Citation

Mani RK, Amin P, Chawla R, Divatia JV, Kapadia F, Khilnani P, Myatra SN, Prayag S, Rajagopalan R, Todi SK, Uttam R. Indian J. Crit. Care Med. 2012; 16(3): 166-181.

Copyright

(Copyright © 2012, Indian Society of Critical Care Medicine, Publisher Medknow Publications)

DOI

10.4103/0972-5229.102112

PMID

unavailable

Abstract

PURPOSE To develop an ethical framework and practical procedure for limiting inappropriate therapeutic interventions to improve the quality of care of the dying in the intensive care unit through a professional consensus process. Evidence Since the publication of the last guideline in 2005,[1] there has been an exponential increase in empirical information and discussion on the subject. The literature reviewed address key surveys, observational studies, randomized controlled and interventional studies as well as guidelines and recommendations for education and quality improvement from all over the world and India. Established and evolving bioethical and medico-legal opinions in the world and in India are also included in this review. The search terms were: End-of-life care; DNR directives; withdrawal and withholding; intensive care; terminal care; medical futility; ethical issues; palliative care; end-of-life care in India; cultural variations.

MATERIALS AND METHODS Proposals from the Chair were debated and recommendations were formulated through a consensus process. The members of the Committee took into account the established ethical principles and procedural practices elsewhere in the world, incorporating the sociocultural and legal perspectives unique to this country.

Language: en

Keywords

human; law; resuscitation; survival; dementia; decision making; mortality; suicide attempt; pain; article; euthanasia; physician; barbituric acid derivative; distress syndrome; opiate; terminal disease; intensive care unit; morphine; coma; practice guideline; brain death; legal aspect; palliative therapy; intervention study; passive euthanasia; treatment withdrawal; personal autonomy; persistent vegetative state; intensive care; cancer patient; health care; court; long term care; artificial ventilation; quadriplegia; family counseling; prospective study; correlation analysis; endotracheal intubation; hospital bed; bioethics; Indian; tertiary health care; disease marker; newborn care; ethical decision making; cardiopulmonary insufficiency; cancer center; systemic circulation; beneficence; carbapenem