This was published in Huffington Post India on March 20, 2017. Here is the link, and below is an excerpt:
In our country, discussions over this most crucial trade-off rarely happen in communications between persons having terminal illness and their family (or doctors). To quote Gawande, modern medicine is good at staving off death with aggressive interventions — and bad at knowing when to focus, instead, on improving the days that terminal patients have left [emphasis added]. Or as the terminally ill character of Anand said in the classic 1970 eponymous movie, zindagi badi honi chahiye, lambi nahi: “it is more important to have a ‘good life’ than simply a ‘long life’”.
India ranks a low 67 out of 80 countries in the latest report on the status of palliative care, the ‘Quality of Death’ index, prepared by the Economist Intelligence Unit. Its ‘score’ in this index is 26 out of 100, while the top-ranking country, the United Kingdom, scores 93… The report however mentions the state of Kerala as a ‘positive exception’ in the country. In May last year, the BBC website published an article titled Why Kerala is the best place in India to die. The US magazine The Atlantic too was all praise for the ‘Kerala model’ two weeks ago, in a report (somewhat broadly) titled “India’s Movement to Help People Die Better”. Kerala has more palliative care centres than the rest of the country put together, and its palliative care programme is bolstered by “thousands of volunteers who give up their time to tend to those who are incurably ill, bedridden or nearing the end of their lives”. The state also has a formal palliative care policy in place, and its government provides funding for community-based care programmes