So, this morning, after having my tasteless breakfast (what more to expect in a hospital), I went to the wards to see the patients admitted under me. During the rounds, when I was instructing duty doctors for the medicines and ancillary care of the patient, a lanky, dark eyed, female, maybe in her thirties (maybe!), came to me. She introduced herself as sister of a patient, the one suffering from brain injury, who was battling with coma and also with all the plastic tubings coming out of various body orifices. My curiosity grew to suspicion, when she asked to talk in private. I, somehow, reluctantly, gave to her demand, despite getting calls from OPD attendant for waiting patients.
She started with telling their humble background (saying humble would be gross injustice to a family whose economic structure is all in shambles), and asked me about the prognosis of the patient. I told her the usual things, which I usually do to ward off the ever asking attendants. She than ask me if they can carry their patient home, to which I denied stating the need of ventilatory support and nursing care.
The next question was a “bolt from the blue“, as she said, “डॉ साब, मार दो इसको, कैसे खर्च उठायेगे इसका?? खाने के पैसे नहीं है, इसकी दवाई गोली कहाँ से लायेगे??. Yes, my suspicion was right. She was asking about Euthanasia, still the most dreaded term in Indian society.. and for a Doctor as well…
For those who don’t know,
“Euthanasia is the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.”
I am usually able to answer to most of the awkward questions and demands of patient’s relatives. But, till now, I have not been able to answer to this question in whole of my medical career. Because, whenever I deny them the choice of Euthanasia, the next question is “how will we manage our patient, would you pay or care for him??..”(Yes, the answer is plain “NO”, as I can not).
But looking at the patient’s perspective, and gauging it with the state of health prevalent in our country, I think upon the fact that, why someone is not allowed to chose the decision of his/her life (in this case, Death)?.. When an establishment is not able to provide care to its citizens, where poverty is rampant, and a person is not able to live a disease or disability free life, where a patient’s attendant is thinking more about the economics than the healthcare of patient, is it not prudent to let the decision reside in the hands of the sufferer itself??
India is a big country, geographically as well as demographically and it is not possible to cater to needs of people, however, basic and important they may be. The healthcare is in doldrums, where the gap between private and state owned health care is too wide, a never ending abyss of poverty, helplessness, and human suffering.
Yes, this debate is a can of worms I have opened up, the lid of which is somewhere lost, but either we can deny the facts and the ground reality as always, or we can let the worms crawl, fly, or
whatever they like to do…
So, Is India ready yet??