End-of-life care policy: An integrated care plan for the dying

Sheila Myatra, Naveen Salins, Shivakumar Iyer, Stanley MacAden, Jigeeshu Divatia, Maryann Muckaden, Priyadarshini Kulkarni, Srinagesh Simha, Raj Mani

Research output: Contribution to journalArticle

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Abstract

Purpose: The purpose was to develop an end-of-life care (EOLC) policy for patients who are dying with an advanced life limiting illness and to develop practical procedural guidelines for limiting inappropriate therapeutic medical interventions and improve the quality of care of the dying within an ethical framework and through a professional and family/patient consensus process. Evidence: The Indian Society of Critical Care Medicine (ISCCM) published its first guidelines on EOLC in 2005[1]which was later revised in 2012. [2]Since these publications, there has been an exponential increase in empirical information and discussion on the subject. The literature reviewed observational studies, surveys, randomized controlled studies, as well as guidelines and recommendations, for education and quality improvement published across the world. The search terms were: EOLC; do not resuscitate directives; withdrawal and withholding; intensive care; terminal care; medical futility; ethical issues; palliative care; EOLC in India; cultural variations. Indian Association of Palliative Care (IAPC) also recently published its consensus position statement on EOLC policy for the dying. [3]Method: An expert committee of members of the ISCCM and IAPC was formed to make a joint EOLC policy for the dying patients. Proposals from the chair were discussed, debated, and recommendations were formulated through a consensus process. The members extensively reviewed national and international established ethical principles and current procedural practices. This joint EOLC policy has incorporated the sociocultural, ethical, and legal perspectives, while taking into account the needs and situation unique to India.

Original languageEnglish
Pages (from-to)615-635
Number of pages21
JournalIndian Journal of Critical Care Medicine
Volume18
Issue number9
DOIs
Publication statusPublished - 01-09-2014

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

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    Myatra, S., Salins, N., Iyer, S., MacAden, S., Divatia, J., Muckaden, M., Kulkarni, P., Simha, S., & Mani, R. (2014). End-of-life care policy: An integrated care plan for the dying. Indian Journal of Critical Care Medicine, 18(9), 615-635. https://doi.org/10.4103/0972-5229.140155