Published on: May 28, 2016

“In India, there is a fight-to-the-death mentality about treating the terminally ill,” writes Dr Jean Jacob in an article titled “Last Resort: India is a bad country to die in” published in The Caravan dated 1 May 2016. “Doctors treating a patient who is past the point of being able to make her own decisions are bound to obey the wishes of her relatives, who typically opt to use all possible means to prolong her life, no matter how artificial that life might be.”

Dr Jacob writes about an 83-year old man with terminal lung cancer who was brought to the Intensive Care Unit of his hospital where he was on duty as an intensivist. After receiving a battery of treatments aimed at prolonging his life, his vital organs began to fail, and their functions were compensated with drugs and invasive tubes. “Confined to a cold bed, isolated from his family and friends, and at the mercy of strangers in white coats, he had a mental breakdown. He raved about how the nurses were trying to kill him, and demanded that he be set free.”

Dr Jacob continues: “To address the situation here, India will need legal reform, and a concerted shift in the medical system to provide greater access to end-of-life care outside hospitals. Such care, if properly planned, can be provided effectively and affordably in patients’ homes, through community-based approaches. There are numerous good examples of such systems across the world, but perhaps the best one for India to consider already exists on its soil.”

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