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Indian Journal of Critical Care Medicine
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Year : 2003  |  Volume : 7  |  Issue : 2  |  Page : 112--117

Limitation of life support in the ICU: Ethical issues relating to end of life care

Respiratory Medicine, sleep disorders and critical care, Indraprastha Apollo Hospitals, New Delhi., India

Correspondence Address:
R K Mani
Respiratory Medicine, sleep disorders and critical care, Indraprastha Apollo Hospitals, New Delhi.
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Source of Support: None, Conflict of Interest: None

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In recent years, increasingly, intensivists have focused attention on the ethical aspects of end-of- life care. This has led to shifts in the approach from aggressive interventions to one of mitigating pain and taking into account the wishes and sensibilities of the patients' families with regard to continuing futile care. While the legal implications of this change in practice has led to the evolution of precise guidelines in the US and in Europe, in India this vital area of critical care remains largely unexplored. This review outlines the recent changes in clinical practice based on ethical principles and the legality of limiting life support in the context of futile or end-of-life care. An appraisal of the ethical issues in critical care urges us to apply intensive care with humanity and compassion. We need to respect the choices and the emotional needs of the patient and his family. Our duties must include providing information, balanced interpretation of results & counseling of the family to enable them to take rational decisions. Our strategy in end-of-life care should be unambiguous and we should ensure that there is consensus among all the physicians involved in the patient’s care. The medical community must work towards evolving legislation appropriate to Indian conditions.


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Online since 7th April '04
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