The Union Health Ministry released draft guidelines on withdrawing or withholding medical treatment in terminally ill patients, closing a regulatory gap that left medical professionals in a lurch. The guidelines, formulated by experts from AIIMS, allow patients to make a considered decision on whether they want to go on life support and whether they want to be resuscitated.
It also allows withdrawal of supportive care like ventilation, dialysis, or ECMO when they have been declared brain dead, they are unlikely to benefit from advanced intervention, and the patient or their surrogate document an informed refusal of care.
The guidelines also makes a mention of advance medical directive — a written declaration made by a person with decision-making capacity documenting how they would like to be medically treated or not treated should they lose capacity.
Once the physician determines the inappropriateness of the life sustaining measures, it says, they will refer the case to the primary medical board. If the board reaches consensus then there will be another multidisciplinary meeting with family and a shared decision will be made.
For forgoing life sustaining treatments, the case will be referred to a secondary medical board, and the support would be withdrawn only after its nod.