"I want to live healthy, and at the time of my death, my interest must be protected,” said 84-year-old Ramakrishnan Nair, who signed his 'living will' at the Institute of Palliative Care in Thrissur on Tuesday. Nair's 80-year-old wife, Swarna, and 28 others also signed documents giving them the 'right to die with dignity' when it is time.

A living will is a document that a person prepares in advance, directing his/her relatives and doctors that all the medical treatments that do not relieve his/her pain and comfort be stopped and that all measures to delay death be withdrawn if the person has an incurable disease and is certain that he/she will not be able to return to a normal life.

In 2018, a Supreme Court bench held that the right to die with dignity was a fundamental right. Last January, a Constitution bench of the apex court issued an order that modified the guidelines from 2018, making it simpler.

Nair, who lives in Tirur since retiring from the Merchant Navy, said he arrived at the decision after watching the sufferings of terminally ill patients. “I have seen relatives of people suffering from incurable diseases put them in ICU, on ventilator and other facilities just to delay their death. The patients live in hell-like situations and nobody is even bothered. I do not want to be in such a situation,” Nair said.

NN Gokuldas, who retired from the Zoology Department in Sree Krishna College, Guruvayur, believes a person's interests are primarily to be protected at the time of death. “I’m a cancer survivor. I went through 10 cycles of chemotherapy to treat Colorectal cancer and I didn’t have the health to undergo two more cycles,” said the 75-year-old.

“The disease is cured, but there is no guarantee that I won't be a cancer patient anymore. Now, I have decided it’s enough. I have realised that the right to live is not the right to just exist, it is the right to live with dignity. Death in today’s world also involves large financial interests. Death is a bigger business than birth. A person is kept in the ICU for as long as it takes to save the finances of the hospitals,” said Prof. Gokuldas, who is one of the founding members of the Thrissur Pain and Palliative Care Society.

P Krishnakumar, a Thrissur resident who signed his living will on the day, is hopeful that their enrollment will mark the beginning of a campaign aimed at educating people that dying with dignity is as important as a dignified life. “Today, we know that the majority of the beds in the ICU and ventilator units are filled with patients waiting to die instead of those who need critical care. Many factors, including social status, wealth, and selfish wishes to see their dear ones for at least a day more deny a person’s basic right to die with dignity,” Krishnakumar said.

Dr P V Ajayan, ENT Professor, Government Medical College, Thrissur, who supervised the signings and certified the documents, expressed hope that programme will spread a positive message. Medical practitioners, palliative care office-bearers and others also signed their living wills on the day.

Living Will: Who can apply and how?
The apex court ruling on the 'living will' stipulates that the person preparing it must be of legal age and of a sound mind. There should be an understanding of the circumstances under which life-prolonging treatment should be terminated. The will must be signed in the presence of two witnesses and be attested by a gazetted officer. A copy of the document is to be sent as a registered post to the secretary of the local body where the person resides. A copy will be provided to the nearest family member who may be children, spouse, sibling or close friend.