AIIMS to en­sure dig­ni­fied death for non-can­cer pa­tients too

The Times of India (New Delhi edition) - - Times City - DurgeshNan­dan.Jha @times­group.com

New Delhi: Of the 80 coun­tries sur­veyed re­cently for qual­ity of death, In­dia ranked 67. The re­sult didn’t come as a sur­prise though be­cause the con­cept of end-of-life care (EOLC) that at­tempts to re­duce the suf­fer­ing of ter­mi­nally ill pa­tients barely ex­ists in the coun­try. In a first, All In­dia In­sti­tute of Med­i­cal Sciences (AIIMS) has de­cided to draft a pol­icy to pro­vide the same to its reg­is­tered in-pa­tients.

Acore com­mit­tee has been formed by the hospi­tal to fa­cil­i­tate a dig­ni­fied dy­ing process for pa­tients who are at their end of life. This in­cludes non-can­cer pa­tients like those suf­fer­ing from se­vere ir­re­versible brain dam­age or those in a per­sis­tent veg­e­ta­tive state.

“Of­ten, fam­i­lies of pa­tients suf­fer­ing from the end stage dis­eases re­quest us to stop treat­ment. They don’t want to see them go­ing away in pain and with mul­ti­ple tubes in­serted in the body. Our EOLC pol­icy will at­tempt to ad­dress these is­sues,” Dr Ran­deep Gu­le­ria, the di­rec­tor of AIIMS, told TOI.

He said that sev­eral rounds of con­sul­ta­tion with stake­hold­ers like ex­perts in pal­lia­tive care and the lawyers have al­ready been held for the pur­pose. Also, the palla­tive medicine di­vi­sion of the hospi­tal is train­ing nurses and doc­tors to iden­tify ter­mi­nal stage of ill­ness where pal­lia­tive care may be re­quired. Care will be en­sured at all lev­els – phys­i­cal, emo­tional, so­cial and spir­i­tual.

AIIMS is one of the few med­i­cal in­sti­tu­tions in the coun­try to have a full-fledged de­part­ment for pal­lia­tive care. But till now, its fo­cus has been on pro­vid­ing EOLC to can­cer pa­tients.

Dr Sushma Bhat­na­gar, pro­fes­sor and head of the de­part­ment, said that they are ex­pand­ing the ser­vices to other de­part­ments also.

In In­dia, the doc­tors say, the physi­cians are re­luc­tant to con­sider lim­i­ta­tion of life sup­port in­ter­ven­tions when com­pared to the doc­tors a broad. Dr Bhat­na­gar said that a pol­icy which is legally vet­ted to re­move grey ar­eas in the im­ple­men­ta­tion of EOLC is needed. “Coun­tries like the United King­dom, which was ranked num­ber one in the sur­vey con­ducted by The Econ­o­mist, has a clear pol­icy for EOLC,” she said.

Stat­ing that hu­man be­ings have the right to die with dig­nity, the Supreme Court had last year al­lowed pas­sive eu­thana­sia. The top court also al­lowed an in­di­vid­ual to draft a ‘liv­ing will’ spec­i­fy­ing that they not be put on life sup­port if they slip into an in­cur­able coma in the fu­ture. In a liv­ing will, a per­son can make a state­ment in ad­vance that their life should not be pro­longed by putting them on a ven­ti­la­tor or an ar­ti­fi­cial sup­port sys­tem.

Dh­vani Me­hta, a se­nior res­i­dent fel­low at Vidhi – Cen­tre for Le­gal Pol­icy, said that fol­low­ing the Supreme Court or­der there has been a sig­nif­i­cant in­crease in the num­ber of queries on how to im­ple­ment a liv­ing will.

“I am help­ing AIIMS from the le­gal per­spec­tive to draft the EOLC pol­icy which has its ge­n­e­sis in the Supreme Court or­der,” she added.

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