In the landmark case of Common Cause v Union of India (2018), the Supreme Court of India recognized the right to die with dignity as a fundamental right under Article 21 of the Constitution. This right establishes the autonomy of individuals to execute Advanced Medical Directives (AMDs), which are documents specifying end-of-life instructions when a patient is unable to communicate their wishes due to terminal illness.

In 2023 the Supreme Court modified the guidelines to make the right to die with dignity more accessible.

The 2018 judgement established stringent guidelines for the validation of AMDs, requiring the formation of two medical boards—a hospital-based board and a district-level board. The doctors serving on these boards were initially mandated to possess at least 20 years of experience.

The subsequent issue revolved around the practical implementation of these guidelines. There were concerns regarding the stringent qualifications for medical board members, the involvement of the Chief Medical Officer on the district board, and the procedural delays due to the requirement of judicial oversight.

In January 2023, a Constitution Bench revisited these guidelines in response to practical challenges faced during implementation. The Bench modified several provisions to streamline the process of validating AMDs:

• • The requirement for doctors serving on the medical boards was reduced from 20 years of experience to 5 years.
• • The necessity of having the Chief Medical Officer on the district board was eliminated.
• • The mandatory countersignature by a Judicial Magistrate of the first class was no longer required.
• • Both medical boards were instructed to arrive at decisions "preferably" within 48 hours of the case being referred to them, aiming to expedite the process and provide timely decisions in critical situations.

The adjustments made by the Supreme Court in January 2023 aimed to balance the protection of individual rights with practical concerns in healthcare, by reducing the experience requirement for medical board members and eliminating certain bureaucratic hurdles. This decision advances a significant development in the jurisprudence surrounding euthanasia and the right to die with dignity, emphasizing respect for individual autonomy.