Disposal of the Dead after Death-Environment Impact & Carbon Cost


     Burning the bodies of the dead was an ancient rite and practice in India. It was observed among Buddhists, Hindus and Jains from well before the start of the Common Era, and was later adopted by Sikhs. Burning the dead historically helped demarcate these religious communities from Muslims and Christians, for whom burial was the norm, and from India’s Parsi community who exposed their dead on Towers of Silence.   Burning  bodies after death, originating at a time when India was still heavily forested, cremation may also have been environmentally more appropriate and sustainable than, for instance, the mummification practised in the dry desert air of ancient Egypt.

Burning Issues: Cremation and Incineration

    In India, one estimate reveals that funeral pyres consume 6 crore trees annually and play a huge role in deforesting the country. Air pollution and deforestation are not the only environmental threats of cremation. They also generate large quantities of ash – around 50 lakh tonnes each year – which is later thrown into rivers, adding to their waters’ toxicity.  The prolonged burning of fossil fuels for cremation results in around 80 lakh tonnes of carbon dioxide or greenhouse gas emissions per year, according to one estimate. It creates different hazardous gases, including dental mercury, which is vaporised and released into the environment leading to health hazards in the surrounding area. Many of these toxins can bio-accumulate in humans, including mercury – often from dental amalgams, but also from general bioaccumulation in the body. Cremation results in various other toxic emissions including persistent pollutants such as volatile organic compounds, particulate matter, sulphur dioxide, nitrogen oxides and heavy metals. An IIT Kanpur study in 2016 found that open-air cremations contribute 4% of Delhi’s carbon monoxide emissions. There are concerns for crematorium workers as well, who may be exposed to nuclear medicine treatments (chemotherapeutics/radiation), orthopaedic (implants) and pacemaker explosions, and nanoparticles.

. In order to tackle the environmental problems stemming from these sites, the Indian government and environmental groups have over the years tried to promote the use of electric crematoriums as an alternative way of cremation. Electric crematoriums largely unsuccessful, are expensive to run, and crucially, traditional rituals are made impossible.

   Carbon Cost estimation -When people are cremated after death, the burning releases carbon into the air. Alkaline hydrolysis, in which the body is dissolved, has about a seventh of the carbon footprint of cremation, and the resulting fluid can be used as fertiliser. A Dutch study of the disposal of bodies found that the lowest amount of money that it would theoretically cost to compensate in terms of the carbon footprint per body was €63·66 for traditional burial, €48·47 for cremation, and €2·59 for alkaline hydrolysis. Composting or natural burial are alternatives.

New Delhi: The National Green Tribunal (NGT) has questioned the centuries-old tradition practised by Hindus to cremate dead bodies at the river banks, saying the method of burning wood leads to air pollution and also effects natural water resources.

Keeping in mind the growing level of pollution, the NGT said that there was a need to adopt environment-friendly methods like electric crematoriums and use of CNG and change the ‘mindset of the people’.

The NGT bench headed by Justice UD Salvi also directed the Union Environment Ministry and the Delhi government to initiate programmes to provide alternative modes of cremation of human remains, saying the traditional emitted hazardous pollutants in the environment.

  “It is also the responsibility of the government to facilitate the making of the mindset of the citizens as well as to provide environment-friendly alternatives for cremation to its citizenry,” the bench further said.

   The green panel said the traditional means of cremation caused adverse impact on environment and dispersal of ashes in the river led to water pollution.

   If we are to survive the climate crisis then almost everything will have to change, including health care, end-of-life care, and how we dispose of the dead.

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The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Compare Reaction to  Death of “Hundreds of healthy people” to  single “perceived negligence” in Hospital  #Morbi-Gujarat


Reaction to ‘Death’ in this  new era  of consumerism has become a story of paradox. Massive civil negligence  and 141 deaths but there are no punching bags  as are  doctors  for revenge in case of a hospitalized death.     Just Compare the media  projection, burden of negligence and accountability of  hundreds of healthy deaths by civic negligence   to the  one hospital death by disease. 

