Dr KK Aggarwal
Federation
of Indian Chamber of Commerce and Industry (FICCI) and End of Life Care in
India Taskforce (ELICIT) have also released an information guide to improve and
facilitate execution of end-of-life decisions for patients and their families,
in addition to their guide for doctors and hospital administrators
Here are excerpts from
the “Action Plan for end-of-life care and decision-making” for patients.
“Plan in
Advance: Self-awareness
is the beginning of any journey. Think about how and where you would like to
die.
Do not be afraid to
bring up the subject of death if you feel it is relevant to you: Senior citizens or
those with serious or life limiting illness should proactively assume the
responsibility of discussing their future medical care preferences with family
and loved ones and their treating doctors.
Ask your treating
doctor and medical team about various options available to you and the
advantages and disadvantages associated with each of them: It is important to
remember that you cannot be forced to accept life-sustaining treatment against
your wishes. Your treating doctor and medical team have an ethical and legal
obligation to respect your wishes if you refuse any offered treatment, after
understanding the consequences of such refusal.
To prepare for
situations when you may not be in a position to express your wishes, make an
Advance Medical Directive (AMD): An Advance Medical Directive has two
components:
1. The
Living Will, which expresses your wishes for care clearly so that doctors can
understand and follow them
2. The
appointment of a healthcare proxy, through a power-of-attorney, who can speak
for you when you are no longer capable of doing so. Your healthcare proxy could
be a member of your family or a friend, but should not be your treating doctor.
This saves the family the agony of taking decisions on your behalf without any
guidance or without knowing your wishes
Discuss your directive
with your family and/or healthcare proxy and make sure that they accept the
appointment. It is advisable to make the directive in the presence of
two witnesses, who will attest to the fact that you have made
the directive with a sound mind. This directive can be revoked verbally/in
writing. Although at present the Supreme Court has mandated a rather cumbersome
process for using these directives, rationalization of the process is being
advocated for.
Take charge and accept
death as part of life: If a serious or terminal illness is diagnosed,
prepare to take charge of the last days of your life. Use all sources medical,
social, psychological and spiritual, to live well till the end. Do not resist
the natural course of death. Discuss your needs and expectations now and in the
future with family members, doctors and trained counsellors. If you realize
that you would rather not know or engage with such matters, appoint a trusted
surrogate decision maker.”
(Source:
FICCI-ELICIT Improving end-of-life care & decision-making information
guide to facilitate execution of end-of-life decisions - for patients and their
families)
See related link:
FICCI-ELICIT guide to
improving end-of-life care & decision-making
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of
Medical Associations in Asia and Oceania (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of
India
Past National President
IMA
