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Institutional end-of-life care policy for inpatients at a tertiary care centre in India: A way forward to provide a system for a dignified death

India has a high share in the global burden of chronic terminal illnesses. However, there is a lack of a uniform system in providing better end-of-life care (EOLC) for large patients in their terminal stage of life. Institutional policies can be a good alternative as there is no national level polic...

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Autores principales: Bhatnagar, Sushma, Biswas, Swagata, Kumar, Abhishek, Gupta, Raghav, Sarma, Riniki, Yadav, Himanshu Prince, Karthik, A.R., Agarwal, Akshat, Ratre, Brajesh Kumar, Sirohiya, Prashant
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629530/
https://www.ncbi.nlm.nih.gov/pubmed/35946200
http://dx.doi.org/10.4103/ijmr.IJMR_902_21
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author Bhatnagar, Sushma
Biswas, Swagata
Kumar, Abhishek
Gupta, Raghav
Sarma, Riniki
Yadav, Himanshu Prince
Karthik, A.R.
Agarwal, Akshat
Ratre, Brajesh Kumar
Sirohiya, Prashant
author_facet Bhatnagar, Sushma
Biswas, Swagata
Kumar, Abhishek
Gupta, Raghav
Sarma, Riniki
Yadav, Himanshu Prince
Karthik, A.R.
Agarwal, Akshat
Ratre, Brajesh Kumar
Sirohiya, Prashant
author_sort Bhatnagar, Sushma
collection PubMed
description India has a high share in the global burden of chronic terminal illnesses. However, there is a lack of a uniform system in providing better end-of-life care (EOLC) for large patients in their terminal stage of life. Institutional policies can be a good alternative as there is no national level policy for EOLC. This article describes the important aspects of the EOLC policy at one of the tertiary care institutes of India. A 15 member institutional committee including representatives from various departments was formed to develop this institutional policy. This policy document is aimed at helping to recognize the potentially non-beneficial or harmful treatments and provide transparency and accountability of the process of limitation of treatment through proper documentation that closely reflects the Indian legal viewpoint on this matter. Four steps are proposed in this direction: (i) recognition of a potentially non-beneficial or harmful treatment by the physicians, (ii) consensus among all the caregivers on a potentially non-beneficial or harmful treatment and initiation of the best supportive care pathway, (iii) initiation of EOLC pathways, and (iv) symptom management and ongoing supportive care till death. The article also focuses on the step-by-step process of formulation of this institutional policy, so that it can work as a blueprint for other institutions of our country to identify the infrastructural needs and resources and to formulate their own policies.
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spelling pubmed-96295302022-11-03 Institutional end-of-life care policy for inpatients at a tertiary care centre in India: A way forward to provide a system for a dignified death Bhatnagar, Sushma Biswas, Swagata Kumar, Abhishek Gupta, Raghav Sarma, Riniki Yadav, Himanshu Prince Karthik, A.R. Agarwal, Akshat Ratre, Brajesh Kumar Sirohiya, Prashant Indian J Med Res Policy Document India has a high share in the global burden of chronic terminal illnesses. However, there is a lack of a uniform system in providing better end-of-life care (EOLC) for large patients in their terminal stage of life. Institutional policies can be a good alternative as there is no national level policy for EOLC. This article describes the important aspects of the EOLC policy at one of the tertiary care institutes of India. A 15 member institutional committee including representatives from various departments was formed to develop this institutional policy. This policy document is aimed at helping to recognize the potentially non-beneficial or harmful treatments and provide transparency and accountability of the process of limitation of treatment through proper documentation that closely reflects the Indian legal viewpoint on this matter. Four steps are proposed in this direction: (i) recognition of a potentially non-beneficial or harmful treatment by the physicians, (ii) consensus among all the caregivers on a potentially non-beneficial or harmful treatment and initiation of the best supportive care pathway, (iii) initiation of EOLC pathways, and (iv) symptom management and ongoing supportive care till death. The article also focuses on the step-by-step process of formulation of this institutional policy, so that it can work as a blueprint for other institutions of our country to identify the infrastructural needs and resources and to formulate their own policies. Wolters Kluwer - Medknow 2022-02 2022-07-30 /pmc/articles/PMC9629530/ /pubmed/35946200 http://dx.doi.org/10.4103/ijmr.IJMR_902_21 Text en Copyright: © 2022 Indian Journal of Medical Research https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Policy Document
Bhatnagar, Sushma
Biswas, Swagata
Kumar, Abhishek
Gupta, Raghav
Sarma, Riniki
Yadav, Himanshu Prince
Karthik, A.R.
Agarwal, Akshat
Ratre, Brajesh Kumar
Sirohiya, Prashant
Institutional end-of-life care policy for inpatients at a tertiary care centre in India: A way forward to provide a system for a dignified death
title Institutional end-of-life care policy for inpatients at a tertiary care centre in India: A way forward to provide a system for a dignified death
title_full Institutional end-of-life care policy for inpatients at a tertiary care centre in India: A way forward to provide a system for a dignified death
title_fullStr Institutional end-of-life care policy for inpatients at a tertiary care centre in India: A way forward to provide a system for a dignified death
title_full_unstemmed Institutional end-of-life care policy for inpatients at a tertiary care centre in India: A way forward to provide a system for a dignified death
title_short Institutional end-of-life care policy for inpatients at a tertiary care centre in India: A way forward to provide a system for a dignified death
title_sort institutional end-of-life care policy for inpatients at a tertiary care centre in india: a way forward to provide a system for a dignified death
topic Policy Document
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629530/
https://www.ncbi.nlm.nih.gov/pubmed/35946200
http://dx.doi.org/10.4103/ijmr.IJMR_902_21
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