     Death is the inevitable conclusion of life, a universal destiny that all living creatures share.   Death can occur through conflict, accident, natural disaster, pandemic, violence, suicide, neglect, or disease. 

Multiple Deaths in healthy people by civic negligence:

Large numbers of death and morbidity happen amongst absolutely healthy population due to preventable causes like open manholes, drains, live electric wires, water contamination, dengue, malaria, recurring floods  etc. The number of   people dying are in hundreds and thousands, and are almost entirely of healthy people, who otherwise were not at risk of death. In fact the burden of   negligence here is massive and these deaths are unpardonable.  Timely action could have prevented these normal people from death. 

Collapse of a pedestrian bridge that killed at least 141 people. #Morbi-Gujarat.

Police in the Indian state of Gujarat have arrested nine people in connection with the collapse of a pedestrian bridge that killed at least 141 people. Four of those detained are employees of a firm contracted to maintain the bridge in the town of Morbi.

Hundreds were on the structure when it gave way, sending people screaming for help into the river below in the dark.

Hopes of finding more survivors are fading. Many children, women and elderly people are among the dead.

The 140-year-old suspension bridge – a major local tourist attraction – had been reopened only last week after being repaired.

Single  Death in Hospital due to disease:

      Reaction to single “in Hospital” medicalized death  is a paradox.   The media has instead, focused on the stray and occasional incidents of perceived alleged negligence in hospital deaths which could have occurred due to critical medical condition of patient.  However an impression is created as if the doctors have killed a healthy person. It is assumed without any investigation that it was doctor’s fault. 

     In present era, the expectation of medicalized death has come to be seen as a civic right and Doctors’ responsibility. People now have less understanding and acceptance of hospital  death. The death is more perceived as failure of medical treatment rather than an invincible power or a certain final event.

Point to ponder-Misplaced priorities:

Who is to be blamed for the deaths of healthy people which occur because of civic negligence?  Here relatives are actually  helpless and the vital questions may go unanswered .  There are no punching bags  as are  doctors  for revenge. Any stray incident of death of an already ill patient is blown out of proportion by media  forgetting the fact that thousands of patients are saved everyday by  Doctors.   

      It is time to check the  emotional reactions to single hospital death due to a disease as compared to hundreds of death  of healthy people due to civil negligence.

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Transition from   ‘Natural death’ to Medicalized Death- Paradox  of dying process


Death is the inevitable conclusion of life, a universal destiny that all living creatures share.   It’s an age-old idea that a good life and a good death go together. Death and dying have become unbalanced in high-income countries, and increasingly in low-and-middle-income countries; there is an excessive focus on clinical interventions at the end of life, to the detriment of broader inputs and contributions.

      The story of dying in the 21st century is a story of paradox. While many people are over-treated in hospitals, with families and communities relegated to the margins, still more remain undertreated, dying of preventable conditions and without access to basic pain relief. In this present era, process of dying represents unbalanced and contradictory picture of death.  

Even though medical advances continue to increase life expectancy, they have raised an entirely new set of issues associated with death and dying. For example, how long should advanced medical technology be used to keep comatose people alive? How should the elderly or incapacitated be cared for? Is it reasonable for people to stop medical treatment, or even actively end their life, if that is what they wish?

          Before the 12th century he describes a period of “Tamed death,”  where death was familiar, and people knew how to die. The dying and their families accepted death calmly; they knew when death was coming and what to do; dying was a public event attended by children.

    Death can occur through conflict, accident, natural disaster, pandemic, violence, suicide, neglect, or disease. The great success with antibiotics vaccines has perhaps further fuelled the fantasy that science can defeat death. But this temporary success as only has been the result of discovery of germ theory and antibiotics.

     In true sense, Death still remains invincible.

   The fear of death also involves the fear of separation.

     As families and communities want more and more hospital care, when critically sick, health systems have occupied the centre stage in the process of dying.  Dying people are whisked away to hospitals or hospices, and whereas two generations ago most children would have seen a dead body, people may now be in their 40s or 50s without ever seeing a dead person. The language, knowledge, and confidence to support and manage dying are being lost, further fuelling a dependence on health-care services.

