New Delhi: The Ministry of Health and Family Welfare released draft guidelines titled “Guidelines for withdrawal of life support in terminally ill patient” for the withdrawal of life support in terminally ill patients. The guidelines stated that the decision should be a “considered” one made by doctors, taking into account specific medical conditions and the patient’s overall health status.
The draft stated, “A considered decision 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.” According to the draft guidelines, the withdrawal of life support includes four conditions which include- the individual must be declared brainstem dead as per the THOA Act; Medical prognostication must indicate that the patient’s condition is advanced and unlikely to benefit from aggressive therapeutic interventions; The patient or surrogate must document an informed refusal, following prognostic awareness, to continue life support; There must be compliance with procedures prescribed by the Supreme Court.
The draft also states that doctors should not consider the decision to not start a life supporting measure in a terminally-ill patient that is unlikely to harm in terms of suffering and loss of dignity. “A considered decision in a patient’s best interests, to not start a life supporting measure in a terminally ill patient, that is unlikely to benefit the patient and is likely to harm in terms of suffering and loss of dignity,” as per the draft. It explains further that in such a situation, three conditions on whether the individual has been declared brainstem dead, if there is a medical prognostication and considered opinion that the patient’s disease condition is advanced, individual declared brainstem death as per the Transplantation of Human Organs Act (THOA), 1994, and patient/surrogate documented informed refusal, following prognostic awareness, to continue life support, have been mentioned in the draft. The Union ministry has invited feedback and suggestions by the mid of next month.