In Karnataka, proposal seeks to include ‘living will’ under digital health records of patients Premium
In Karnataka, proposal seeks to include ‘living will’ under digital health records of patients Premium
Citizens in Karnataka may soon be able to record their desired medical treatment in the future in an Advance Medical Directive (AMD) or a ‘living will’. The State Health Department, which has come out with a circular on AMD, is now contemplating getting this ‘living will’ included under the digital health records of patients.
The AMD would indicate to healthcare providers the kind of treatment the patient wants or prefers to avoid. A patient can also nominate two persons in the AMD, to decide medical treatment on his/her behalf, in case of a situation where the patient does not have decision-making capabilities
“Any adult patient of sound mind can execute an AMD and should send a copy of the AMD to a competent officer who is to be appointed for this purpose by the local government. AMDs can also be maintained in the paper/digital health records of the patient which are maintained by the medical establishment,” stated a separate circular issued in this regard on January 30.
Harsh Gupta, Principal Secretary (Health and Family Welfare), told The Hindu that the Department was now contemplating getting the AMD included under the patients’ digital health records.
“The AMD should be stored safely and be available for verification. To avoid its misuse, we are planning to write to the Centre to come up with a common mechanism with a unique ID such as the Aadhaar number or Ayushman Bharat Health Account (ABHA) number for AMDs. This unique ID will help even if the person migrates to some other State. We will submit a proposal in this regard to our Chief Secretary, as a common policy should be put in place for the unique ID,” he said.
Meanwhile, welcoming the move Sundar Sankaran, nephrologist and director of Aster Institute of Renal Transplantation in Bengaluru, said as a doctor he has always wanted such a directive. “Most of the time, family members are reluctant to let go of a patient, especially if the children are abroad. The situation is further complication if the children/relatives of a patient are doctors themselves. I am in the same predicament, with my children being abroad and being doctors. Hence, I have already mentioned in my joint will with my spouse that no active invasive intervention should be done with regard to my medical treatment. No one should die alone in the ICU without family and friends, if possible,” he said.
Nagesh Simha, medical director of Karunashraya Hospice Trust in Bengaluru, who has been working closely with the Health Department seeking dignified death for the terminally ill, said the move to allow the withholding of or withdrawal of life-sustaining treatment in cases of terminally ill patients with no hope of recovery comes as a huge relief for people in critical care. “Karnataka has set a precedent with this order. Although a similar order has been issued by the Government Medical College Hospital, Kollam, Kerala, the panel of doctors for the secondary medical board to approve of the withdrawal of life support treatment has only government doctors,” he said.
“I am relieved and grateful to the Karnataka Health Department for implementing the Supreme Court’s order. Now, the next step is to include more doctors in the panel,” said Dr. Simha.
Vishal Rao U.S., a surgical oncologist who specialises in head and neck cancer at HCG Hospitals, said it is ideal to have the secondary medical board doctors trained, certified and well versed with declaring brain death, especially at district-level hospitals.
“For this, an expert team comprising physicians, intensivists, neurologists, and neurosurgeons can be nominated to conduct a training. At the district-level hospitals, at least a trained physician, CMO, and anaesthetist should be part of the team,” he added.
