Note4Students
From UPSC perspective, the following things are important :
Mains level: Health Care; Passive Euthanasia; Palliative Care;
Why in the News?
Min. of Health and Family Welfare issued draft Guidelines for the withdrawal of life support in terminally ill Patients, aimed at implementing the Supreme Court’s 2018 and 2023 rulings that uphold the right to die with dignity for all Indians.
What is Passive euthanasia?Passive euthanasia involves allowing a terminally ill patient to die naturally by withholding or withdrawing life-sustaining treatments, like ventilators when they no longer provide benefits. |
What are the draft guidelines released by the Ministry of Health and Family Welfare?
- The guidelines aim to operationalize the Supreme Court’s 2018 and 2023 orders, which recognize the right to die with dignity as part of Article 21 of the Indian Constitution.
- Key Mechanisms Proposed:
- Primary and Secondary Medical Boards: Hospitals are required to set up these boards to determine when further medical treatment for a terminally ill patient would no longer be beneficial.
- Nomination of Doctors: District Chief Medical Officers will nominate doctors to serve on Secondary Medical Boards to confirm or reject the Primary Medical Board’s recommendations.
- While India does not have dedicated legislation on withholding or withdrawing life-sustaining treatment, these guidelines and the Supreme Court’s judgments provide a defined legal framework to make these actions lawful.
What is meant by withholding/withdrawing life-sustaining treatment?
- It refers to discontinuing medical interventions, such as ventilators or feeding tubes, when they no longer contribute to the patient’s recovery or only prolong suffering.
- Life-sustaining treatments replace essential bodily functions artificially (e.g., mechanical ventilation, artificial nutrition).
- The intention is to allow the underlying illness to take its natural course while providing comfort care, focusing on symptomatic relief and palliative care.
- The right to refuse medical treatment is recognized under common law and is considered part of India’s fundamental right to life and personal liberty (Article 21).
Is Withholding/Withdrawing treatment akin to giving up on the patient?
- Withholding or withdrawing treatment does not mean the doctor is giving up on the patient. It is an acknowledgment that continued medical intervention may no longer be beneficial and could cause unnecessary suffering.
- The process involves shifting the focus from life-sustaining measures to palliative care to manage pain and ensure the patient’s comfort.
- Often, doctors practice “discharge against medical advice” because of misconceptions about the legality of withholding/withdrawing treatment. This practice leads to patients suffering without appropriate care.
What medical procedure is laid down by the SC and reaffirmed by the guidelines?
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Way forward:
- Public Awareness and Training: Educate the public and healthcare professionals about the legal framework for end-of-life care, emphasizing the distinction between withholding treatment and euthanasia, to reduce misconceptions.
- Strengthen Palliative Care Services: Expand access to palliative care across hospitals and healthcare facilities, ensuring that terminally ill patients receive compassionate and effective pain management and comfort care.
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