Do not attempt resuscitation

Sir,

There is in connection with the ICMR consensus guidelines on the subject of do not attempt resuscitation1. I have read the guidelines and also the correspondence published recently on the subject2. Personally, I believe that the decision is not to be left entirely in the hands of the treating physician at the hospital. The patient should have the right to choose resuscitation or not. As a cardiac surgeon with 40 yr experience, I have seen more of the misery that ensues end-of-life support complications, costs, emotions and inevitable finality of death. My spouse (also a retired ophthalmologist) and I have recorded our desire to die peacefully and not undergo resuscitation as end-of-life event. The document will be available to our children and immediate family, in such an event, and we expect that the decision will be honoured and we may be allowed to die peacefully without suffering any of the consequences of life support measures. This has been recorded and witnessed during our life in a condition of health and awareness. Your guidelines do not allude to such signed declarations of patients during life and propose that the treating physician is the final decision-maker.

In another context, my publication on the subject3 of organ donation is relevant here. What are the guidelines for organ donation from a prisoner sentenced to death? Like all other human beings, he/she may offer his/her organs while living or all organs after his/her death, which is pre-determined. How does medical profession set guidelines in such cases?