IAPCON 2016
The progression of Indian end of life care
Dr Naveen Salins - Tata Memorial Hospital, Mumbai, India
With regards to the end of life care, what has been developed, a lot of developments were done by the Indian Society of Critical Care Medicine. They are the pioneers of end of life care development in India. A way back, from 2002 onwards, they have been advocating for end of life care in India. In the year 2005 they brought out the first guidelines for end of life care for the Indian intensive care units. The second guidelines for the Indian intensive care units were brought out again by the Critical Care Society of Indian in the year 2012. From the Indian Association of Palliative Care perspective this movement actually began only in the year 2013 and in the year 2014 a consortium was created which was a joint creation between the Indian Association of Palliative Care and the Indian Society of Critical Care Medicine.
What were the aims of the consortium?
The three important objectives of the consortium were to come out with joint society guidelines, to go to the Supreme Court of India for an unambiguous legislation on end of life care and to start end of life care certificate programmes. The first objective was achieved in September 2014 where the Indian Association of Palliative Care brought out its position statement and the joint statement was published in the Indian Journal of Critical Care Medicine between the Indian Association of Palliative Care and the Indian Society of Critical Care Medicine.
In October 2014 the first end of life care certificate programme was launched in multiple cities in India and as it was broadcast in fifty centres. The Indian Society of Critical Care Medicine, the Indian Association of Palliative Care and with an NGO called Common Cause has filed a petition in the Supreme Court of India for an unambiguous end of life care legislation.
Now, over the last year, year and a half, there have been more further developments. The Indian Academy of Neurology has joined hands and a taskforce is created called ELICIT taskforce which stands for End of Life Care Taskforce which mainly deals with medical futility, brain death and incorporating and integrating palliative care in ICUs and in terminal neurological conditions. There has been a pre-conference workshop on 11th February, the workshop was attended by the critical care physicians, the palliative care physicians and we had senior lawyers from across India attending the conference.
What are the next steps?
What we hope to achieve is to bring out a white paper of the pre-conference proceedings and this white paper will be given to the government of India and to the Supreme Court so that we can. The Supreme Court has already taken up discussions around euthanasia but what we are asking the court is not about euthanasia but mainly to have a legislation for end of life care so that a lot of fear-based practice which the doctors are having regarding litigations will probably go away with that.
