Letter for ISCCM/IAPC day campaign to all ISCCM members
Dear Friends,
Indian Society of Critical Care Medicine (ISCCM) continues the tradition of celebrating our foundation day in October with a focused theme. This year, we are planning a joint campaign with the Indian Association of Palliative Care (IAPC) focusing on "End of Life Care".
End of Life decisions and care are driven by significant emotions of patients, families and caregivers and never easy. This is particularly complicated when we do not have guidelines specific to our practice environment. ISCCM developed a position statement in 2005 (
ISCCM EOLC position statement 2005) which has provided guiding principles. Following this a law commission report outlined the need for clarity in the law and suggested promulgation of a draft bill for regulation of end of life issues.A second iteration of the ISCCM guidelines was published in 2012 (
EOLC guidelines 2012 ).
India figured last in a list of 40 countries evaluated for quality of death internationally, which is shameful to say the least. The Supreme Court has re-ignited the issue by calling for a nation wide debate on the topic. The government sounded a cautious note stating that the prerogative of formulating any law was that of parliament. We are sure most of you must have read the article that made headlines in the Sunday edition of Times of India and the interview by Dr. Mani in the same edition (
"Forcing ventilator on dying is assault" ).
ISCCM as the premier society of intensive care professionals can play an important role in this debate and facilitate the promulgation of appropriate laws by parliament. It has and should continue to guide end of life care till such laws are formulated.To this end, ISCCM has intervened in the case before the Supreme Court with an impleadment motion filed by ISCCM.
In order to create greater awareness and a nationwide consensus we are working with the Indian Society of Palliative Care (IAPC). A joint position statement (
"Integrated care plan for the dying" ) was published in the September 2014 issue of IJCCM, along with editorials by Dr. R K Mani (
"Coming together for care of the dying" ) and Dr. S Iyer (
Challenges in the implementation of EOLC). We are keen on involving other professional societies in this effort.
The theme for the ISCCM day this year (October 9, 2014)being jointly celebrated with the World Palliative Care Day (11th Oct) is "End of Life Care". Our campaign would be "We must know when to Stop"& "Who Cares? – We Do". We propose a week long campaign (October 4 -11, 2014) across the country and seek your active participation to promote humane end of life care to provide dignity to the dying patient.
Our proposed activities are listed below. However, we strongly encourage branches, institutions and individual members to also consider other innovative measures to sensitize our colleagues and general public and share details to others through our newsletter.
1. Dissemination of the joint ISCCM & IAPC position statement " Integrated Care Plan For The Dying"
published in IJCCM September 2014 issue to all members of ISCCM and IAPC and other interested professionals.
2. Standard slide sets on End of life care for both medical professionals and laypersons for use during the
ISCCM/IAPC campaign
3. Preparing a toolkit for implementing end of life guidelines at hospitals all over the country
4. Signing an online pledge for humane EOL by all members of ISCCM, IAPC, other medical societies and
interested members of the legal community and laypersons
5. Web conference/workshop from Mumbai to all ISCCM, IAPC members on 4th October 2014 on the standard
slide sets and toolkit (Train the Trainers program (see attachment))
6. Brochure/booklet on frequently asked questions at the end of life
7. Round table meeting in Delhi with senior doctors from ISCCM, IAPC, other medical societies, senior
lawyers, judges, NABH, MCI representatives and the media for creating awareness and establishing
consensus about the difficult ethical, legal and medical issues in end of life care (see attachment)
8. A survey on End of Life Practices in Indian ICU's has also been planned which addresses most of the EOL
issues confronting Indian Intensivists. This will strengthen our voice when we lobby with the government for
appropriate laws on EOL care.Please complete the survey questionnaire that will reach you on email or by
logging on to the ISCCM website
We invite all of you once again to participate in this effort to make end of life care in our ICUs more humane.
Dr. Shivakumar Iyer Dr. DhruvaChaudhry Dr. N. Ramakrishnan
President, ISCCM Secretary, ISCCM Chairperson, ISCCM Day