‘Ties between kin of patient, doc key in passive euthanasia’

MUMBAI:The Supreme Court may have granted the right to die with dignity by legalizing passive euthanasia and approving a living will, but its effective implementation will remain a tricky business till there are more conversations around the subject of death and better communication between doctors and patients.

In the first public discussion on the subject at Tata Memorial Hospital on Friday, neurologists, intensivists, public health and legal experts stressed on the importance of communication if such a practice has to evolve in the country, while expressing their displeasure over the use of the blanket word ‘euthanasia’ to define everything that comes under end-of-life care. The SC verdict passed on March 9 provided terminally ill patients or those in an incurable vegetative state the right to a dignified death by refusing medical treatment or life support.

Neurologist Dr Roop Gursahani said the SC has given a broad framework to work with, but three factors—kno-wledge about probable treatment outcomes, control over the method or place of death to ensure dignity, and symptom control or pain relief—are crucial for effective implementation. “We have to evolve mechanisms to ensure these factors exist and work in tandem,” said the doctor, also a member of the End of Life Care in India Taskforce.

Emphasizing on communication as a key, Dr Farhan Kapadia, intensivist at Hinduja Hospital, said, “It has to sta-rt from the moment a patient enters the hospital and not in ICU.” Challenges in drafting and implementing living wills were discussed in the event organized by Narotam Sekhsaria Foundation, Maharashtra Palliative Care Network and Forum for Medical Ethics Society. “Living wills can never cover all circumstances...an individual must empower someone trustworthy to know what he really wants so that nobody is guilty about pulling the plug,” he said.