Although India's Supreme Court legalized passive euthanasia in 2018 and permitted life support withdrawal in a landmark 2024 case, most Indians remain unaware of their right to create living wills, and families lack guidance on end-of-life care options.
India's legal framework now permits passive euthanasia and allows terminally ill patients to document their medical preferences through living wills, yet the vast majority of the country's population remains unfamiliar with these rights. The Supreme Court recognized the "right to die with dignity" as part of constitutional protections in 2018, and in March 2024, approved the withdrawal of life support for Harish Rana, a 32-year-old who had been in a vegetative state for 13 years—marking the first such case in India.
Despite this legal progress, awareness remains critically low. A 2019 survey found that 73 percent of urban Indians in major cities were unaware of living wills, and only 6 percent of those aware had actually drafted one. According to a 2025 analysis, an estimated seven to 10 million people in India require palliative care, but only about 4 percent receive it. Families of terminally ill patients often find themselves without guidance when treatment options are exhausted, leaving them to navigate end-of-life decisions during moments of grief and uncertainty.
The legal process itself presents significant obstacles. The Supreme Court's guidelines require living wills to be signed before witnesses and countersigned by a magistrate, with multiple medical boards and potential involvement of district magistrates and High Courts. While the court simplified these requirements in 2023, the complexity remains daunting for ordinary citizens. Only two living will clinics operate in India—both in private hospitals beyond the reach of most people—and no parliamentary legislation governs the issue, despite Supreme Court requests to the government in 2018 and 2023.
Cultural factors compound the challenge. Death remains a taboo subject in many Indian households, with discussions about dying considered inauspicious. Doctors and palliative care specialists report that families often appear confused when told treatment has ended and they must take patients home, with no one explaining what comes next or how to maintain dignity during end-of-life care.
