New Delhi: The Indian Medical Association ( IMA) has expressed concerns over the new guideline proposed by the health ministry regarding decisions on withdrawing life support for terminally ill patients, ToI reported on September 30. The guideline suggests that life support can be discontinued if both a primary and secondary medical board, along with the patient’s family or surrogate, give their consent.
The guideline aims to ensure that life support is used effectively and helps families and doctors make informed decisions regarding the treatment of terminally ill patients.
Dr. R V Asokan, national president of IMA, stated that such decisions have traditionally been made by doctors based on good faith. “Our job is to inform the patient or her or his family member about the condition and explain to them about the prognosis. After that, it is their call as to whether they want to continue life support or not. This guideline, however, intends to create a framework defining the role of doctors which is concerning for us,” he said.
The draft guideline proposes that the primary medical board (PMB) comprises the primary physician and at least two subject experts with over five years of experience. Their decision must then be verified by a secondary medical board (SMB), which includes one registered medical practitioner nominated by the Chief Medical Officer (CMO) and at least two other subject experts. Members of the PMB cannot be part of the SMB. Additionally, a clinical ethics committee may be formed for audit, oversight, and conflict resolution.
Dr. Sushma Bhatnagar from AIIMS, who contributed to the guideline's development, highlighted the necessity of this framework. “In medicine, we all have learnt how to diagnose and how to treat but no one has taught us what should be our approach when end is inevitable. Thus, we keep treating a person even if we know that there is no chance of recovery...This policy can help in better understanding of diagnosis and prognosis. Patients and family members will be able to make informed choices,” she said.
The guideline aims to ensure that life support is used effectively and helps families and doctors make informed decisions regarding the treatment of terminally ill patients.
Dr. R V Asokan, national president of IMA, stated that such decisions have traditionally been made by doctors based on good faith. “Our job is to inform the patient or her or his family member about the condition and explain to them about the prognosis. After that, it is their call as to whether they want to continue life support or not. This guideline, however, intends to create a framework defining the role of doctors which is concerning for us,” he said.
The draft guideline proposes that the primary medical board (PMB) comprises the primary physician and at least two subject experts with over five years of experience. Their decision must then be verified by a secondary medical board (SMB), which includes one registered medical practitioner nominated by the Chief Medical Officer (CMO) and at least two other subject experts. Members of the PMB cannot be part of the SMB. Additionally, a clinical ethics committee may be formed for audit, oversight, and conflict resolution.
Dr. Sushma Bhatnagar from AIIMS, who contributed to the guideline's development, highlighted the necessity of this framework. “In medicine, we all have learnt how to diagnose and how to treat but no one has taught us what should be our approach when end is inevitable. Thus, we keep treating a person even if we know that there is no chance of recovery...This policy can help in better understanding of diagnosis and prognosis. Patients and family members will be able to make informed choices,” she said.
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