At this moment, over a million people in India are in unimaginable pain. We refuse to look the other way. We choose to hear the cry, and to do what we can.
Please join us. Your help is needed.

‘Clarity from SC, dialogue on euthanasia need of the hour’ – Dr Nagesh Simha

2015 May 23

The death of Aruna Shanbaug has brought into focus the urgent need for clarity from the Supreme Court on the issue of withholding or withdrawing futile medical treatment. While passing a judgement related to Aruna Shanbagh, the Supreme Court seems to have created some confusion by referring to “passive euthanasia”. Dr Nagesh Simha, President of the Indian Association of Palliative Care, tells Times of India how it is ethical to withhold or withdraw futile medical intervention and the urgent need for clarity in the law.

Click here to read the interview.

We would like to add that a large number of patients being admitted to Intensive Care Unit eventually may have to be withdrawn from the life support. This process can be inhuman, without the introduction of palliative care at the right time. In fact, all principles of palliative care must be applied during intensive care, too. While life-saving measures are in place, comfort measures should be concurrently given so that the patient does not recollect the period of intensive care with terror. Eventually, when the time comes, weaning from artificial life support measures should also be associated with palliative care principles.

Pain Relief in India: Another major step forward

2015 May 23

When the Narcotic Drugs and Psychotropic Substances (NDPS) Act of India was amended by the Indian Parliament in February 2014, many expected immediate results, but the procedural barriers were many. According to the Parliament’s legislation, the power to change the state rules was transferred from the state to the central government. We were expecting the central government notification of uniform state rules for the whole country. But it was delayed. Finally, we are glad to report that the state NDPS rules have been notified. All the states in India now have a simple procedure, which essentially is a modification of the Kerala rules which have been in existence since 1999. Contrary to the Kerala rules, the present notification extends to all formations of morphine, fentanyl and some other opioids.

Gazette Notification No.923 regarding Essential Narcotic Drugs dated 05 05 2015

Gazette Notification No.285 regarding NDPS State Rules and Procedures dated 05 05 2015

Would this mean immediate improvement in access to pain relief in India? We fear not. There are two major hurdles before us: the first is education of professionals in pain management and the second is ensuring that all the states implement the new rules without bringing in procedural complications.

We have a lot of work to do!

Aruna Shanbaug leaves us with many questions

2015 May 18

On 18th May 2015, Aruna Shanbaug left us. Brutally raped and strangled at the age of 25 by a hospital attendant, Aruna Shanbaug had a vegetative existence for 42 years more. The fact that she lived might seem at one glance to be a victory for medical science, but if so, it was a victory of empty, heartless science.

Her assailant walked out of prison after seven years, a free man. Aruna Shanbaug continued her life of rigorous imprisonment in the hospital, the height of which is obvious when we are told that she died on a ventilator. Today, as she leaves us, we still do not have a law covering end-of-life decisions or covering withdrawal of life support. Medical science is confused, not having bothered to study the issue at depth, leaving the judiciary also confused, making them believe that withdrawal of artificial life support is a form of euthanasia.

Her life for the last 42 years would have forced us into action if our society had a conscience. Rest in peace, Aruna.

Tell your story to the world.

2015 May 16

It’s amazing how little the developed world knows about the burden of pain and other suffering in the developing world and, much too often, it is the developed world that shapes global health policy.

We need to get the story of people’s suffering out there for others to hear. The Journal of Pain and Palliative Care Pharmacotherapy has such a feature. Write your narrative. Tell your story to the world. It is a peer-reviewed, indexed journal; but has a fast-track system for narratives. You can get published, quick.

In May 2015, the journal has made all narratives open access. Just visit and read the stories. You can see the heart-rending narratives from many parts of the world, stories of needless suffering, stories of how palliative care turned things around for patients with cancer pain, patients with post-traumatic pain and that of a bereaved daughter.

Tell your story. You will help to change the world. If you have questions, write to us:

“My Mother Did Not Go Bald” second edition is published

2015 May 9

Nazeem BeegumNazeem Beegum’s book, My Mother Did Not Go Bald, is a memoir of her experiences when her mother went through cancer and eventually died. The Hindu, in its review, writes, “she subtly touches upon the alienation of senior citizens, the breaking up for family ties in modern Kerala, the emotional turmoil of caring for terminally ill patients and the commercialisation of health care sector that tends to see each patient as just another ‘case’. Nazeem’s candid speak does not spare her family or herself. Disease and death are events that touch every family at some point or other.”

It would be more than worth a read – a sort of preparation for life. All the profit from her book came to Pallium India to support patient care. Nazeem writes to say about the next edition, which is available as Print on Demand:

“My book is proof read again to remove printing devils and mistakes. DC Books [Expressions] is ready to print copies of My Mother Did Not Go Bald on your demand. Interested readers are kindly requested to order the book through DC Books – Online Bookstore. Click here to order the book and support the efforts of Dr Rajagopal and Pallium India to raise awareness about palliative care. The book is also available on Amazon Kindle.”