Right to Palliative Care and End-of-Life Decisions in Gujarat

Source: Supreme Court of India, Common Cause v. Union of India, (2018) 5 SCC 1 (passive euthanasia / advance medical directives); National Health Policy, 2017; NMC Regulations 2023

Reviewed by the Commoner Law Editorial Team. Sourced from Indian central (Union) law — Constitution of India, central Acts of Parliament, and Supreme Court decisions. State-level information reflects each state's own Acts and High Court rulings. Written in plain language for general understanding — this is educational content, not legal advice. Our editorial standards

Indian Central Law

What is this right?

The Supreme Court in Common Cause (2018) recognised the right of a terminally ill patient to refuse life-sustaining treatment — upholding the concept of "dying with dignity" as part of Article 21.

Passive euthanasia is legal in India — withdrawal of life-sustaining treatment (ventilator, artificial nutrition) at the patient's informed refusal is permitted, and courts have allowed it with procedural safeguards.
Advance Medical Directive (Living Will): The Supreme Court (Common Cause, 2018) permitted competent adults to make a valid advance directive specifying that they do not wish to be put on artificial life support in terminal illness. The directive must be:
- In writing, signed by the person and two witnesses.
- Countersigned by a Judicial Magistrate First Class.
- A Nominated Representative must be named to carry out the directive.
Palliative care: The National Health Policy, 2017 recognises the need for universal access to palliative care — pain management (including opioid analgesics for terminal patients) is a part of the right to health under Article 21.
Opioid access: The Narcotic Drugs and Psychotropic Substances Act (amended 2014) allows essential narcotic medicines (morphine, oxycodone) for pain management in palliative care through government hospitals and licensed institutions.
Right to information: A terminally ill patient has the right to know their diagnosis and prognosis — doctors cannot withhold a terminal diagnosis from a competent patient (though family wishes can be considered).

When does it apply?

You or a family member is terminally ill and wishes to refuse further curative treatment and focus on comfort/palliative care.
You want to make an advance medical directive (Living Will) specifying your wishes for end-of-life care.
A terminally ill person is in severe pain and requires access to opioid pain management.

What to Do If a Terminally Ill Person in India Is Being Denied Adequate Palliative Care

To make an Advance Medical Directive: prepare a written document specifying your wishes, have it signed before two witnesses and a Judicial Magistrate First Class (JMFC), and keep a copy with your nominated representative and your family doctor.
Discuss palliative care options with the treating doctor — every major government hospital must have a palliative care wing (National Health Policy mandate). Ask for a referral to the hospital's palliative care team or a specialist palliative care facility.
If a family member is dying in pain and opioid medication is being withheld due to prescription reluctance, escalate to the hospital's pain management department or request a palliative care specialist's involvement.

What should you NOT do?

Do not confuse passive euthanasia (legal) with active euthanasia (illegal) — the Supreme Court has only permitted withdrawal of life-sustaining treatment, not active steps to end life.
Do not make an advance directive without the proper formalities (magistrate's countersignature) — an informal written note does not have the legal standing of the advance directive under Common Cause.
Do not keep the advance directive secret from your nominated representative, family doctor, and the hospital — it must be accessible at the time of need to be acted upon.

Gujarat Law

How Gujarat differs from central law

Palliative care rights in Gujarat are governed by the central Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 (as amended in 2014), which simplified the process for obtaining essential opioid medications for pain relief. Gujarat has amended its state NDPS rules to allow recognized medical institutions to procure morphine and other essential opioids for palliative care without excessive bureaucratic hurdles.

Gujarat's National Programme for Palliative Care (NPPC) implementation includes establishing palliative care services at district hospitals and community health centres. However, palliative care access in Gujarat remains concentrated in urban centres like Ahmedabad, Surat, and Vadodara, with limited availability in rural areas. Several NGOs and private hospitals in Gujarat offer palliative care and hospice services.

Patients receiving palliative care in Gujarat have the right to adequate pain management, informed decision-making about their treatment, and dignity in end-of-life care. The Supreme Court's ruling in Common Cause v. Union of India (2018) recognizing the right to a living will and passive euthanasia applies across Gujarat.

Additional Steps in Gujarat

For palliative care services, contact the district hospital or a palliative care centre in your area. The Gujarat Cancer and Research Institute in Ahmedabad provides palliative care. You can also contact the Indian Association of Palliative Care for referrals to palliative care providers in Gujarat. For pain medication access, speak with your treating physician about morphine availability.

Relevant Law: Narcotic Drugs and Psychotropic Substances Act, 1985 (amended 2014); National Programme for Palliative Care; Common Cause v. Union of India (2018) 5 SCC 1

Common Questions

When does right to palliative care and end-of-life decisions apply?

You or a family member is terminally ill and wishes to refuse further curative treatment and focus on comfort/palliative care.You want to make an advance medical directive (Living Will) specifying your wishes for end-of-life care.A terminally ill person is in severe pain and requires access to opioid pain management.

What should I do if a hospital in India is refusing to allow my terminally ill family member to refuse further curative treatment?

To make an Advance Medical Directive: prepare a written document specifying your wishes, have it signed before two witnesses and a Judicial Magistrate First Class (JMFC), and keep a copy with your nominated representative and your family doctor.Discuss palliative care options with the treating doctor — every major government hospital must have a palliative care wing (National Health Policy mandate). Ask for a referral to the hospital's palliative care team or a specialist palliative care facility.If a family member is dying in pain and opioid medication is being withheld due to prescription re...

What mistakes should I avoid with right to palliative care and end-of-life decisions?

Do not confuse passive euthanasia (legal) with active euthanasia (illegal) — the Supreme Court has only permitted withdrawal of life-sustaining treatment, not active steps to end life.Do not make an advance directive without the proper formalities (magistrate's countersignature) — an informal written note does not have the legal standing of the advance directive under Common Cause.Do not keep the advance directive secret from your nominated representative, family doctor, and the hospital — it must be accessible at the time of need to be acted upon.

Right to Palliative Care and End-of-Life Decisions in other states

Same topic, different jurisdiction. Pick the one that applies to you.