Doctor groups plead for law to spare patients of needless medical expenses

Medical care in India might be cheap for foreigners, who throng the country for its affordable healthcare. But for Indians, the medical care is synonymous to exorbitant charges and needless medical tests and treatments. But this time round, the doctors have taken it in their hands to prevent this from happening anymore. On Sunday, three doctors' associations representing thousands of doctors - neurologists, critical care specialists and palliative care doctors - came together to call for legislation that would prevent inappropriate medical treatment and give patients and families the right to refuse unnecessary intervention. The Indian Society of Critical Care Medicine (ISCCM), Indian Academy of Neurology (IAN) and Indian Association of Palliative Care (IAPC) have come together to form an End of Life Care in India task-force (ELICIT) to develop an alternative draft bill to the one proposed by the health ministry. The ministry made public the draft Medical Treatment of Terminally-Ill Patients (Protection of Patients and Medical Practitioners) Bill, 2016 in May with June 19 as the last day for submitting comments on it. Doctors from the three societies were unanimous in rejecting the use of the word euthanasia anywhere in the discussion or in the bill. & quot Our legal system has mixed up end-of-life care with suicides and euthanasia. We abhor the term euthanasia and will not tolerate it in the legislation or in any discussion on end-of-life issues. You euthanise animals. Sentient human beings take charge of their last days,& quot said Dr RK Mani of ISCCM, chairperson of the ELICIT steering committee. ELICIT has called for a uniform definition of death, which will include brain death. & quot In India we are ready to declare brain death only if the patient is willing to donate organs. If they are not, we are not willing to certify brain death, which in effect means that you are actually ventilating a dead person,& quot pointed out Dr Sanjay Nagral, a gastroenterological surgeon from Mumbai who is also a member of the editorial board of the Indian Journal of Medical Ethics. Many doctors at the meeting talked of their daily experiences in dealing with end- of-life decisions. & quot It is an everyday occurrence when dealing with serious patients. So, the solution has to be local. & quot The suggestion in the draft bill to approach the high court in such cases is just impractical, knowing how overburdened the judiciary is. And to say the high court will deliver a judgement in a month is ridiculous because terminally ill patients or acutely ill patients might not have a month left. ICU charges are Rs 35,000-50,000 excluding cost of drugs. Who will pay the bill at the end?& quot asked one of them. Girish Gokhale, a senior lawyer assisting ELICIT in preparing the draft bill, said that instead of using the term right to die he would put it as the right to regulate treatment. He called upon doctors to explore the potential of providing palliative care as no fresh legislation was needed to do that.

OUR TAKE

With so less transparency in the healthcare sector of the country, such problems and situations are bound to occur. The only solution is to prevent such doctors to take matters in their own hands and charge exorbitantly. Treatment of patients who are terminally ill is very expensive and with each passing day, the doctor burns a hole into the pocket of the kin of the patient. Why do this, when the doctor knows the end result? This needs to change and it surely will, once the new law is passed.