 

   Death systems are the means by which death and dying are understood, regulated, and managed. These systems implicitly or explicitly determine where people die, how people dying and their families should behave, how bodies are disposed of, how people mourn, and what death means for that culture or community.

Death systems are unique to societies and cultures.

    The increased number of deaths in hospital means that ever fewer people have witnessed or managed a death at home. This lack of experience and confidence causes a positive feedback loop that reinforces a dependence on institutional care of the dying.

     Medical culture, fear of litigation, and financial complexities contribute to overtreatment at the end of life, further fuelling institutional deaths and the sense that professionals must manage death. Social customs influence the conversations in clinics and in intensive care units, often maintaining the tradition of not discussing death openly. More undiscussed deaths in institutions behind closed doors further reduce social familiarity with and understanding of death and dying.

     How people die has changed radically over recent generations. Death comes later in life for many and dying is often prolonged. Futile or potentially inappropriate treatment can continue into the last hours of life. The roles of families and communities have receded as death and dying have become unfamiliar and skills, traditions, and knowledge are lost.

    At first only the rich could expect that doctors would delay death. However, by the 20th century this expectation had come to be seen as a civic right.

         ‘Natural death’ is now the point at which the human organism refuses any further input of treatment.

       Corporatization of health care has projected medicine as a purchasable commodity and consequently resulted in an illogical distribution of health care. People, who can afford, spend millions in the last few days of their life, just to have only a few more days to live. Resources spent in such a futile quest are equivalent to thousands of times the money for food and medicines for the poor who lose lives for fraction of that expense.

     Death is not so much denied but has become invisible to people. People now have less understanding and less acceptance of death. The death is more perceived as failure of medical treatment rather than an invincible power or a certain final event.

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Anne Heche’s (Hollywood Actress) Accident-Brain Death & Organ Donation


  Brain dead patients are potential organ donors. 

Anne Heche, 53, had spent several days in a coma at the Grossman Burn Center at West Hills (California) Hospital and Medical Center after her Mini Cooper ran off the road Aug. 5 and smashed  into a two-story home.

      On Friday-  Anne Heche  (Hollywood actress ) had been declared brain dead, although she remained on life support for organ donation, a rep for the actress told  The Hollywood Reporter  on Friday. According to the actress’ publicist Holly Baird, Heche is “legally dead according to California law.” However, her heart is still beating and she has not been taken off of life support so that “OneLegacy can see if she is a match for organ donation.”

The actress’ team had previously shared an update on her health Thursday, stating that she suffered a severe anoxic brain injury and wasn’t expected to survive following an Aug. 5  car crash.

According to Baird, the star had been hospitalized in a coma and in critical condition since the accident. The actress crashed her car into a two-story home in L.A.’s Mar Vista neighborhood, sparking a fire, according to a Los Angeles Fire Department report.

In the statement Thursday from Heche’s rep, it “has long been her choice to donate her organs” and she was being kept on life support to determine whether her organs were viable.

 

National Organ Transplantation Programme (India)

Background

The shortage of organs is virtually a universal problem but Asia lags behind much of the rest of the world. India lags far behind other countries even in Asia.  It is not that there aren’t enough organs to transplant. Nearly every person who dies naturally, or in an accident, is a potential donor. Even then, innumerable patients cannot find a donor.

Situation of shortage of organs in India

There is a wide gap between patients who need transplants and the organs that are available in India. An estimated around 1.8 lakh persons suffer from renal failure every year, however the number of renal transplants done is around 6000 only. An estimated 2 lac patients die of liver failure or liver cancer annually in India, about 10-15% of which can be saved with a timely liver transplant. Hence about 25-30 thousand liver transplants are needed annually in India but only about one thousand five hundred are being performed. Similarly about 50000 persons suffer from Heart failures annually but only about 10 to 15 heart transplants are performed every year in India.  In case of Cornea, about 25000 transplants are done every year against a requirement of 1 lakh.

