‘Living Will’ counters in Kerala: Local self-government eyes expansion for more public access
Thiruvananthapuram: Kerala’s Local Self-Government Department has sought legal advice on opening additional living will counters across the state, following favourable reports from Joint Directors of local government institutions.
The move comes amid growing demand to streamline access to advance medical directives, commonly referred to as living wills or death wishes, in line with Supreme Court guidelines.
A living will guarantees an individual’s right to live with dignity—and die with the same dignity. It is a written declaration made in advance stating that life should not be artificially prolonged through medical intervention in the event of a terminal illness or irreversible condition with no reasonable chance of recovery.
In cases where a patient is in an indeterminate medical state, family members may rely on the documented living will to guide end-of-life decisions in accordance with legal and ethical norms.
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The system was introduced in Kerala following a 2018 Supreme Court judgment recognising the validity of advance medical directives and passive euthanasia under strict safeguards.
At present, living will counters operate in the Palliative Care Divisions of Paripally Medical College in Kollam and Alappuzha Medical College. The intended public benefit can be fully realised only if the facility is made available statewide.
Under the proposed framework, the registered living will must be deposited with the concerned local self-government institution. Implementation of related medical procedures would require coordination with the Health Department.
The latest development follows a petition submitted to the Local Government Department by Alappuzha-based social activist Chandradas Keshhava Pilla. Acting on the petition, the Principal Director sought feasibility reports from Joint Directors across districts.
After receiving positive responses supporting the expansion of living will registration counters, the department referred the matter to the Law Department for further examination.
The legal review will assess procedural safeguards, administrative responsibilities and compliance with Supreme Court directives before a final decision is taken.
Similar living will registration mechanisms are currently being implemented in Maharashtra, Karnataka, Odisha and Haryana, providing a model for decentralised advance directive systems.