New Delhi, Oct 2
Hailing the Union Health Ministry's draft Bill on passive euthanasia, experts on Tuesday called it a “progressive step”.
The recent ‘Draft Guidelines’ call on doctors to take a "considered decision" on withdrawal of life support in terminally-ill patients.
Euthanasia is the practice of intentionally ending life.
It is of two types: Active and passive. Active euthanasia occurs when medical professionals, or another person, deliberately do something that causes the patient to die.
On the other hand, in passive euthanasia, a patient is intentionally left to die by not providing a life support system.
As per the ministry, passive euthanasia can be considered “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”.
Dr. Harshal R Salve, Additional Professor, Centre for Community Medicine at AIIMS, New Delhi, told IANS, “This is a very welcome and progressive step by the health ministry.”
“This will go a long way in ensuring the welfare of family members, and attendants as well as the peace of the patient. It will also reduce out-of-pocket expenditure and reduce the strain on the already stressed health care set up in India,” he added.
The guidelines also lay out conditions such as if the individual has been declared brainstem dead, or if there is a medical prognostication and considered opinion that the patient's disease condition is advanced and not likely to benefit from aggressive therapeutic interventions.
Patient/surrogate-documented informed refusal, following prognostic awareness, continuing life support, and compliance with procedure prescribed by the Supreme Court are also to be considered.
The new draft norms, meanwhile, also include guidelines for patients with severe, devastating traumatic brain injury, who show no recovery post 72 hours or more.
Dr Rajat Agrawal, Director and Head, Critical Care, Fortis Escorts Heart Institute, Okhla said passive euthanasia is needed because the patient’s autonomy is paramount.
“It reduces suffering and pain of the patient and the family. Prolongation of life on artificial life support systems reduces the dignity of the individual with increased burden on society and stretched out healthcare systems,” Agrawal said.
However, some experts raised concerns about the role of physicians in it.
Passive euthanasia is withholding or withdrawing life-sustaining medical treatments, allowing patients to die naturally.
According to some experts, it can overburden physicians and also put them at risk of litigation by the family later.
Meanwhile, Agrawal noted that the provision “has the potential to be misused for vulnerable patients”.
“A section of the medical fraternity may also feel that it goes against the First Principle of Medicine: Do no harm,” the doctor said.
However, to make it successful in the Indian context, “it should be well-etched in the framework of the Indian Constitution,” the expert suggested.
Clear communication with the patient and family is of vital importance.
He also urged the need to boost the support systems for palliative care.