The legal Framework in India

Transplantation of Human Organs Act (THOA) 1994 was enacted to provide a system of removal, storage and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs. THOA is now adopted by all States except Andhra and J&K, who have their own similar laws. Under THOA, source of the organ may be:

  • Near Relative donor (mother, father, son, daughter, brother, sister, spouse)
  • Other than near relative donor: Such a donor can donate only out of affection and attachment or for any other special reason and that too with the approval of the authorisation committee.
  • Deceased donor, especially after Brain stem death e.g. a victim of road traffic accident etc. where the brain stem is dead and person cannot breathe on his own but can be maintained through ventilator, oxygen, fluids etc. to keep the heart and other organs working and functional. Other type of deceased donor could be donor after cardiac death.

Brain Stem death is recognized as a legal death in India under the Transplantation of Human Organs Act, like many other countries, which has revolutionized the concept of organ donation after death. After natural cardiac death only a few organs/tissues can be donated (like cornea, bone, skin and blood vessels) whereas after brain stem death almost 37 different organs and tissues can be donated including vital organs such as kidneys, heart, liver and lungs.

Despite a facilitatory law, organ donation from deceased persons continues to be very poor. In India there is a need to promote deceased organ donation as donation from living persons cannot take care of the organ requirement of the country. Also there is risk to the living donor and proper follow up of donor is also required. There is also an element of commercial transaction associated with living organ donation, which is violation of Law. In such a situation of organ shortage, rich can exploit the poor by indulging in organ trading.

Government of India initiated the process of amending and reforming the THOA 1994 and consequently, the Transplantation of Human Organs (Amendment) Act 2011 was enactedSome of the important amendments under the (Amendment) Act 2011 are as under:-

  1. Tissues have been included along with the Organs.
  2. ‘Near relative’ definition has been expanded to include grandchildren, grandparents.
  3. Provision of ‘Retrieval Centres’ and their registration for retrieval of organs from deceased donors. Tissue Banks shall also be registered.
  4. Provision of Swap Donation included.
  5. There is provision of mandatory inquiry from the attendants of potential donors admitted in ICU and informing them about the option to donate – if they consent to donate, inform retrieval centre.
  6. Provision of Mandatory ‘Transplant Coordinator’ in all hospitals registered under the Act
  7. To protect vulnerable and poor there is provision of higher penalties has been made for trading in organs.
  8. Constitution of Brain death certification board has been simplified- wherever Neurophysician or Neurosurgeon is not available, then an anaesthetist or intensivist can be a member of board in his place, subject to the condition that he is not a member of the transplant team.
  9. National Human Organs and Tissues Removal and Storage Network and National Registry for Transplant are to be established.
  10. There is provision of Advisory committee to aid and advise Appropriate Authority.
  11. Enucleation of corneas has been permitted by a trained technician.
  12. Act has made provision of greater caution in case of minors and foreign nationals and prohibition of organ donation from mentally challenged persons

In pursuance to the amendment Act, Transplantation of Human Organs and Tissues Rules 2014 have been notified on 27-3-2014

Directorate General of Health Services, Government of India is implementing National Organ Transplant Programme for carrying out the activities as per amendment Act, training of manpower and promotion organ donation from deceased persons.

National Organ Transplant Programme with a budget of Rs. 149.5 Crore for 12th Five year Plan aims to improve access to the life transforming transplantation for needy citizens of our country by promoting deceased organ donation. 

Issues and Challenges

  • High Burden (Demand  Versus Supply gap)
  • Poor Infrastructure especially in Govt. sector hospitals
  • Lack of Awareness of concept of Brain Stem Death among stakeholders
  • Poor rate of Brain Stem Death Certification by Hospitals
  • Poor Awareness and attitude towards organ donation— Poor Deceased Organ donation rate
  • Lack of Organized systems for organ procurement from deceased donor
  • Maintenance of Standards in Transplantation, Retrieval and Tissue Banking
  • Prevention and Control of Organ trading
  • High Cost (especially for uninsured and poor patients)
  • Regulation of Non- Govt. Sector

Objectives of National Organ Transplant Programme:

  • To organize a system of organ and Tissue procurement & distribution for transplantation.
  • To promote deceased organ and Tissue donation.
  • To train required manpower.
  • To protect vulnerable poor from organ trafficking.
  • To monitor organ and tissue transplant services and bring about policy and programme corrections/ changes whenever needed.

