Indian Society of Critical Care Medicine and Indian Association of Palliative Care Expert Consensus and Position Statements for End-of-life and Palliative Care in the Intensive Care Unit.

End-of-life care (EOLC) exemplifies the joint mission of intensive and palliative care (PC) in their human-centeredness. The explosion of technological advances in medicine must be balanced with the culture of holistic care. Inevitably, it brings together the science and the art of medicine in their full expression. High-quality EOLC in the ICU is grounded in evidence, ethical principles, and professionalism within the framework of the Law. Expert professional statements over the last two decades in India were developed while the law was evolving. Recent landmark Supreme Court judgments have necessitated a review of the clinical pathway for EOLC outlined in the previous statements. Much empirical and interventional evidence has accumulated since the position statement in 2014. This iteration of the joint Indian Society of Critical Care Medicine-Indian Association of Palliative Care (ISCCM-IAPC) Position Statement for EOLC combines contemporary evidence, ethics, and law for decision support by the bedside in Indian ICUs. Mani RK, Bhatnagar S, Butola S, Gursahani R, Mehta D, Simha S,

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*One of the questions that the Court framed for consideration was “In a person in a permanent vegetative state, should WH or WD of life-sustaining therapies be permissible or not unlawful” #Section 115 of the Act states that any person who attempts to commit suicide is presumed to have severe stress and shall not be tried or punished under the Indian Penal Code. $Common cause, Paragraphs 198 and 199 of Chief Justice Mishra's judgement consistently refer to both WH and WD while laying down the procedure. @Section 2(i) of THOA defines “near relative” to mean “spouse, son, daughter, father, mother, brother, sister, grandfather, grandmother, grandson, or granddaughter.” *Only if donation after circulatory determination of death (DCDD) is included in the THOA protocol.