An NRI who has executed a Health Care Proxy in New York or another US state may assume that document protects their medical decision-making preferences if they are incapacitated while in India. It does not — not automatically. India has its own framework for Advance Medical Directives (Living Wills) established by the Supreme Court in Common Cause v. Union of India (2018) and the subsequent Standard Guidelines notified by the Government in 2019. An NRI with elderly parents in Kerala, or an NRI who spends extended periods in Kerala, must understand both frameworks — and ideally execute an Indian Advance Medical Directive in addition to any foreign document.
How a US Healthcare Proxy Relates to an Indian Living Will
NRIs who have executed healthcare proxies or advance directives in the United States often ask whether those documents are valid in India if they become incapacitated while visiting or residing here. The short answer is: not directly, but the principles are compatible, and having an Indian living will alongside the US document provides comprehensive protection.
US Healthcare Proxy — What It Does
A US Healthcare Proxy (also called a Medical Power of Attorney or Healthcare Power of Attorney in different states) designates an agent to make healthcare decisions on behalf of the principal when they are unable to do so themselves. A Living Will (or Advance Healthcare Directive) records the principal's specific wishes about medical treatment — including decisions about life support, CPR, and artificial nutrition — to guide medical providers and the healthcare proxy.
Indian Advance Directive — The Supreme Court Framework
The Supreme Court of India in Common Cause v. Union of India (2018) 5 SCC 1 recognised the right to die with dignity as part of Article 21 and laid down detailed guidelines for executing a valid "Advance Directive" (living will) in India. The directive must: be in writing; be executed by an adult of sound mind; be signed before two witnesses and a Judicial Magistrate First Class; be kept with the District Medical Board and the Judicial Magistrate. Medical institutions are bound to act on a valid Advance Directive.
The NRI Situation — Practical Approach
For NRIs who divide their time between India and abroad, the best approach is to have both: a US-compliant healthcare proxy/advance directive for situations arising in the US, and a separately executed Indian Advance Directive complying with the Supreme Court guidelines for situations arising in India. The Indian Advance Directive need not mirror the US document exactly — it should reflect the individual's current wishes expressed in the form required by Indian courts and the Ministry of Health guidelines.
For detailed guidance on this topic specific to your circumstances, the office is available at luka@lukeandluka.in or +91 96057 61330, Monday to Friday, 10:00 AM to 5:30 PM IST. Remote consultations — by video call, WhatsApp or email — are available for NRIs and OCI holders in all time zones.