Mumbai: The Maharashtra government has laid down a framework for constituting primary and secondary medical boards in private hospitals to implement Supreme Court guidelines on end-of-life decisions or ‘living will’ and withdrawal of life-sustaining treatment in terminally ill patients.The framework, part of a Government Resolution (GR) issued by the state public health department follows the Supreme Court’s March 11, 2026 judgment in the case of Harish Rana, who had remained in a severely incapacitated state for 13 years and was unable to communicate or express pain. The apex court permitted withdrawal of clinically assisted nutrition, hydration and other life support measures in accordance with his advance directive. Rana was shifted to AIIMS, New Delhi, where he passed away on March 24.The Supreme Court’s judgment in the Rana case had reiterated that decisions on withdrawing life-sustaining treatment in accordance with a patient’s advance directive or living will must be examined and approved by designated medical boards.Passive euthanasia entails withdrawal or withholding of life-sustaining medical treatment to allow a natural death.The GR stated that the Supreme Court, while referring to its Common Cause judgment, had made it mandatory that whenever treatment is proposed to be withdrawn in accordance with a patient’s living will, approval of both a primary and a secondary medical board is necessary.The state had already constituted such boards in government hospitals through a GR issued on November 29, 2024, and has now extended the mechanism to private hospitals, it said.According to the order, the primary medical board in a private hospital will be constituted by the hospital’s medical director, chief executive officer or medical superintendent, and comprise the hospital administrator as chairperson, the treating medical expert, a critical care specialist, and a senior physician or surgeon.The secondary medical board will be constituted under the district civil surgeon for hospitals outside Mumbai and the Mumbai Suburban districts.In Mumbai and Mumbai Suburban, the medical superintendent of the state-run JJ Hospital will be part of the process.The board will include the hospital’s medical director as chairperson, the treating doctor, two subject experts with more than five years of experience, an empanelled external specialist nominated by the district civil surgeon, and the district civil surgeon.The government has also directed district civil surgeons to prepare panels of registered medical practitioners from their respective districts for nomination as external experts on the secondary medical boards.It has further instructed district authorities to bring the GR to the notice of all private hospitals in their jurisdictions.
