Health Ministry proposes guidelines for withdrawing life support from terminally ill patients

The health ministry has suggested that life support can be withdrawn from terminally ill patients if both the primary and secondary medical boards of a hospital, along with the patient's family or surrogate, provide consent, according to a report by The Times of India. Additionally, the withdrawal of supportive care such as ventilation, dialysis, or ECMO (extracorporeal membrane oxygenation) is permissible if patients are declared brain dead, unlikely to benefit from advanced interventions, and if the patient or their surrogate documents an informed refusal of care, as reported by The Indian Express.

In draft guidelines released for public comment, the ministry emphasized that many patients in intensive care units (ICUs) are terminally ill and not expected to gain from life-sustaining treatments (LST), which can include mechanical ventilation, surgical procedures, parenteral nutrition, and ECMO. The ministry stated, "In such circumstances, LST is non-beneficial and increases avoidable burdens and suffering for patients. This approach is considered standard ICU care worldwide and is upheld by several jurisdictions."

Terminal illness is defined as an irreversible or incurable condition from which death is inevitable in the foreseeable future, including severe traumatic brain injuries that show no recovery after 72 hours or more.

According to the proposed guidelines, life support can be withdrawn if a patient is brain dead or if their prognosis indicates they are unlikely to benefit from aggressive treatment. A surrogate, who represents the patient's best interests, can make decisions on their behalf if the patient loses decision-making capacity. If a valid advance medical directive (AMD) exists, the surrogate will be the person named in that directive; otherwise, it defaults to the next of kin or guardian.