Millennium Post

Restoring patients' Will

The mammoth Indian healthcare system is characterised by the presence of government and private hospitals. Government hospitals witness a high rush of patients and its hospitals, hospital beds, medicine distribution system, and all other facilities come under tremendous pressure to provide healthcare services to a large number of patients who come for treatment. The idea that patients should get quality treatment with minimum hassle gets lost in the rush of patients and inadequate infrastructure in government hospitals and healthcare centres. Private hospitals and healthcare facilities try to give patients a better experience but they are mostly unaffordable for a large section of people. The problem becomes all the more serious when the patient is suffering from conditions that require cost-intensive healthcare facilities. In government hospitals, there is a long waiting list for everything from seeing a doctor to getting various tests done. Patients and their attendants have to wait for hours for most facilities and critical time for patients is lost in waiting for different surgeries and procedures, where the waiting period is three to six months. Private hospitals which have to keep a close watch on the costs for various medical facilities and services offered become too expensive and unaffordable for patients. Indian pharmaceutical industry, for obvious reasons, is doing well.
In a major decision, the Supreme Court on Friday allowed passive-euthanasia and 'living will'. The SC accepted the argument that 'the right to life' includes the idea of 'right to die with dignity'. So, when the patient is terminally ill and if he does not want the life support system to continue when he is unable to give an informed consent, a living bill written when he was in a position to make an informed decision can facilitate taking away the life support system and allowing the patient to die without further treatment. Passive euthanasia, in which the patient makes an appeal for the permission to die, has been allowed with a number of riders. It has been allowed only in terminally-ill cases when a board of doctors under the supervision of a High Court will pronounce that the patient is terminally-ill or in a coma that cannot be treated. In both the cases of terminally ill patients and those in a vegetative state or incurable coma, the patients and their families incur huge costs without a hope. The patients' appeals to allow assisted euthanasia are also not considered. The Supreme Court ruling has offered a dignified way-out to patients by allowing passive euthanasia and living will.
It was the famous Aruna Shanbaug case that triggered the need to change euthanasia laws in India. The Apex Court recognised passive euthanasia in Aruna Shanbaug case in 2011. It permitted withdrawal of life-support system from patients not in a position to make an informed decision.
The Indian Supreme Court has dealt with an intimate issue involving medical ethics versus the final days of man's life with great thoughtfulness. Across the globe, there is a debate on medical ethics involved in euthanasia and a patient's rights to die in a dignified manner. Different countries have taken their own decisions on the issue and all of them are not on the same page. But when we look at the costs that a patient or his family incurs in treating a terminally-ill patient and the kind of pressure it puts on everyone from the family to the healthcare system, the Supreme Court ruling looks to be in the right direction. This will make the legalities involved in the final days of someone's life easier. It also makes things easier for the medical staff and the hospitals. At least, they have a clear roadmap to go about in such cases of terminally-ill or in-coma patients. Even the families of such patients will be saved from the hassles. More importantly, it gives the patient the power to decide the fate of his life, when there is no hope. It helps him die faster than degenerate slowly into a lifeless body. It makes their experience better about the final days of his life.

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