Dear Friends, thank you for your kind words of appreciation after having reflected on what I said in 🔗 FC #28. I am very grateful to all of you for helping me get my reader base closer to that magical number of 1000. I am just 10 shy of that target, so, please continue to share your favourite editions and encourage people to sign up.
🙏🏽 Sankranti
You may have celebrated Sankranti or Pongal with the family on Thursday, and enjoyed pongal and other delicacies. I’m sure this year meant a more mellow celebration, with social distancing limiting a gathering of the extended family. At our house, we formed our own family bubble with just three families getting together and celebrated the festival in somewhat a subdued way.
The exchange of ellu (white til gently roasted with bits of jaggery and copra, or desiccated coconut, with a piece of sugar cane and in some cases sugar candy in different shapes, like birds, flowers etc.) has been a customary practice for as long as I remember. When we were kids the added fun was the showering of ellu mixed with lots of coins by the eldest member in the family on all the kids present — the scrambling that followed to get hold of as many coins as one could was indeed exciting.
Interestingly, kids did not mean just the little ones, say under 12, but included all regardless of age so long as you are younger than the person showering ellu on you. It was absolutely rib-tickling to see a person earning a five-figure salary scrambling to grab as many coins as they could. It brought out the kids in all of us. When I was a child, our joint family had more than a dozen kids and it was such fun when this shower took place. The boys cried foul when the girls spread out their skirts to catch more coins than boys could with their outstretched hands.
In our home in Mysuru, we had a few cows and buffaloes and we enjoyed the ritual of painting their horns and making them walk over a low fire of hay. It was believed that this symbolic ritual would protect the cows and the crops.
The Sankranti festival is celebrated differently all over India.
In Mumbai where I lived for over 25 years, the Maharashtrians would distribute Sesame (til) laddus. It was an occasion to visit near and dear ones and distribute tilgul saying, “Tilgul ghya, god god bola!” — meaning “Take a tilgul and talk sweet!” The underlying thought in the exchange of tilguls is to forget the past ill-feelings and hostilities and resolve to speak sweetly and remain friends. This year, in Punjab, Lohri was celebrated on the 13th of January. Lohri is indeed a colourful celebration and it marks the end of winter and the time to harvest rabi crops. A bonfire is lit, families whirl around it singing Punjabi folk songs and popping sesame seeds, popcorn and jaggery.
In Assam, this festival is called Magh Bihu.
Despite the different celebrations, this festival represent the same thing, the end of the past winter and the fresh start offered by a new year.
Dear Readers, may the year 2021 be a year free of COVID-19 and may the world be one caring family: Vasudhaiva Kutumbakam.
✍🏽 Living Will
One of my readers, who is also my niece, Dr Shubha Prasad, spent the better part of her life in Australia where she practised medicine. Having been born and brought up in Mysuru, she and her husband decided to reverse migrate to Mysuru after nearly four decades. Initially, they enjoyed living in their own modest bungalow in Gokulam area but as years passed by, they found it very challenging to maintain the property and getting help to run the household. They moved into a modest apartment within a senior living complex and are very happy knowing help is at hand and all essential things are taken care of.
In my view, she made a wise move. I too have made provision for such a contingency by owning an apartment in a Senior Living Community called Serene Urbana just 3 kilometers after the Bengaluru International Airport.
Being a practical person and a medical doctor, Shubha visualises certain contingencies and aims to plan as much ahead as is possible. So, after reading 🔗 FC #28 she messaged me to say she liked it very much and went on to request me to write on ‘Living Will’.
Readers may recall that I had discussed at length the various aspects of a Will, which is a testamentary disposition, in 🔗 FC #007 (you can find it here if you wish to refresh your memory).
Living Will, as it is popularly known, is actually an advance medical directive. It operates during the lifetime of the person, unlike a normal Will which takes effect after the demise of the testator.
There are two essential ingredients that are found in a Living will. One, it becomes effective only when the person who made it is no longer able to make an informed decision or communicate his or her wish. The person authorised will take those decisions in accordance with those directives. For example, the person can make a directive that after death the body be handed over to medical research after harvesting the organs. The authorised person will need to ensure it is done. Second, there cannot be any directive to carry out active euthanasia.
