Do We Need Euthanasia Debate or Call for Action: Well, I thought I will give my perspective on the current ongoing debate on issue of Euthanasia, Firstly, I think we should abandon the word “Euthanasia” as I fully agree with Dr R K Mani former president of ISCCM, (Indian Society for Critical Care Medicine) as it has a Nazi hangover, Aktion T4, was the name used after World War II for Nazi Germanys non-voluntary euthanasia programme under which physicians killed thousands of people who were judged incurably sick, by critical medical examination. In October 1939 Hitler signed an euthanasia decree backdated to 1 September 1939 that authorized Phillipp Bouhler and Karl Brandt to carry out the programme of euthanasia. All though the program officially ended in august 1941 where in more than 70 thousand people were given euthanasia, this policy with a negative apptoach led to killing of additional 2 lakh people thereafter. The better word to be used is “end of life decision”. On 7th March 2011 the Supreme Court of India legalized passive euthanasia by means of the withdrawal of life support to patients in a permanent vegetative state. The decision was made as part of the verdict in a case involving Aruna Shanbaug, who has been in a vegetative state for 37 years at King Edward Memorial Hospital. The high court rejected active euthanasia by means of lethal injection. In my opinion, one, the word euthanasia should be completely abandoned and the term “end of life decision” which is more sober and subtle has to be used by the medical fraternity. Two, there has to be clear responsibility on various stake holders, like the healthcare providers. The medical consumer, the watch dogs like QCI or NABH and the government. Instead of debating what is wrong or what is right, I guess its time we get into action. Responsibility of the Healthcare Provider A frame work or a consent should be prepared by the hospital or the healthcare provider which clearly explains the end of life care decision. It consent along with the signature, relationship with the patient with ID proof should be documented. And the document should be treated just the way medical record of a MLC is treated. Apart from this a social worker or a counselor should be available in the hospital who would make the patients family understand about the prognosis give the family required moral support in taking a decision. Responsibility of NABH/QCI Guide lines should be include in the A consent should be made mandatory by NABH, for every healthcare provider to document the same, they should include the objective elements and certain standards regarding the end of life decision in chapters 1: Access, Assessment and Continuity of care 2: Care of Patient and 4: Patient Rights and Responsibility respectively. Responsibility of Medical Consumer Its very important the patient’s attendant and relatives to understand the prognosis from the treating doctors, take a informed decision in the family, understand pro’s and cons of the decision they are taking and sign the consent forms accordingly. Role of Government In my opinion the government should take some radical decisions to reduce the burden of terminally ill patients, they should earmark certain funds to the terminally ill patients and help the families in distress, perhaps a body or a board or a trust should be created especially to identify the terminally ill patients and help them out. The another best solution is authorizing home healthcare companies to take care of the terminally ill patients at home itself so that the patients has a graceful end at home itself. Sudhaker Jadhav Healthcare Professional sudhakerjadhav@gmail
Posted on: Tue, 22 Jul 2014 08:48:57 +0000
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