Minister Dinesh Gundu Rao reiterated that this move would bring relief to many terminally ill patients and their families, allowing them to make informed decisions about their end-of-life care. (Wikimedia Commons) 
MedBound Blog

Right to Die: Karnataka Implements Landmark Policy for Terminally Ill Patients

This policy aligns with the Supreme Court’s focus on reducing prolonged suffering for patients with irreversible medical conditions

Sai Sindhuja K

The Karnataka Health Department has officially put into effect a policy that upholds the Supreme Court’s ruling, which grants terminally ill patients the right to die with dignity. This policy is specifically for patients with incurable conditions or those who have no chance of recovery while being kept alive by life support systems.

Two-Step Medical Review Process:

Under the new policy, a two-step medical review process will be followed to assess each case. First, a primary board of three doctors will evaluate the patient's condition. Then, a secondary board, consisting of three doctors along with one government-appointed doctor, will review the findings. Once these steps are completed, the report is forwarded to the court for final approval.

If the court agrees to the request, life support will be withdrawn under medical supervision, allowing the patient to pass away peacefully. This process only commences after a request from the patient's family.

A Step Towards Reducing Suffering:

This policy aligns with the Supreme Court’s focus on reducing prolonged suffering for patients with irreversible medical conditions. Karnataka Health Minister, Dinesh Gundu Rao, shared on social media, emphasizing the benefit this will bring to terminally ill patients with no hope of recovery, those in a persistent vegetative state, and patients who no longer benefit from life-sustaining treatment. He also highlighted the introduction of an Advance Medical Directive (AMD), or living will, where patients can document their preferences for future medical treatment. This initiative is seen as an important step in providing closure and dignity to families and individuals.

Minister Dinesh Gundu Rao emphasized that the policy will benefit individuals with irreversible medical conditions, helping to withdraw life-sustaining treatments that are no longer effective.

Siddaramaiah Government’s Historic Decision:

In a groundbreaking decision, the Karnataka government, led by Chief Minister Siddaramaiah, directed the implementation of the ‘Right to Die with Dignity’ policy for terminally ill patients, in line with the Supreme Court’s ruling. Minister Dinesh Gundu Rao emphasized that the policy will benefit individuals with irreversible medical conditions, helping to withdraw life-sustaining treatments that are no longer effective.

In a post on X (formerly Twitter), he stressed that this decision would provide significant relief to terminally ill patients and their families, reinforcing the state's commitment to upholding progressive and just values.

The Supreme Court recognized the "Right to Die with Dignity" as part of the fundamental right to life under Article 21 of the Indian Constitution.
Harish Gupta, Principal Secretary to the Health and Family Welfare Department

Supreme Court Ruling and Legal Framework:

Harish Gupta, Principal Secretary to the Health and Family Welfare Department, explained that the Supreme Court recognized the "Right to Die with Dignity" as part of the fundamental right to life under Article 21 of the Indian Constitution. According to the Court, life-sustaining treatments may be withdrawn or withheld from patients who are terminally ill with no chance of recovery or those in a persistent vegetative state when the treatment no longer serves a beneficial purpose.

Additionally, the Court recognized Advance Medical Directives (AMDs) and established guidelines for their execution. The Court affirmed that when a patient’s medical condition is irreversible and no recovery is possible, withholding or withdrawing life-sustaining treatment is an acceptable course of action.

How the Process Works?

The Supreme Court has outlined a procedure for withdrawing life-sustaining treatment (WLST), which requires the approval of the treating doctor. The hospital treating the patient must also form both Primary and Secondary Medical Boards, each comprising three registered medical practitioners. The Secondary Medical Board should include a medical practitioner appointed by the District Health Officer.

The decision to withdraw life support can only be made after obtaining consent from the patient's next of kin or the person designated in the patient's Advance Medical Directive. Once these steps are completed, the case will be sent to the court for final approval.

Implementation of the Supreme Court’s 2023 Ruling:

Karnataka's Health Department has acted on the Supreme Court’s 2023 ruling, which allows terminally ill patients the option of a dignified death. This policy applies exclusively to patients who have no possibility of recovery and are currently on life support. The process begins only if the patient's family agrees and requests the court to authorize the withdrawal of life support.

The case is then reviewed according to the two-step medical review process. First, a primary board of three doctors evaluates the patient’s condition, and then a secondary board, including one government-appointed doctor, reviews the report before submitting it to the court for approval.

Minister Dinesh Gundu Rao reiterated that this move would bring relief to many terminally ill patients and their families, allowing them to make informed decisions about their end-of-life care. He highlighted the introduction of Advance Medical Directives as a key component of this policy, ensuring patients' wishes regarding their medical treatment are respected in the future.

(Input from various sources)

(Rehash/Sai Sindhuja K/MSM)

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