It is a very cumbersome task for patients

 Active euthanasia is illegal in India. The Supreme Court has recently approved passive euthanasia but the guidelines are to be formulated and the protocols are yet to be set. Presently, there exists a living will where a patient, when he is fully conscious can make a will stating that he would not want intensive care treatment and would not want to be given critical care and also would not like to be put through the rigors of palliative care.

This living will has to be framed by a lawyer and also submitted in the magistrate court, where the magistrate would have to approve of the same. This is a very burdensome task and many patients are not even aware of these formalities.

Dr S.V.S.S. Prasad, senior medical oncologist, explained, “It is a very cumbersome task for patients as they have to follow-up with the legal team and also with the doctors involved in the treatment. In India, patients are shielded by their family members who do not allow them to get the full knowledge of their health condition, the state of deterioration or even to accept their end-stage status. When family members are not ready to accept the critical situation of the patient, even if the patient is ready for the big step, he is not able to do anything about it. Hence, in the new guidelines, the hospital committee for end-stage patients will be at the core centre to deal with all these aspects.”

A critically ill-patient, before reaching the end-stage, will have access to the hospital committee to opt for making a will in his fully conscious state, about whether or not, he wants to continue with intensive care. This affidavit will be with the consent of the doctors’ committee, in the presence of a lawyer and will be submitted in court. This will be kept on record for the benefit of the hospital and the family.

Dr Ravi K.S. of a hospice centre explained, “Aggressive life-prolonging medical intervention such as advanced life-support systems is very burdensome for both the patient and the family. Allowing a natural death gives the patient time to spend his last moments with his family members. The choice to end life-support must be granted and it must be legally binding on the hospitals, which should not insist on intensive care. It is important for the medical fraternity to define when to stop the treatment and opt for palliative care. There exists a thin line and many of them are not forthcoming in giving up the patient and asking them to opt for end-of-life care.”