Living Will: Making Your Healthcare Wishes Known

About the Author

Uma Iyer is a counsellor and psychotherapist with a special interest in Psycho-Oncology, Grief and Bereavement, and Palliative Care. She volunteers with Sparsh Hospice.

As a race, we tend to plan for many things in life. We make vacation plans years in advance, we invest in long term assets, we buy health insurance to manage medical expenses, we write Wills to decide how our wealth will be distributed. But how often do we discuss what should happen if, one day, we are unable to make decisions about our own medical treatment?

It is an uncomfortable conversation, particularly in Indian families where healthcare decisions are often made collectively. When a parent is seriously ill, children find themselves discussing treatment options with doctors, trying to understand what their loved one would have wanted. And since we are who we are, the extended family and friends and society all play a role in the decision-making.

Should every possible intervention be attempted? What if treatment can prolong life but cannot reverse the underlying condition? What would the person have chosen if they could speak for themselves?

These are not easy questions. And they are often asked when a family is already dealing with a great deal of stress.

A Living Will is one way of addressing some of these questions in advance. It allows a person to record their preferences for medical care in circumstances where they may no longer have the capacity to communicate or make decisions.

What Exactly Is a Living Will?

A Living Will is a written document in which a person, while they have the capacity to make decisions, records their preferences regarding medical treatment should they become unable to communicate those decisions in the future. It is also referred to as an Advance Medical Directive (AMD) or Advance Directive.

What is the difference between a Will and a Living Will?

A conventional Will deals with what happens to your assets after your death. A Living Will deals with your healthcare preferences while you are alive but may no longer be able to express your wishes.

For instance, a person may want to record their preferences regarding life-sustaining medical interventions if they develop an advanced, irreversible condition and are no longer able to make decisions. These preferences may relate to treatments such as mechanical ventilation, resuscitation or other interventions intended to sustain bodily functions.

The document helps communicate the person’s wishes to their family and treating medical team. It is not a substitute for medical assessment, and it does not mean that treatment decisions can be made without considering the person’s medical condition and the applicable legal requirements.

The important distinction is that a Living Will records the patient’s wishes, rather than leaving the family to guess what those wishes might have been.

Why Does a Living Will Matter?

Consider a situation many families may recognise.

An elderly parent is admitted to hospital following a serious illness. The condition deteriorates, and the parent is no longer conscious or able to communicate. The medical team explains the available interventions, but the likely outcome remains uncertain. The family is asked to make decisions.

One child feels that every possible treatment should be attempted. Another remembers conversations in which the parent expressed a wish not to be kept alive through prolonged medical interventions. A third is worried that choosing not to proceed with a treatment might mean they are giving up on their parent.

Nobody wants to make the wrong decision. And nobody wants to feel responsible for what happens next. In such situations, families may experience considerable emotional distress. They are trying to understand medical information, make decisions under pressure and cope with the possibility of losing someone they love.

A Living Will can help by providing a record of the person’s own preferences. It does not remove the sadness or uncertainty of the situation, but it can reduce some of the burden of having to make decisions without knowing what the person would have wanted.

Having discussed and documented preferences in advance gives families something concrete to refer to. It allows them to focus more on supporting the person and less on trying to reconstruct their wishes during a crisis.

What Does Indian Law Say About Living Wills?

In India, the legal position on Living Wills has evolved through important Supreme Court judgments.

The Supreme Court’s 2018 judgment in Common Cause v. Union of India recognised the right to execute an Advance Medical Directive and laid down safeguards for its preparation and implementation. The Court connected this right with personal autonomy, dignity and the right to refuse medical treatment in appropriate circumstances.

In January 2023, the Supreme Court modified the procedural guidelines established in 2018 to make the process more practical.

These developments are significant because they recognise that decisions about medical treatment are not solely the domain of doctors or family members. A person who has the capacity to make decisions has an important say in how they wish to be treated.

For the current legal position and applicable procedures, readers should refer to the Supreme Court of India and obtain appropriate legal guidance rather than relying on an old template or an informal online source.

What are the key provisions?

The following is a general summary of the Supreme Court’s framework, not a substitute for legal advice.

Does a Living Will Mean Refusing Medical Treatment?

This is one of the most common concerns surrounding Living Wills.

For many people, the idea of documenting treatment preferences can sound like giving up on life or refusing medical help. Families may worry that signing a Living Will means doctors will stop treating the person, or that they will be denied care when they need it most.

That is not what a Living Will is intended to do.

A Living Will concerns a person’s preferences about particular medical interventions in specified circumstances. It does not mean refusing all medical treatment, and it does not prevent a person from receiving appropriate care.

For example, a person may wish to receive treatment for infections, pain, breathlessness or other symptoms while also expressing preferences about certain life-sustaining interventions if they develop an irreversible condition and lose decision-making capacity.

The distinction is between treatments intended to address a medical problem and interventions that may prolong the dying process in circumstances covered by the directive. The actual medical decisions depend on the person’s condition, the directive’s terms and the applicable safeguards.

It is also important to understand that a Living Will does not authorise active euthanasia. The Supreme Court’s framework concerns the refusal or withdrawal of medical treatment in specified circumstances, subject to safeguards. It does not permit deliberate action to cause death.

Choosing not to undergo a particular medical intervention is not the same as choosing not to receive care.

Living Wills and Palliative Care: Understanding the Connection

Palliative care is often misunderstood as care provided only in the final days of life. In reality, it focuses on improving quality of life for people living with serious illnesses through pain and symptom management, psychological support, communication and care for families.

