Haryana to constitute medical boards to implement SC’s Right to Die with Dignity guidelines
Chandigarh: The Haryana government is implementing the Supreme Court’s judgment on the right to die with dignity, directing hospitals across the state to follow a legally prescribed protocol for end-of-life care, constitute specialist medical boards, and operationalise the framework relating to living wills.
The Stae Health Department has instructed civil surgeons to ensure adherence to the Supreme Court’s guidelines. District authorities have also been asked to nominate doctors for secondary medical boards, which serve as an important safeguard before life-sustaining treatment can be withdrawn from terminally ill patients, reports The Times of India.
Medical Dialogues had earlier reported that the apex court allowed the withdrawal of artificial life support for a 32-year-old man who has been in a permanent vegetative state (PVS) for nearly 13 years. The bench stated, “The right to die with dignity is inseparable from the right to receive quality palliative and EOL care. It is imperative to ensure that the withdrawal process is not marred by pain, agony, or suffering.”
In Gurgaon, the Civil Surgeon has directed all hospitals registered under the Clinical Establishments Act to implement the prescribed protocol and submit compliance reports.
According to the Daily, a living will, also known as an advance medical directive, enables an adult to state in advance how he or she wishes to be treated in the event of a terminal illness and loss of the ability to communicate or make medical decisions. The directive must be executed voluntarily, signed in the presence of two witnesses, and attested by a notary or a gazetted officer. The individual is also required to nominate a guardian or a close relative to represent his or her wishes if necessary.
Dr Kajal, anaesthesiologist Suman Khurb and anaesthetist Kusum have been appointed by the government as members of its secondary medical board. However, the guidelines ensure that no doctor or family members can unilaterally decide to take a patient off life support.
“If a patient has a valid living will and doctors conclude that further treatment is medically futile, the hospital must first constitute a primary medical board comprising the treating doctor and two specialists,” a health department official told the Daily.
Moreover, in cases where the primary committee recommends withdrawing the treatment, a secondary medical board comprising a doctor nominated by the chief medical officer and two specialists must review it. Life support may be withdrawn or withheld only when both medical boards agree, and after notifying the jurisdictional Judicial Magistrate First Class.
The same safety measures should be applicable in the absence of a living will also. Under emergency circumstances, the doctor should first discuss the options with the patient’s family, after which two medical expert boards should review the condition and the options of the patient. According to officials, the framework will be beneficial in handling the legal uncertainty which often compels the hospitals to use resources in the treatment of patients despite knowing that there will be no hope of recovery in reality.
On July 29, the health department will assess the implementation at a meeting led by Additional Chief Secretary (Health) Mani Ram, before filing a compliance report with the Supreme Court.
