
• Secondary Medical Board: Three physicians, including one appointed by the district's Chief Medical Officer, who review the first board's decision 

Legal Standing 

• While India has no specific law about withdrawing life support, it's legal because: 
• The Supreme Court recognizes it under Article 21 (Right to Life) 
• It's different from active euthanasia (which remains illegal) 
• Adults can legally refuse treatment, even if it leads to death 

Way Forward 

• While these guidelines represent significant progress, their success will depend on effective implementation at the state and hospital levels.  
• Medical institutions must now work to establish the required boards and protocols, while ensuring their staff is properly trained in both the technical and ethical aspects of end-of-life care.