It can be provided alongside treatments intended to control or treat the underlying illness.

For a broader understanding of palliative care and its role in serious illness, the World Health Organization’s overview of palliative care is a useful reference.

A Living Will and palliative care are connected because both encourage conversations about what matters to the person, what outcomes they value and what kind of care they would prefer.

For someone living with an advanced illness, these conversations may include questions about comfort, independence, the burdens and benefits of treatment, the place where they would prefer to receive care and the people they want involved in decisions.

These are deeply personal matters. Two people with the same diagnosis may have very different preferences. One may wish to pursue every medically appropriate treatment available, while another may place greater emphasis on comfort and avoiding particular interventions.

Neither preference should be assumed.

The role of healthcare professionals is to explain the available options, discuss likely benefits and burdens, and support informed decisions within the applicable medical and legal framework.

A Living Will gives people an opportunity to consider these questions before they become urgent.

These conversations are also part of a much wider question of planning for healthcare costs and care needs in later life. GreySmiles has previously explored how to plan for healthcare costs in retirement, including the importance of thinking beyond routine medical expenses.

For families also thinking about the practical realities of serious illness at home, our guide to Home ICU and elder-care nursing costs in India looks at another aspect of planning that families often encounter only when a crisis has already begun.

Why We Often Avoid This Conversation

In many Indian families, conversations about serious illness and death tend to happen only when there is an immediate medical concern. Even then, people may avoid discussing the possibility that treatment may not lead to recovery.

There are understandable reasons for this. Talking about end-of-life care can feel frightening or pessimistic. Parents may worry about upsetting their children, while children may feel that raising the subject is disrespectful or suggests that they have lost hope.

Sometimes, families believe that discussing a Living Will means they are inviting something unfortunate to happen but discussing a possibility does not make it inevitable.

It can also open up conversations that are useful well before the end of life. What does quality of life mean to you? What are you most concerned about when it comes to serious illness? Who would you trust to help communicate your wishes? What information would your family need to make decisions in keeping with your values?

These discussions do not have to happen in one sitting. They can begin with a simple conversation and continue as circumstances or preferences change.

The aim is not to make the family comfortable with death. It is to make it easier for them to understand your wishes if difficult decisions arise.

Preparing a Living Will: Where Do You Begin?

A Living Will deserves careful thought. It is not simply a form to sign and put away.

The first step is to understand what an Advance Medical Directive does and the circumstances in which it may become relevant. It is useful to discuss your questions with a healthcare professional familiar with serious illness and end-of-life care, and to obtain appropriate guidance on the legal requirements.

1. Think about what matters to you

Consider what you value in terms of quality of life, independence, comfort and medical treatment. You may want to think about your preferences regarding life-sustaining interventions in circumstances where recovery is not expected and you are unable to make decisions.

These are not questions that require immediate answers. Take the time to understand the medical implications of the choices being considered.

2. Discuss your wishes with your family

Talk to the people who may be involved in your care. Explain what you are considering and why. Give them an opportunity to ask questions and share their concerns.

This is particularly important if you intend to nominate a guardian or close relative to help communicate your wishes when you are unable to do so.

3. Seek medical and legal guidance

The Supreme Court has laid down specific requirements for the preparation, authentication and implementation of Advance Directives. Obtain the appropriate document and ensure that it complies with the applicable guidelines.

A general online template may not address all the requirements or your particular circumstances.

4. Make sure the document can be found

A Living Will is of little practical use if nobody knows it exists or where it is kept.

Provide copies to the people identified in the directive and your family physician, if any. Consider whether it can be incorporated into your digital health records. Make sure your family knows how to access it.

5. Review it when circumstances change

Your understanding of medical treatment and your personal preferences may change over time. Review the document periodically, particularly after a significant change in health or circumstances.

If you wish to modify or revoke a directive, obtain guidance on the appropriate procedure so that your current wishes are accurately recorded.

How Sparsh Hospice Is Helping People Have This Conversation

Sparsh Hospice, a centre for palliative care in Hyderabad, provides inpatient, outpatient and home-based care for people living with serious and terminal illnesses, with a focus on pain relief, symptom management and support for patients and families. Its multidisciplinary team includes doctors, nurses, counsellors and social workers.

In October 2025, Sparsh Hospice launched a Living Will Clinic in Hyderabad to support individuals and families with advance care planning. The clinic offers medical and legal guidance, counselling and assistance with documenting healthcare preferences, helping people approach these conversations with greater clarity.

The initiative reflects an important aspect of palliative care: helping people make informed decisions about their care while supporting their families through the process.

A Conversation Worth Having

Most of us would prefer not to think about a time when we may be unable to speak for ourselves. It is understandable. Serious illness and end-of-life decisions are difficult subjects, and no document can remove the uncertainty or sadness that families may experience.

But planning ahead can make some aspects of that situation easier.

A Living Will gives you an opportunity to express your healthcare preferences while you have the capacity to do so. It helps your family understand what matters to you and gives your medical team information that may be important when decisions need to be made.

It does not replace conversations with your family, nor does it guarantee a particular medical outcome. It is one part of preparing for future healthcare decisions, alongside discussions with doctors, appropriate legal documentation and access to good palliative care.

Perhaps the simplest place to begin is with a question:

If not, there is no need to have all the answers today. Start the conversation, ask questions and seek reliable guidance.

Because making your wishes known is not about expecting the worst. It is about ensuring that, should the need arise, your voice remains part of the decisions about your care.

Sources & References

• Supreme Court of India — official source for judgments and current legal information relating to Advance Medical Directives.
• World Health Organization — Palliative Care.