On Monday, the Supreme Court of India will hear its related Bench on the National Guidelines for Intensive Care Units and Critical Care Unit Intensive across the country for the treatment of patients and protection of Intensive and Critical Care Units.
This case has revealed the disparity in ICU norms across states and UTs, and it has emerged that of them, only eight states have complied with the Union government’s release in September 2023. A bench comprising Justice Sudhanshu Dhulia sought to know whether all the states and UTs would follow these guidelines or suggest any changes by November 4.
The guidelines under preparation in the Union were developed in an attempt to standardize the ICU and CCU treatment policies in India, which include criteria for admission and discharge, minimum general qualification for critical care specialists, and patient management protocols. The states of Andhra Pradesh, Chandigarh, Chhattisgarh, Haryana, Jammu and Kashmir, Meghalaya, Punjab, and Rajasthan have already agreed to these standards.
The guidelines form part of the Union government’s response to a Public Interest Litigation (PIL) filed in 2015 by one Asit Baran Mondal claiming damages for negligence, which led to the death of his wife in a Kolkata hospital in 2013. Mondal said that there are inadequate guidelines for prescribing treatment for ICU patients; hence, it is a medical negligence case.
The Supreme Court, while passing an order in 2016, has also drawn attention to massive medical negligence taking place in several private hospitals, calling for a standard in the ICU. In response to this, the Union government set up a committee in 2022 to develop priorities policies and directives for case admissions to the ICU, the management of untreatable patients, and processes for treatment withholding or withdrawal when needed.
Recommendations of the committee have also sought to define the qualifications of ICU specialists with postgraduate degrees as mandatory and training or experience in the care of intensive care patients as prescribed essential, besides some states proposing that experience be sufficiently met.
Further, the guidelines describe conditions under which patients with severe illness may not be appropriate for ICU admission.
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