​​The legal right to die with dignity is true… Know why people are not aware

New Delhi: Rajni Surendra Bhatt, a doctor from Bengaluru, met a man suffering from health issues last month. his/her 80-year-old father was suffering from dementia and Parkinson’s for the last few years. Repeated infections meant he/she was admitted to hospital four times in six months. Bhatt says, ‘After every infection, he/she was taken from one hospital to another. he/she used to get treatment and then fall ill. The family did not want the elderly man to suffer more. Doctors advised home care. Bhatt explained to the family that they were free to choose to stop or withdraw life-saving treatment in a terminally ill patient, after which the family took the decision collectively. They also gave him/her medicines to reduce his/her pain and shortness of breath. ‘he/she spent time at home with his/her family and embraced death peacefully with memories of everyone around him/her,’ she says. Patient experience is rare. Six years after the Supreme Court issued guidelines that legally allow a patient or caregivers to withdraw life-saving treatment in cases of terminal illness, few have opted for it.

N N Gokuldas, a zoology professor, fed up with the pain of endless treatment, signed off on AMD. he/she had cancer. After two years of treatment, the doctors told that there would be no benefit from further treatment. 74 year old Gokuldas has decided that he/she will no longer undergo chemotherapy and radiation. he/she said, ‘I did not consult my family while taking this decision. I have the right to die in peace.’

legal hurdles

In 2018, the Supreme Court had made rules for end-of-life care (EOLC), but there were many difficulties in implementing these rules. The government tried to simplify these rules, but no significant work was done in training the doctors and explaining the rules. Dhvani Mehta of the Vidhi Center for Legal Policy, who works on EOLC policies, says the government has not made much effort to enforce these rules. Recently the Central Government has issued some guidelines to implement the directions of the Supreme Court, this is the first step.

• In the 2018 decision, a three-level monitoring system was created. An internal medical board for initial opinion on the patient’s condition, followed by a review board headed by the district collector and finally final verification by a judicial magistrate. This process proved to be very complex. So in January 2023, the Court simplified it by removing the rules requiring a Judicial Magistrate and a District Collector.
• Doctors have not received any training to explain treatment options to patients and help them make complex decisions such as stopping treatment. The government needs to do more to enforce EOLC rules. ‘Doctors have not been given any training to explain treatment options to patients and help them make complex decisions such as stopping treatment.’

The family cannot bear the shock of death

Usually, after a patient has spent a long time in the ICU without any hope of recovery, the hospital says there is nothing more they can do for him/her. Often the patient is discharged and dies in an ambulance or at home. The shock of death falls on the family or caregiver. Dr IP Yadav, a surgeon from Kollam district in Kerala, had a similar experience with his/her father, who was paralyzed in 2010, and has been agonizing over his/her decision for years. he/she says. ‘My dad told me he/she didn’t want to be on a ventilator or in the ICU. But I ignored his/her wishes, thinking I was doing what was best for him/her. he/she wanted to be with his/her family. Instead, he/she died alone in a hospital room. I decided that I would not go through this or let the rest of my family suffer like this.