Mrityunjay: a rational dialogue on dignified death


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This program was held on a web based platform on Sunday, 28/06/2020.

NICHE Advocacy Foundation is an organisation working in the field of emotional fitness and mental health.

Death is our common reality. Along with a good life, a lot of concepts exist around the concept of a good death.

We get so swept up with life, that we don’t spare any time to think about death. When asked, ‘where would you like to die?’ most people would answer: at home with my loved ones. and yet many of us in the modern life style, are dying in the intensive care units amidst strangers. Autonomy and other basic rights dissolve as death approaches and we find ourselves in an undignified state.

Through the MRITYUNJAY campaign of our organisation, we want to urge people to take a rational view on death and dying and rise over the dark stigma of fear and taboo surrounding it. We should aim for a good death.

Our first speaker was Dr. Arvind Panchanadikar, a renowned psychiatrist from Pune. He spoke about grief and the process of bereavement. Some people are engrossed in the process of grief so much that their health starts getting affected. He mentioned Elizabeth Kubler Ross, who has written extensively on death and dying. He also spoke in detail on the process of bereavement. He urged the audience to approach for help whenever needed.

Dr. Shivakumar Iyer, Intensivist from Pune, spoke about futile medical interventions and the difficulties faced in the ICU. There comes a time in every person’s life when no intervention can save life. At such times the intervention is futile. Statistics can help predict the utility of an intervention. But whether at that point in time that intervention can be helpful for our patient or not is an entirely different matter. Good and transparent communication between care givers and care seekers is absolutely essential. Accepting that the intervention is futile can be challenging for the relatives of the patient in distress. In addition there are laws for withdrawing the life sustaining interventions. So if the patient and relatives are already educated about their rights, it makes things much simpler in the ICU. However this needs a lot of education of the people regarding this matter. He discussed the different typed of futile interventions.

Dr. Roop Gursahani, Neurologist from Mumbai, spoke about the important topic of Living Wills (icchapatra, as it is called in Marathi). This is a document which deals with how you want others to manage you or treat you in case you are unable to communicate, unconscious and unable to express your wishes during your last days. A surrogate decision maker is also to be appointed in such a case. A simple document stating the basic requirements with signature of witnesses, and a consent by your surrogate decision maker is required. This has to be converted into a legal document after a legal procedure. More and more people should should come forward to register their legal living wills.

Mrs. Sandhya Durge, Psychiatric Social Worker from Nagpur, who is a part of our team trying to execute living wills, spoke about practical difficulties and feelings in people’s minds about living wills.

Dr. Poornima, Neurologist from Pune and Director of NICHE Advocacy Foundation anchored the program. She narrated several anecdotes of problems faced by doctors while handling death and the emotional upheavals and events that unfold surrounding it.

In conclusion, more awareness is needed about this topic.