• End of life care
• Terminal care
• Supportive care
• Quality of life

Caring for terminally ill patients in India has become a complex and challenging task in the 21st century. A cross-country comparison of expert assessments of the Quality of Death And Dying in 2021 ranked End of Life Care in India as low as 59th among 81 countries studied.1 The poor status of access to palliative care is shown by the fact that even basic pain relief reaches less than 4% of the needy in India.2 Paradoxically, many are subjected to more suffering in the form of irrational artificial life support systems which are continued even in the face of futile treatment.3

In India, there is no specific legislation for the care of the terminally ill patient. There are guidelines from the Medical Council of India,4 and position statements from organisations like the Indian Association of Palliative Care,5 Indian Society of Critical Care Medicine,6 Indian Academy of Pediatrics7 and Federation of Indian Chambers of Commerce & Industry,8 but these are not legally binding.

The Indian Penal Code provides protection against euthanasia, but it is not clear how this applies to patients who are in the final stages of life. There is a need for clear legislation to protect the rights of terminally ill patients in India and to ensure that they receive the care and support they need.

In the absence of specific legislation, the right to dignified end-of-life care is interpreted through the Constitution of India Article 21 (right to life and personal liberty) and Article 14 (equality before law). The legislation related to the concept of care for the terminally ill patient in India has evolved over time (figure 1).