NOTTO: National Organ and Tissue Transplant Organization

National Network division of NOTTO would function as apex centre for all India activities of coordination and networking for procurement and distribution of organs and tissues and registry of Organs and Tissues Donation and Transplantation in country. The following activities would be undertaken to facilitate Organ Transplantation in safest way in shortest possible time and to collect data and develop and publish National registry.

At National Level:

  1. Lay down policy guidelines and protocols for various functions.
  2. Network with similar regional and state level organizations.
  3. All registry data from States and regions would be compiled and published.
  4. Creating awareness, promotion of deceased organ donation and transplantation activities.
  5. Co-ordination from procurement of organs and tissues to transplantation when organ is allocated outside region.
  6. Dissemination of information to all concerned organizations, hospitals and individuals.
  7. Monitoring of transplantation activities in the regions and States and maintaining data-bank in this regard.
  8. To assist the states in data management, organ transplant surveillance & Organ transplant and Organ Donor registry.
  9. Consultancy support on the legal and non-legal aspects of donation and transplantation
  10. Coordinate and Organize trainings for various cadre of workers.

For Delhi and NCR

  1. Maintaining the waiting list of terminally ill patients requiring transplants
  2. Networking with transplant centres, retrieval centres and tissue Banks
  3. Co-ordination for all activities required for procurement of organs and tissues including medico legal aspects.
  4. NOTTO will assign the Retrieval Team for Organ retrieval and make Transport Arrangement for transporting the organs to the allocated locations.
  5. NOTTO will maintain the waitlist of patients. needing transplantation in terms of the following:-
  6. Hospital wise
  7. Organ wise
  8. Blood group wise
  9. Age of the patient
  10. Urgency ( on ventilator, can wait etc.)
  11. Seniority in the waitlist (First in First Out)
  12. Matching of recipients with donors.
  13. Allocation, transportation, storage and Distribution of organs and tissues within Delhi and National Capital Territory region.
  14. Post-transplant patients & living donor follow-up for assessment of graft rejection, survival rates etc.
  15. Awareness, Advocacy and training workshops and other activities for promotion of organ donation
  16. ROTTO: Regional Organ and Tissue Transplant Organization
Name of ROTTOStates covered 
Seth GS medical college and KEM Hospital, Mumbai (Maharashtra)Maharashtra, Gujarat, Goa, UTs of DNH, Daman, Diu, M.P., Chhattisgarh
Govt. Multispecialty Hospital, Omnadurar, Chennai (Tamil Nadu)TN, Kerala, Telangana, Seem Andhra, Karnataka, Pondicherry, A & N Islands, Lakshadweep
Institute of PG Medical Education and Research, Kolkata (West Bengal)West Bengal, Jharkhand,Sikkim, Bihar and Orissa
PGIMER Chandigarh(UT of Chandigarh)Punjab, Haryana, HP, J &K , Chandigarh , Rajasthan, Uttar Pradesh and Uttarakhand
Guwahati Medical College (Assam)Assam, Meghalaya, Arunachal Pradesh, Manipur, Nagaland, Mizoram, Tripura.
  • SOTTO: State Organ and Tissue Transplant Organization

It is envisaged to make 5 SOTTOs in new AIIMS like institutions.

  • Govt. supported Online system of Networking

A website by the name www.notto.nic.in has been hosted where information with regards to the organ transplantation can be obtained. An online system through website is being developed for establishing network for Removal and Storage of Organs and Tissues from deceased donors and their allocation and distribution in a transparent manner. A computerized system of State/Regional and National Registry of donors and recipients is also going to be put in place.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes        

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons              

Expensive Medical College  seat- Is it worth it? 

Concept of Death: Ancient to Modern- Through the Ages


   Death is an evolving and complex concept. Philosophers and theologians from around the globe have recognised the value that death holds for human life. Death and life are bound together: without death there would be no life. Death allows new ideas and new ways. Death also reminds us of our fragility and sameness: we all die.

