Evidence map›Paper›PMID 42024905›Full record

ArticleThe Indian journal of medical research2026

Procedures to implement the Supreme Court of India directives to withdraw/withhold life-sustaining medical treatment.

Nandini Vallath, V Parvathy, Pratyasa Padhi, Angelin Johny T, Mathangi Krishnakumar, P S Varghese

Abstract read
In one paragraph

Article in The Indian journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Authors' response.The Indian journal of medical research · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nandini VallathDepartment of Pain and Palliative Medicine, St John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
V ParvathyDepartment of Pain and Palliative Medicine, St John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
Pratyasa PadhiDepartment of Pain and Palliative Medicine, St John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
Angelin Johny TDepartment of Pain and Palliative Medicine, St John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
Mathangi KrishnakumarNeuro and Surgical Intensive Care Unit, Department of Anaesthesia, St John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
P S VargheseDepartment of Forensic Medicine and Toxicology, St John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In 2018, the Supreme Court of India legally recognised the rights of patients with terminal illness through the judgement in Common Cause (A Registered Society) v. Union of India and Another, (2018) 5 SCC 1. The processes prescribed to withhold or withdraw artificial life-support medical treatments became practical after the 2023 amendment. The law aimed to ensure the dignified dying of sick individuals whose condition was deemed terminal and irreversible. Healthcare institutions can comply with the Court's guidelines in their entirety only after the concerned State Governments activate specific processes. Karnataka state activated the legal mandates by early 2025. Using an implementation case study, we describe the institutional processes to uphold the ethical and legal mandates when withholding/withdrawing life-support treatment (WH/WD-LST) in a mentally incompetent, terminally ill elderly patient, admitted to a tertiary care hospital in Karnataka. It aims to clarify, (i) validation of 'Advance-Medical-Directive', or the living will; (ii) sequential institutional processes for WH/WD-LST as per ethical and legal mandates; (iii) constitution of the primary, secondary medical boards (PMB, SMB); (iv) reporting formats for PMB, SMB evaluations, and (v) the templates relevant to institutional administrators to convey the mandated details of WH/WD-LST to their jurisdictional judiciary magistrate of first class. The impressions and impact of activating the living will and WH/WD-LST on the family, on patient care, for the professionals, and for the institution are described in brief.

Indexed as

Advance DirectivesLife Support CareTerminal CareWithholding TreatmentHumansIndiaSupreme Court DecisionsTerminally IllAdvance directivesEnd-of-life-policyLiving willsMedical futilitySupreme court-judgmentTerminally ill

Identifiers

PMID42024905
PMCPMC13126532

What OpenQuestion holds

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LicenceCC BY-NC-SA
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.