Udupi, Mar 25: Kasturba Hospital, Kasturba Medical College in association with the Manipal Academy of Higher Education developed procedural guidelines on the limitation of life-sustaining treatment and end of life care for patients with a terminal illness where continuing aggressive invasive medical interventions is considered futile. The booklet ‘Blue Maple’ is a compendium of these procedural guidelines which is an acronym for “Before Life Ends, Understand and Evaluate the Choice of Medical Treatment Offered: A Methodised Action Plan for Limitation of Life-Sustaining Treatment and End of Life Care”. It is a historic moment for Manipal as it is the first time such a document is created and released in India which is in alignment with the principles and philosophy of March 2018 Supreme Court Verdict on “Right to live and die with dignity”.
The booklet was released on March 24 at Senet Hall, MAHE by the chief guest of the event, Dr B N Gangadhar, director of NIMHANS and Member, Board of Governors of the Medical Council of India. Presided by Dr H S Ballal, Pro-Chancellor of MAHE. Dr Nagesh Simha, Medical Director of Karunashraya, Dr Poornima Baliga, the Pro-Vice-Chancellor of MAHE, Dr Pragna Rao, the Dean of KMC Manipal Guest of honour of the program. Mr C G Muthana, Chief Operating Officer Manipal cluster, Dr Avinash Shetty, Medical Superintendent and Dr Padmaraj Hegde, Deputy Medical Superintendent of Kasturba Hospital, Dr Naveen Salins, Professor and Head, Department of Palliative Medicine were present.
On this occasion Dr Gangadhar told how explained doctor’s apathy, lack of communication and inappropriate treatments has led to a rise in the medico-legal litigations and negative perceptions among the public about the doctors. He applauded the bold and candid efforts of the Manipal team in creating this much-needed document that could mitigate the pain and suffering of patients and their families facing critical and terminal illness. Dr Nagesh Simha, Medical Director of Karunashraya, highlighted the need for communication skills training for the doctors. Dr H S Ballal, Pro-Chancellor of MAHE impressed upon how a systematic approach for patients with a terminal illness can avoid needless harm and cost and provide good end of life care. Dr Poornima Baliga, the Pro-Vice-Chancellor of MAHE emphasised that the patient and family experiences of treatment are as important as cutting edge treatment offered. Dr Pragna Rao, the Dean of KMC Manipal, announced the incorporation of the palliative care topics and attitude, ethics, communication skills (AETCOMS) in the undergraduate curriculum. C G Muthana, Chief Operating Officer of Kasturba Hospital, explained the process involved in creating the ‘Blue Maple’ document. Dr Naveen Salins, Professor and Head, Department of Palliative Medicine, narrated the history behind the creation of the procedural guidelines. Dr Avinash Shetty, Medical Superintendent of Kasturba Hospital, welcomed the gathering and Dr Padmaraj Hegde, Deputy Medical Superintendent, proposed the vote of thanks.
The procedural guidelines laid down in the ‘Blue Maple’ document will be implemented at KMC Manipal and other associated hospitals of Manipal Group. The document will be made available in the open domain for other hospitals to use it. It will also be submitted to FICCI (Federation of the Indian Chamber of Commerce and Industry) and ICMR (Indian Council of Medical Research) as they are involved in similar efforts towards creating guidelines for limitation of life-sustaining treatment for patients with a terminal illness.