Sri Jayati and Sri Arun from team Vishnudutas attended 15 days extensive training on Counseling and Palliative Care conducted by Tata Memorial Hospital, Mumbai.
It was an informal meet of small crew of Vishnudtas at Mumbai. Sarvesh Soni, Dr. Meena Samtani and Bharat Chandra Dasa met and had discussions on how things can be taken up further in Vishnudutas.
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.
The policy document can be downloaded here:
In a recent study conducted by HCAH guided by End of Life Care in India Task Force (ELICIT), found that only 27% of Indians are aware about “Advance Medical Directive” also known as “Living Will”.
Dr RK Mani, head of End of Life Care in India Task Force ( ELICIT), said: “What we now wish is to have a simplified process laid down to help people execute their Living will”.
It was also found that the moment they were told about its importance, more than 79% found the concept of Living Will relevant.
Further, after understanding the concept of Living Will, 87% of respondents found it highly relevant for terminally ill or patients on artificial life support. The acceptance was at 92% in respondents above 60 years of age. Interestingly, on being asked the relevance of Living Will for themselves, this number dipped from 87% to 76%!
96% of senior citizens who thought Living Will to be a relevant concept see it as an important way to reduce financial stress on their family while 93% of respondents in the 25 – 35 years group found it relevant to put an end to the suffering of patients on artificial life support”.
Other findings came to light such as 76% people who found the concept of Living Will relevant, 91% wished to discontinue any life support system in case they were declared terminally ill on artificial life support with no or marginal hope of recovery. Only 5% found Living Will concept irrelevant, with few worried about its misuse and while few find it hard to chart the course of their last moments themselves and will leave it on their kin to decide.
The news was published in the Financial Express on April 16th, 2019.