Maha: Private hospitals to set up medical boards for end-of-life decisions

Mumbai: The Maharashtra government has issued a framework for setting up primary and secondary medical boards in private hospitals to implement the Supreme Court's guidelines on end-of-life decisions, including the execution of a patient's living will and withdrawal of life-sustaining treatment in terminally ill patients.

The framework has been issued through a Government Resolution (GR) by the state's Public Health Department. The move follows a Supreme Court judgement of March 11, 2026, in the case of a terminally ill patient, in which the Court permitted the withdrawal of clinically assisted nutrition, hydration and other life-support measures in accordance with the patient's advance directive.

A living will, also known as an advance directive, allows a person to specify in advance the medical treatment they wish to receive, or refuse, if they become unable to communicate their decisions in the future. The Supreme Court has recognised such directives while laying down safeguards for withdrawing life-sustaining treatment. 

Under the new framework, any decision to withdraw life-sustaining treatment in accordance with a patient's living will must first be reviewed by a primary medical board and then approved by a secondary medical board. The requirement aims to ensure that such decisions are made after careful medical evaluation and in line with legal safeguards.

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, reports TOI. 

The State Government had already introduced the two-tier medical board mechanism in government hospitals through a Government Resolution (GR) issued on November 29, 2024. As per the order, the primary medical board will be constituted by the hospital's Medical Director, Chief Executive Officer or Medical Superintendent. Chaired by the hospital administrator, it will also include the treating doctor, a critical care specialist, and a senior physician or surgeon. 

The secondary medical board will be constituted under the District Civil Surgeon for private hospitals outside Mumbai and Mumbai Suburban districts. In Mumbai and Mumbai Suburban, the Medical Superintendent of JJ Hospital will oversee the process.

The board will comprise the hospital's Medical Director, the treating doctor, two subject experts with at least five years of experience, an empanelled external specialist nominated by the District Civil Surgeon, and the District Civil Surgeon. It also directs District Civil Surgeons to prepare panels of registered medical practitioners for appointment as external experts and instruct district authorities to notify all private hospitals about the new guidelines.   

According to The Times of India, the Government Resolution follows the Supreme Court's March 11, 2026 judgment, which reiterated that whenever withdrawal of life-sustaining treatment is proposed in accordance with a patient's living will, the approval of both the primary and secondary medical boards is mandatory.