Scant awareness about end-of-life care, complicated guidelines, and stigma prevent people from exercising palliative options.
Lack of trust in the healthcare system, the lack of concrete guidelines until recently, and low awareness even within the medical fraternity have made end-of-life care (EOLC) harder to access.
Active euthanasia, which is the intentional act of killing a terminally ill patient on voluntary request, through direct intervention by the doctor — such as by injecting a lethal drug — continues to be illegal in India. Advance Medical Directives (AMD) or living wills allow patients to determine how they wish to be treated if incapacitated. They can confer decision-making power onto a family member or decide when medical treatment should be withdrawn or withheld.
LACK OF AWARENESS:-
Others have not followed suit because of a lack of awareness. With advances in modern medicine, it is possible to prolong life, but that does not mean life must be extended at all costs in every case.
“Appropriate medical practice is to balance treatment with benefits. We advocate limiting futile treatment that is risky and without benefit for patients and caregivers.”
LEGAL HURDLES:-
The 2018 judgment had laid down a three-level system of oversight – an internal medical board for a preliminary opinion, followed by the decision of a review board constituted by a district collector, and a final physical verification by a judicial magistrate.
FOLLOWING BY EXAMPLE:-
Typically, after a patient spends lengthy periods in the ICU without any hope for recovery, the hospital says they cannot do more. Often the patient is discharged and dies either in the ambulance or at home. The trauma of the death gets pushed on the family or the caregiver.
OPTIONS FOR THE END OF THE ROAD:-
A Living Will or Advance Medical Directive (AMD) is a written declaration made by a person with decision-making capacity, documenting how they would like to be medically treated or not treated should they lose capacity.
Withdrawal (WD) treatment is a considered decision in a patient’s best interests, to stop or discontinue ongoing life support in a terminally ill disease that is no longer likely to benefit the patient or is likely to harm in terms of causing suffering and loss of dignity.
Withholding (WH) treatment is a decision not to start the support treatment. Do-Not-Attempt Resuscitation (DNAR) is a considered decision not to perform cardiopulmonary resuscitation (CPR) in the event of an anticipated cardiac arrest if there is no realistic possibility of survival or meaningful recovery.