      Death is the inevitable conclusion of life, a universal destiny that all living creatures share. Even though all societies throughout history have realized that death is the certain fate of human beings, different cultures have responded to it in different ways. Through the ages, attitudes toward death and dying have changed and continue to change, shaped by religious, intellectual, and philosophical beliefs and conceptions. In the twenty-first century advances in medical science and technology continue to influence ideas about death and dying.

ANCIENT TIMES

Archaeologists have found that as early as the Paleolithic period, about 2.5 million to 3 million years ago, humans held metaphysical beliefs about death and dying—those beyond what humans can know with their senses. Tools and ornaments excavated at burial sites suggest that the earliest ancestors believed that some element of a person survived the dying experience.

Ancient Hebrews (c. 1020–586 B.C.), while acknowledging the existence of the soul, were not preoccupied with the afterlife. They lived according to the commandments of their God, to whom they entrusted their eternal destiny. By contrast, early Egyptians (c. 2900–950 B.C.) thought that the preservation of the dead body (mummification) guaranteed a happy afterlife. They believed a person had a dual soul: the ka and the ba. The ka was the spirit that dwelled near the body, whereas the ba was the vitalizing soul that lived on in the netherworld (the world of the dead). Similarly, the ancient Chinese (c. 2500–1000 B.C.) also believed in a dual soul, one part of which continued to exist after the death of the body. It was this spirit that the living venerated during ancestor worship.

Among the ancient Greeks (c. 2600–1200 B.C.), death was greatly feared. Greek mythology—which was full of tales of gods and goddesses who exacted punishment on disobedient humans—caused the living to follow rituals meticulously when burying their dead so as not to displease the gods. Even though reincarnation is usually associated with Asian religions, some Greeks were followers of Orphism, a religion that taught that the soul underwent many reincarnations until purification was achieved.

THE CLASSICAL AGE

Mythological beliefs among the ancient Greeks persisted into the classical age. The Greeks believed that after death the psyche (a person’s vital essence) lived on in the underworld. The Greek writer Homer (c. eighth century–c. seventh century B.C.) greatly influenced classical Greek attitudes about death through his epic poems the Iliad and the Odyssey. Greek mythology was freely interpreted by writers after Homer, and belief in eternal judgment and retribution continued to evolve throughout this period.

Certain Greek philosophers also influenced conceptions of death. For example, Pythagoras (569?–475? B.C.) opposed euthanasia (“good death” or mercy killing) because it might disturb the soul’s journey toward final purification as planned by the gods. On the contrary, Socrates (470?–399? B.C.) and Plato (428–348 B.C.) believed people could choose to end their life if they were no longer useful to themselves or the state.

Like Socrates and Plato, the classical Romans (c. 509–264 B.C.) believed a person suffering from intolerable pain or an incurable illness should have the right to choose a “good death.” They considered euthanasia a “mode of dying” that allowed a person’s right to take control of an intolerable situation and distinguished it from suicide, an act considered to be a shirking of responsibilities to one’s family and to humankind.

THE MIDDLE AGES

During the European Middle Ages (c. 500–1485), death—with its accompanying agonies—was accepted as a destiny everyone shared, but it was still feared. As a defense against this phenomenon that could not be explained, medieval people confronted death together, as a community. Because medical practices in this era were crude and imprecise, the ill and dying person often endured prolonged suffering. However, a long period of dying gave the dying individual an opportunity to feel forewarned about impending death, to put his or her affairs in order, and to confess sins. The medieval Roman Catholic Church, with its emphasis on the eternal life of the soul in heaven or hell, held great power over people’s notions of death.

By the late Middle Ages the fear of death had intensified due to the Black Death—the great plague of 1347 to 1351. The Black Death killed more than twenty-five million people in Europe alone. Commoners watched not only their neighbors stricken but also saw church officials and royalty struck down: Queen Eleanor of Aragon and King Alfonso XI (1311–1350) of Castile met with untimely deaths, and so did many at the papal court at AvignonFrance. With their perceived “proper order” of existence shaken, the common people became increasingly preoccupied with their own death and with the Last Judgment, God’s final and certain determination of the character of each individual. Because the Last Judgment was closely linked to an individual’s disposition to heaven or hell, the event of the plague and such widespread death was frightening.

