Dr. Rahalkar's thoughts...

Friends,

These are some stray thoughts and I sincerely wish and hope that you will very graciously give it some concrete shape by offering your candid comments, suggestions and even criticism if deemed fit to.

In fact, this is a global problem, which is particularly evident in India. Let me spell out the problem straightaway. You see, there are larger numbers of old, decrepit people who are literally waiting and praying for ‘Death’. No Nation on the planet has yet been able to ‘Legislate’ ‘Voluntary Death’ and ‘Mercy-killing’. Overall longevity of the elderly is certainly on the rise, may be due to various palliative measures along with some cures as well, which is most commendable.

However, there are still large numbers who are beyond recovery, in fact ‘incurables’. Both the elderly as well as his/her close relatives literally get ‘fed-up’ with the pitiable condition of the elderly sick. In a very big majority of the cases in India, close relatives try to do their best to keep the elderly and the sick in particular, as much comfortable as possible. However, more often than not they are frustrated, tired and ultimately tend to lose patience while looking after them at home.

In such cases there is just no alternative but to get the elderly sick ‘admitted’ in a hospital.
Now, the ‘hospital’ must play its role to come to a ‘diagnosis’ by ordering various types of ‘Investigations’, ‘Expert’s opinions and so on, which are expensive, cumbersome and truly speaking useless in most of the cases. They must keep poking, pricking and ‘exploring’ the admitted ‘patient’; moreover, they must ‘administer’ treatment as well, otherwise there is no point in admitting a ‘case’!

I am a Medical man and therefore can understand the ‘ethics’ behind the entire paraphernalia’; however, I fail to understand the ‘rationale’. Why can we not accept the fact, that we can never avoid the inevitable, that is, Death? Why should we not allow such cases just to ‘die’ comfortably and peacefully, rather than ‘torturing’ them to death?

I am aware that the Constitution and Law does not permit to do so. Therefore, there is need to consider and find out some via-media, whereby the Law is not broken and the ‘case’ dies peacefully and comfortably. I wish to offer a solution that is likely to be practical.

There can be centre or centers in every town meant to cater to the Terminally Sick, the ‘Terminal Care Centers’.

1). Such a centre could be located in the hospital itself, where there is provision of just Nursing care, appropriate diet and calm, tranquil atmosphere. No ‘active’, ‘aggressive’ or ‘invasive’ treatment is advised or carried out. At the most, adequate pain-relievers or sedation may be used.
Such cases should be ‘selected’ by a qualified medical person before transferring to the Terminal Care Unit and very naturally death would be certified by him when the inevitable happens ultimately.

2). Whether such centers can be run by philanthropic persons or organizations after duly honoring provisions of the Nursing Home Act.
Those could be in the form of ‘old-age homes’ with entire amenities for food, shelter and entertainment with added Nursing care under Medical supervision but without any ‘active’ treatment as mentioned above.

3). Is it possible to create greater awareness about this problem through various publicity media? Indeed, I am very much impressed by the Marathi Film ‘SUKHANTA’. However, although the end of the film is quite convincing looking at the overall situation, it does not answer the basic query, that of ‘ethics’, ‘morality, ‘helplessness’ and law!

(I am aware that I am looking ‘confused’ at this stage! In fact, that is the exact reason for seeking your counsel, comments, words of caution etc. Let there be a debate at various levels, so that some solution to the confronting problem comes to fore!!)

With warm regards,

Dr.P.S.Rahalkar
A-2, 604, Aditya-Shagun,
Bavdhan, Pune-411021

Tel: 020-22953764
Mobile- 9890422498