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Image use for representational purposes
Image use for representational purposes

The Indian Council of Medical Research (ICMR), has prepared ‘Do Not Attempt Resuscitation (DNAR)’ draft for doctors who try to revive terminally-ill patients.

According to ICMR, these guidelines would help doctors to manage patients in complicated situations better without causing more pain to them.

On December 2nd, ICMR is going to organise a national consultation to discuss the ‘Do Not Attempt Resuscitation’ (DNAR) draft. Health experts, doctors, patient rights activist, clinicians and nurses in critical care are invited to deliberate the draft in detail at the event.

The ‘Do Not Attempt Resuscitation (DNAR)’ draft which has been uploaded on ICMR’s website, would guide treating physicians to make an informed decision whether or not to perform Cardiopulmonary Resuscitation (CPR) on the patient, given the background of an incurable disease where the patient’s chances of survival are extremely low.

While speaking to My Medical Mantra Dr Roli Mathur, Head, ICMR Bioethics Unit, NCDIR, Bengaluru, who is closely working on draft, said, “ICMR Bioethics Unit of National Centre for Disease Informatics and Research will hold a national consultation to engage with stakeholders including patient’s representatives, clinicians, social scientists, legal and others.”

The medical fraternity has welcomed this decision and has stated that the doctor should consult the family whether the patient would want to be resuscitated or not.

Dr Vijay Surase, a senior consultant interventional cardiologist at Jupiter Hospital, Thane, stated, “Every patient has a right to live. So, doctors try their best to revive the patient. In a few cases, knowing that the patient will not survive, but as per the famil’s wish, doctors try to revive the patient. But, no one including the family thinks about what the patient would be going through. So, we welcome the draft prepared by the Indian Council of Medical Research. This will surely reduce the pain of the patient.”

The purpose of the draft is:

  • To help and guide treating physicians regarding their decision on ‘Do Not Attempt Resuscitation’ (DNAR)
  • The intention is not to prolong the suffering of the patient and to preserve dignity in death by avoiding medically non-beneficial CPR while providing compassionate care.
  • According to ICMR, this document would apply to a patient with an incurable disease where CPR is inappropriate, non-beneficial and may only prolong the suffering of the patient in the best judgment of the treating physician(s).
  • Also, the document is intended to facilitate the process of informed decision making about CPR and ‘DNAR’ by the treating physician on a case to case basis.

Dr Anil Pachnekar, Vice President, Indian Medical Association, said, “CPR is given by doctors in emergency cases. To revive the patient until they reach the hospital. But, when a patient is suffering from an incurable disease, it is not right to give him CPR and revive him. People need to understand the importance of CPR. CPR is given to save the life. So, the doctors should consult with their relatives and take a decision.”

To know about the draft click on the link below:

http://ethics.ncdirindia.org/PDF/Draft%20ICMR%20Position%20Paper%20on%20DNAR.pdf 

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