THE RENAISSANCE                                       

From the fourteenth through the sixteenth centuries, Europe experienced new directions in economics, the arts, and social, scientific, and political thought. Nonetheless, obsession with death did not diminish with this “rebirth” of Western culture. A new self-awareness and emphasis on humans as the center of the universe further fueled the fear of dying.

By the sixteenth century many European Christians were rebelling against religion and had stopped relying on church, family, and friends to help ease their passage to the next life. The religious upheaval of the Protestant Reformation of 1520, which emphasized the individual nature of salvation, caused further uncertainties about death and dying.

The seventeenth century marked a shift from a religious to a more scientific exploration of death and dying. Lay people drifted away from the now disunited Christian church toward the medical profession, seeking answers in particular to the question of “apparent death,” a condition in which people appeared to be dead but were not. In many cases unconscious patients mistakenly believed to be dead were hurriedly prepared for burial by the clergy, only to “come back to life” during burial or while being transported to the cemetery.

An understanding of death and its aftermath was clearly still elusive, even to physicians who disagreed about what happened after death. Some physicians believed the body retained some kind of “sensibility” after death. Thus, many people preserved cadavers so that the bodies could “live on.” Alternatively, some physicians applied the teachings of the Catholic Church to their medical practice and believed that once the body was dead, the soul proceeded to its eternal fate and the body could no longer survive. These physicians did not preserve cadavers and pronounced them permanently dead.

THE EIGHTEENTH CENTURY

The fear of apparent death that took root in the seventeenth century resurfaced with great intensity during the eighteenth century. Coffins were built with contraptions to enable any prematurely buried person to survive and communicate from the grave.

For the first time, the Christian church was blamed for hastily burying its “living dead,” particularly because it had encouraged the abandonment of pagan burial traditions such as protracted mourning rituals. In the wake of apparent death incidents, more long burial traditions were revived.

THE NINETEENTH CENTURY

Premature and lingering deaths remained commonplace in the nineteenth century. Death typically took place in the home following a long deathbed watch. Family members prepared the corpse for viewing in the home, not in a funeral parlor. However, this practice changed during the late nineteenth century, when professional undertakers took over the job of preparing and burying the dead. They provided services such as readying the corpse for viewing and burial, building the coffin, digging the grave, and directing the funeral procession. Professional embalming and cosmetic restoration of bodies became widely available, all carried out in a funeral parlor where bodies were then viewed instead of in the home.

Cemeteries changed as well. Before the early nineteenth century, American cemeteries were unsanitary, overcrowded, and weed-filled places bearing an odor of decay. That began to change in 1831, when the Massachusetts Horticultural Society purchased seventy-two acres of fields, ponds, trees, and gardens in Cambridge and built Mount Auburn Cemetery. This cemetery was to become a model for the landscaped garden cemetery in the United States. These cemeteries were tranquil places where those grieving could visit the graves of loved ones and find comfort in the beautiful surroundings.

Literature of the time often focused on and romanticized death. Death poetry, consoling essays, and mourning manuals became available after 1830, which comforted the grieving with the concept that the deceased were released from worldly cares in heaven and that they would be reunited there with other deceased loved ones. The deadly lung disease tuberculosis—called consumption at the time—was pervasive during the nineteenth century in Europe and the United States. The disease caused sufferers to develop a certain appearance—an extreme pallor and thinness, with a look often described as haunted—that actually became a kind of fashion statement. The fixation on the subject by writers such as Edgar Allan Poe (1809–1849) and the English Romantic poets helped fuel the public’s fascination with death and dying. In the late twentieth and early twenty-first centuries the popularization of the Goth look is sometimes associated with the tubercular appearance.

Spiritualism

By the mid-nineteenth century the romanticizing of death took on a new twist in the United States. Spiritualism, in which the living communicate directly with the dead, began in 1848 in the United States with the Fox sisters: Margaret Fox (1833?–1893) and Catherine Fox (1839?–1892) of Hydesville, New York. The sisters claimed to have communicated with the spirit of a man murdered by a former tenant in their house. The practice of conducting “sittings” to contact the dead gained instant popularity. Mediums, such as the Fox sisters, were supposedly sensitive to “vibrations” from the disembodied souls that temporarily lived in that part of the spirit world just outside the earth’s limits.

