The State government has issued the “Tamil Nadu Advance Medical Directive Guidelines, 2026” for the implementation of AMDs in the State. An AMD takes effect only when the executor becomes incapable of making or communicating informed decisions regarding medical treatment. It must name a guardian or close relative authorised to consent to refuse or withdraw medical treatment, if the person becomes incapable of decision-making. It should consist of the treating physician and two experts from the institution with at least five years’ experience. Ms. Yachu said that another priority for Tamil Nadu should be training of doctors to ensure better understanding of withholding and withdrawal of medical treatment and its implementation.