Published on: June 30, 2025

In India, end-of-life decisions are not made in isolation. They are shaped by love, hope, faith, and duty. The notion of planning for one’s decline is often misunderstood as an act of giving up or losing faith. For families, initiating a conversation about an AMD (Advance Medical Directives) can feel emotionally difficult—as though acknowledging death might somehow hasten it. The idea of documenting one’s wishes in advance can feel like giving up or being disloyal to loved ones. As a result, families often avoid these conversations—until it’s too late. 

But when emergencies strike without an AMD in place, families are left scrambling to make decisions under intense emotional strain. In many such cases, life-sustaining interventions are administered by default, even when they may not align with the patient’s values or wishes. The result is often prolonged suffering for the patient and lasting emotional burden for the family. 

To bridge this gap, AMDs must be humanized. They should be seen not as giving up, but as an act of compassionate preparation. Embedding AMDs into routine care, such as chronic illness management or geriatric check-ups, can normalize them. These conversations are best held in calm, not crisis. Normalizing these conversations before a medical emergency allows patients and families to think clearly, share values, and make informed choices in a calm setting.

India stands at a unique moment: the law now supports a dignified end of life, but the cultural and healthcare systems are still catching up. Moving from policy to practice requires emotionally intelligent, culturally sensitive, and systemically supported frameworks.

By integrating AMDs into mainstream health care—and by treating them not as documents, but as dialogues—we can shift the narrative. One that honours autonomy, compassion, and dignity at life’s most vulnerable threshold.