Noida: Gautam Budh Nagar and Ghaziabad administration have constituted district-level Secondary Medical Boards to examine cases related to palliative care, advance medical directives and end-of-life care, in line with a Uttar Pradesh govt directive.The move follows the Supreme Court’s direction in the Harish Rana vs Union of India case, asking states to strengthen palliative and end-of-life care systems and submit compliance reports on the implementation of its earlier directions concerning the dignity of terminally ill patients.As per the state government’s order, each district-level board will comprise a registered medical practitioner nominated by the district administration along with specialists from various disciplines with at least five years of experience. In Noida and Ghaziabad, officials said the panel will include specialists from surgery, ophthalmology, ENT, orthopaedics, gynaecology and anaesthesia.“For each case, the examination will be carried out by the nominated medical practitioner and at least two specialists relevant to the patient’s condition,” said a senior health official.Officials explained that the Primary Medical Board is constituted by the treating hospital to examine the patient’s medical condition and determine whether the patient meets the criteria for withholding or withdrawing life-sustaining treatment. The board then issues a preliminary opinion which is reviewed by the Secondary Medical Board, constituted at the district level by the Chief Medical Officer.The Secondary Medical Board independently examines the patient and assesses the findings of the Primary Medical Board. If it agrees with the preliminary opinion, it certifies that the Advance Medical Directive (living will) or the end-of-life care decision may be implemented.The government has also directed all district hospitals to ensure strict compliance with existing guidelines. Hospitals have been asked to provide dignified and sensitive treatment to patients suffering from serious and incurable illnesses and to sensitise doctors and nursing staff about relevant legal provisions. Authorities have also been instructed to maintain proper legal records in cases where the Supreme Court-prescribed procedure is applicable.
