TNFNew Delhi/ TNF
In a significant move, the Central Health Ministry has released a draft of new guidelines regarding passive euthanasia, focusing on the removal of life support for terminally ill patients. The guidelines emphasize that doctors should make well-considered decisions, keeping in mind several conditions, to ensure that the removal of life support is in the patient’s best interest.
According to the draft, four key conditions have been outlined to help decide whether withdrawing life support is appropriate. These conditions apply in cases where the patient’s illness is so severe that continuing life support provides no benefit or worsens their suffering, causing a loss of dignity. The guidelines are aimed at situations where medical interventions fail to improve the patient’s condition and prolong unnecessary suffering.
Concerns from the Medical Community
However, this move has caused some concern among doctors. The President of the Indian Medical Association (IMA), Dr. R.V. Ashokan, has expressed reservations, stating that these guidelines might put undue stress on doctors by placing their decisions under legal scrutiny. Dr. Ashokan explained that clinical decisions of this nature are made with great care and only after consulting the patient’s family. He emphasized that doctors always act in good faith and ensure the family is fully informed before making any decision.
He also criticized the assumption that doctors unnecessarily prolong life by using machines, stating that it is incorrect to believe that life support is used without purpose. Dr. Ashokan voiced concerns that this kind of scrutiny could damage the doctor-patient relationship, turning sensitive decisions into legal issues, and creating additional stress for medical professionals.
The IMA has expressed its intention to review the document carefully and will present its thoughts and concerns to the ministry. Dr. Ashokan also urged that some matters should be left to the discretion of doctors, patients, and their families, based on medical judgment and the specific circumstances of each case.
Definition of Terminal Illness
The Health Ministry’s draft defines terminal illness as an irreversible or incurable condition that is expected to result in death in the near future. This also includes severe brain injuries where no improvement is seen after 72 hours or more. Many patients in intensive care units (ICUs) fall into this category, where life-sustaining treatments (LST) like mechanical ventilation, dialysis, or other critical care measures are unlikely to be of any benefit.
The draft also highlights that in such cases, life support not only fails to help the patient but may increase their suffering. Additionally, the emotional burden on the family and ethical dilemmas faced by healthcare providers in these situations are considerable.
Global Standards
Removing life support in such cases is recognized as a standard practice in many ICUs worldwide and is legally approved in several countries. The decision to withdraw LST is taken after considering the medical, ethical, and legal aspects. The draft emphasizes the importance of taking these factors into account before placing a patient on life support.
These new guidelines aim to provide a balanced approach to end-of-life care, ensuring that decisions are made thoughtfully, without prolonging unnecessary suffering.
