We all deserve to die with dignity

Modern medicine has advanced a lot but “death by intensive care” in isolation, with ventilator and life support systems is all the more painful and frightening. No one would like to die that way. While certain amount of pain is inevitable at the time of death, palliative treatment will help minimize pain, avoid the distress caused physically and monetarily.

• Death is the one certainty in life. About 10% die due to a sudden death. The remaining will have to go through a bed-bound stage before going finally. Half of them end up in ICU's and one-third with ventilator and other life support systems. These people die miserable death in isolated hygiene rooms with no loved ones on bedside at the time of death.
• Every human being yearns for a peaceful death. People who are terminally ill or bed-ridden at least expect a dignified death, but most of them are denied that privilege owing to certain misconceptions. People should be made aware of the real situation.
• Palliative care is about giving empathetic treatment to patients and the concept of spending one's final days largely at peace with oneself and then dying with dignity.
• It is true that we cannot always fully control the disease and pain of our loved ones, but we can certainly mitigate their level of pain through palliative care options.
• About 8.4 million people die in India every year. At least 5 million of them will have significant suffering during the bed-ridden state — pain, breathlessness or a host of other symptoms, not to mention the emotional and social distress that may be associated.
• In India, the poor die in agony in neglect, the middle-class die in agony in ignorance, and the rich die in agony on a ventilator. No one gets a dignified and pain-free death.
• The poor are rejected by hospitals and told that “there is nothing more we can do, so go home”; the middle class gets futile treatment that breaks the family financially; those having resources are imprisoned in intensive care units and put on meaningless artificial life support measures that often cause intense physical, psychological and financial distress.
• This suffering is unnecessary. Palliative care can relieve distress and enables the person to live, and when the time comes to die, with as much comfort and dignity as possible.
• In 2015, in a study of 80 countries on Quality of Death Index, India was ranked among the 15 worst countries to die in. The denial of access to pain relief, if it causes severe pain and suffering, constitutes cruel, inhuman or degrading treatment or punishment. 
• In the absence of palliative care, treatment of incurable diseases becomes inappropriate. The implications on the family are seldom recognised or discussed. In the absence of any form of support, family members have to leave their jobs and the next generation is forced to drop out of school.
• Even today, the basic principles of modern pain management are not being taught to medical and nursing students.
• Many elderly people and their children want aggressive treatment, advanced tests, and the latest remedies — which may not really enhance the quality of life. Everything that can be done will be done in a major hospital, whether it is necessary or not, at a cost. Patients may fall into an endless loop of irrevocable conditions, extending their suffering.
• People should set down on paper their well-considered preferences with regard to the kind of treatment that should be given to him/her in case they become at some point too incapacitated to take a decision and express it. This will make it easier for their children, caregivers and relatives to take a decision on their behalf.
• Governments have neglected health care and private sector exploiting and pushing 4 crore people annually below poverty line is a matter of national shame. 

A solution at the national level seemed promising when the Ministry of Health of the Government of India created a National Programme for Palliative Care (NPPC) in 2012. However it lacked budget allocations.