MUMBAI, Aug. 29 -- Every Saturday morning, one of the consultation rooms at the PD Hinduja Hospital in Mahim attracts a very different set of visitors. They are not patients but come to discuss how they would want their lives to end - or, more precisely, how they would not want them prolonged. Set up in June last year, the hospital's 'Living Will Clinic' has helped more than 100 people make critical end-of-life decisions and make a living will. Unlike a regular will, a living will is a legal document that specifies which life-sustaining medical treatments an individual would want to refuse if they become terminally ill or enter a permanent vegetative state. At the clinic, discussions often centre on issues such as the role played by family members and local health representatives, and the legalities around the process. Simply put, the clinic educates individuals on the subject and attempts to dispel misconceptions. "These are decisions people take when they are healthy and in a position to take them. It is not activated on the first day of hospitalisation; rather, it can be activated only in case of terminal illness and only when it becomes clear that no further treatment will be beneficial for the patient," explains Dr Smriti Khanna, who heads the hospital's Living Wills Clinic. Many who decide to make a living will don't want to burden their families with difficult decisions. "I have seen a relative shoulder a massive emotional, physical and financial burden as she struggled to handle her mother's last days. Although she was a doctor, and it was evident her mother's chances of survival were slim, it was very difficult for her to take a call. I don't want my family to go through that," said Aditi Date, who didn't go through with the process for want of guidance. Making a living will ensure that doctors and caregivers honour an individual's choices about end-of-life treatment. "There is a nationwide repository for living wills on the anvil but it is not yet functional," says Dr Khanna. "We have a long way to go. In countries like the US, living wills are incorporated within the public health system, where doctors initiate discussions on the subject with their patients and take it forward. Even so, only 50% of the population has signed up for it. So, we have a long way to go here." observes neurologist and epileptologist, Dr Roop Gursahani, from the End of LIfe Care in India Taskforce (ELCIT), the moving force behind Hinduja Hospital's clinic. After drafting a living will, an individual must get it notarised by a lawyer and registered with the health department of their local municipal ward office. A copy may also be given to the person's local general practitioner and another to their custodian or immediate family members. If doctors determine that further treatment would not benefit a patient who is unable to make decisions, family members can share the living will with the hospital. The document requires approval at two levels. First, the treating doctor, head of the treating department and institutional medical head must approve it. It is then sent to a secondary committee comprising the medical superintendent of government-run JJ Hospital (for Mumbai and suburbs), two subject experts and an empanelled expert. Only after this committee gives its approval can the hospital implement the directions in the living will....