A petition was filed seeking enactment of a law on the lines of the “Patient Autonomy and Self-determination Act” of the USA, which sanctions the practice of executing a Living Will in the nature of an advance directive for refusal of life-prolonging medical procedures in the event the person is no more in a condition to give consent.
In a landmark order, the Supreme Court on March 9, 2018, has held that the right to die with dignity is an inextricable facet of Article 21 of the Constitution. It further said that an adult human having the mental capacity to make an informed decision has the right to refuse medical treatment including withdrawal from life-saving devices such as ventilators and other life support equipment. The Court did not rule on ‘active euthanasia’ which essentially means withholding treatment which could have an outside chance to save the patient.
One may recall the case of Aruna Shanbhag, a nurse in Mumbai’s KEM hospital who lapsed into a vegetative state after strangulation which cut off the oxygen supply from her brain. She lay in the hospital in that state for 42 years and though a plea was made for ending her life by ‘active euthanasia’ the hospital resisted and eventually Aruna died a natural death.
Reverting to the topic of making a Living Will, though a Bill has been proposed, it has not been enacted as law. The Bill is called “The Management of the Patient with Terminal Illness Withdrawal of Medical Life Support Bill”.
Consequently, until the Bill becomes law, certain directives issued by the Supreme Court will have to be followed. Ordinary citizens may find the procedure rather cumbersome.
If you wish to make a Living Will, the steps to be followed by you, in brief, are:
Living Will can only be executed by an adult with a sound mind and who is physically and mentally in a condition to communicate, relate and comprehend the objectives and consequences of executing such advance medical directives document.
The person should specify the medical conditions like vegetative state, terminal illness, coma where the person doesn't want the kind of treatment that prolongs suffering, pain etc. just to be kept alive.
You should mention the name of a trusted close relative who, in the event that you become incapable of taking decisions, shall have the authority to give consent to refuse or withdraw medical treatment in a manner consistent with your advance directives.
It should be witnessed by two witnesses and should be authenticated by a Magistrate.
A copy of this Living Will is then given to the District Court and also to the Municipality.
The procedure is rather cumbersome but given the seriousness of the advance directive in the context of the terminal stages of illness when you are unable to communicate and entrust the decision making to someone else, it appears desirable to follow these precautions until the law is enacted prescribing some other procedure. Making a Living Will also reduces the burden on your loved one to take a difficult decision in an already difficult time.
Some people may want to execute a medical power of attorney. But, a medical power of attorney is different from a Living Will, which is a document that details your wishes regarding the specific types of medical care you do and don’t want to receive. Medical power of attorney, on the other hand, simply allows someone to make those medical decisions for you. Such medical power of attorney is prevalent in other parts of the world but not in India.
If one is not inclined to go through the elaborate procedure of creating a Living Will, it should be noted that in the absence of such a Living Will, a medical board will have to take a decision after making an assessment of the patient’s condition. If some directive has been given by the patient and a person has been appointed to carry out that directive, it may make it easier for the doctors to decide on the course of action. Though such a directive may not qualify as a living will as enunciated by the apex court, in my personal view, a notarized document may be of some collateral support for the doctors to take a view. If you wish to know more about making a living will, please visit: 🔗 Living Will: Step by Step Procedure for Executing- iPleaders
I hope Shubha and others who are interested in knowing more about Living Wills find this newsletter informative. Please write to me if you have any questions.
Let me end this edition on a happy note. Kite flying is part of the Sankranti festival. The English expression ‘Go Fly a Kite” means “leave me alone”. But kids enjoy being left alone, to fly a kite.
“Let’s Go Fly a Kite” is a popular song from the 1964 Disney Musical Mary Poppins. Give it a listen:
Take care, my friends! See you next week!
Very well written. I had drafted a living will for a client about 5-6 years ago as she wanted to do so as to control her decisions, if she is unable to make decisions.
As part of planning for future, we have been toying with the idea of getting a home in a senior citizens condominium but have not got around to it. Your writing has again put me in the "put it into action" mode.
Your "go fly a kite" sounded so bindaas that it left me grinning. Waiting for the next filter cuppa :)
Well done.