Doctors in India, for the past five decades, have been trained to be confident about always
when the heart and breathing stop. There is an unwritten supposition that they could come under the legal radar if they fail to perform CPR, even in case of a patient dying from an incurable or terminal disease. However, the current practices related to this matter around the globe, are highly contrasting.
The newly published report on this subject recommends that in cases where CPR would probably be required, the patient or family/surrogates be informed about this and the possible outcomes, thus making it an ideal medical practice. This stand eliminates the numerous uncertainties clouding the subject.
Cardiopulmonary resuscitation (CPR) is the medical technique used to restart the heart and breathing when they cease unexpectedly. It could be lifesaving when performed promptly on a reasonably healthy patient. However, this gives rise to the question of the procedure being unsuccessful if delayed for some reason or performed on someone already critically ill. As a matter of fact, things could take an adverse turn; while the heart may have restarted, as a consequence of loss of blood circulation for a crucial amount of time, the brain could be severely damaged. CPR could be traumatic and unfruitful, result in broken ribs and may also needlessly prolong death, particularly in weak, ailing aged patients.
ICMR has endorsed that CPR is not a default option in
end-of-life care situations. Rather, it is only a medical procedure that should not/does not have to be performed in certain circumstances where it only may prolong the suffering of patients with incurable illnesses. It therefore becomes the responsibility of the treating physician(s) to make the final call about DNAR and CPR, based on the ICMR consensus guidelines.
References:
- Mathur, Roli. ICMR Consensus Guidelines on 'Do Not Attempt Resuscitation'. Indian J Med Res. Apr 2020;151:303-310.DOI: 10.4103/ijmr.IJMR_395_20
-
Important Judgment of the Supreme Court of India - (https://nhrc.nic.in/press-release/important-judgment-supreme-court-india-1)
Source: Medindia
