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Mens Sana Monogr. 2016 Jan-Dec;14(1):152-170. doi: 10.4103/0973-1229.193077.

End-of-Life Care and Psychiatry: Current Trends and Future Directions in India.

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MD (Psych), DPM, DNB (Psych), MRCPsych. Associate Professor, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India.


Although 80% of the deaths worldwide occur in middle- and low-income countries such as India, there is less awareness of end-of-life care (EOLC) for people with chronic, serious, progressive, or advanced life-limiting illnesses, including dementia. EOLC involves good communication, clinical decision-making, liaison with medical teams and families, comprehensive assessment of and specialized interventions for physical, psychological, spiritual, and social needs of patients and their caregivers. The psychiatrist can play a significant role in each of the above domains in EOLC. The current trends in India are examined, including ambiguities between EOLC and euthanasia. Future directions include formulating a national EOLC policy, providing appropriate services and training. The psychiatrist should get involved in this process, with major responsibilities in providing good quality EOLC for patients with both life-limiting physical illnesses and severe mental disorders, supporting their caregivers, and ensuring dignity in death.


Advance care planning; Advance directives; Current issues in end-of-life care; Dementia; Dementia and end-of-life care; End-of-life care; Ethical principles in end-of-life care; Future directions in end-of-life care; Good death; Medical futility; Palliative care; Policy; Psychiatry; Psychiatry in end-of-life care; Serious life-limiting

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