Recommendations to the Maharashtra Task Force to Manage Critically-Ill Covid-19 Patients

Reports by Vidhi Aid · April 21, 2020
Author(s): Akshat Agarwal and Dhvani Mehta

The Government of Maharashtra constituted a task force of doctors to give recommendations regarding a patient management protocol for critically Ill Covid-19 Patients. The Vidhi Centre for Legal Policy submitted recommendations regarding Do Not Attempt Resuscitation decisions, withdrawing and withholding life-sustaining treatment, palliative care and the need for pandemic triage protocol which could be considered by the Task Force in framing its own recommendations. Some of our key suggestions include:

• Develop protocols on the use of Do Not Attempt Resuscitation to guide decisions about CPR in Covid-19 patients.

• Consider emergency legislative intervention to replace the Supreme Court guidelines on withholding and withdrawing life-sustaining treatment with practical, workable guidelines. Alternatively, develop protocols on withholding or withdrawing life-sustaining treatment that lay down criteria for initiating end of life care discussions, rely on shared decision making amongst physicians and/or their near relatives and require clinical ethics committees to participate in such decisions.

• Make arrangements for the provision of adequate and quality palliative care for critically ill Covid-19 patients at the end of life.

• Prepare pandemic triage protocols based on consistent ethical principles which are not arbitrary or discriminate solely on the basis of factors such as age, disability etc., in anticipation of a surge in patients.

• Prepare clear and simple information in multiple languages for patients about the above protocols, including the rationale underlying them.

Download: Recommendations to the Maharashtra Task Force to manage critically ill Covid-19 patients

About Akshat Agarwal:

Akshat is a Research Fellow at Vidhi and currently works with the Vidhi Aid initiative. At Vidhi, he has advised on projects relating to the regulation of the digital economy, privacy and federalism. Currently, he is working on research projects relating to LGBT+ rights, withdrawal of care from terminally ill patients and public health. His research interests include public law, human rights, family law and gender and sexuality. Akshat is an alumnus of the National Law School of India University, Bangalore and was previously an Associate at the leading Indian law firm Khaitan & Co., where he worked with their disputes and regulatory practices. He has been published in peer reviewed journals as well as media outlets such as The Wire, LiveMint etc., and has also contributed to international blogs such as the Oxford Human Rights Hub and the IACL-AIDC blog. He served as the Chief Editor of the National Law School of India Review and was also on the editorial board of the Indian Journal of International Economic Law. Link to full bio

About Dhvani Mehta:

Dr. Dhvani Mehta {B.L.S. LL.B. (University of Mumbai); BCL, D.Phil (Oxon)} is a Senior Resident Fellow and Team Lead of the Vidhi Aid initiative, where she works on environmental and health regulation, medical ethics and the right to education. She has worked specifically on research projects on environmental clearances, the National Green Tribunal, organ transplant laws, end of life care, and pharmaceutical and medical device regulation. She has appeared in the Supreme Court of India in petitions filed by Vidhi on advance medical directives and discrimination against persons affected by leprosy. She has authored chapters on the implementation of environmental judgments and healthcare corruption in India. Dhvani read for a doctoral degree at the University of Oxford on a Rhodes Scholarship, where she was Chairperson of Oxford Pro Bono Publico and an editor of the Oxford Human Rights Hub blog. Her doctoral thesis explores the idea of an environmental rule of law in India and was cited by the Supreme Court of India.