This was not the first time people tried to communicate with the dead. Spiritualism has been practiced in cultures all over the world. For example, many Native Americans believe shamans (priests or medicine men) have the power to communicate with the spirits of the dead. The Old Testament (I Samuel 28:7–19) recounts the visit of King Saul to a medium at Endor, who summoned the spirit of the prophet Samuel, which predicted the death of Saul and his sons.

The mood in the United States in the 1860s and 1870s was ripe for Spiritualist s´ances. Virtually everyone had lost a son, husband, or other loved one during the Civil War (1861–1865). Some survivors wanted assurances that their loved ones were all right; others were simply curious about life after death. Those who had drifted away from traditional Christianity embraced this new Spiritualism, which claimed scientific proof of survival after physical death.

THE MODERN AGE

Modern medicine has played a vital role in the way people die and, consequently, the manner in which the dying process of a loved one affects relatives and friends. With advancements in medical technology, the dying process has become depersonalized, as it has moved away from the familiar surroundings of home and family to the sterile world of hospitals and strangers. Certainly, the institutionalization of death has not diminished the fear of dying. Now, the fear of death also involves the fear of separation: for the living, the fear of not being present when a loved one dies, and for the dying, the prospect of facing death without the comforting presence of a loved one.

Changing Attitudes

In the last decades of the twentieth century, attitudes about death and dying slowly began to change. Aging baby boomers (people born between 1946 and 1964), facing the deaths of their parents, began to confront their own mortality. Even though medical advances continue to increase life expectancy, they have raised an entirely new set of issues associated with death and dying. For example, how long should advanced medical technology be used to keep comatose people alive? How should the elderly or incapacitated be cared for? Is it reasonable for people to stop medical treatment, or even actively end their life, if that is what they wish?

The works of the psychiatrist Elisabeth K¨bler-Ross (1926–2004), including the pioneering book On Death and Dying (1969), have helped individuals from all walks of life confront the reality of death and restore dignity to those who are dying. Considered to be a highly respected authority on death, grief, and bereavement, K¨bler-Ross influenced the medical practices undertaken at the end of life, as well as the attitudes of physicians, nurses, clergy, and others who care for the dying.

During the late 1960s medical education was revealed to be seriously deficient in areas related to death and dying. However, initiatives under way in the late twentieth and early twenty-first centuries have offered more comprehensive training about end-of-life care. With the introduction of in-home hospice care, more terminally ill people have the option of spending their final days at home with their loved ones. With the veil of secrecy lifted and open public discussions about issues related to the end of life, Americans appear more ready to learn about death and to learn from the dying.

Hospice Care

In the Middle Ages hospices were refuges for the sick, the needy, and travellers. The modern hospice movement developed in response to the need to provide humane care to terminally ill patients, while at the same time lending support to their families. The English physician Dame Cicely Saunders (1918–) is considered the founder of the modern hospice movement—first in England in 1967 and later in Canada and the United States. The soothing, calming care provided by hospice workers is called palliative care, and it aims to relieve patients’ pain and the accompanying symptoms of terminal illness, while providing comfort to patients and their families.

Hospice may refer to a place—a freestanding facility or designated floor in a hospital or nursing home—or to a program such as hospice home care, in which a team of health-care professionals helps the dying patient and family at home. Hospice teams may involve physicians, nurses, social workers, pastoral counsellors, and trained volunteers.

WHY PEOPLE CHOOSE HOSPICE CARE. Hospice workers consider the patient and family to be the “unit of care” and focus their efforts on attending to emotional, psychological, and spiritual needs as well as to physical comfort and well-being. With hospice care, as a patient nears death, medical details move to the background as personal details move to the foreground to avoid providing care that is not wanted by the patient, even if some clinical benefit might be expected.

THE POPULATION SERVED. Hospice facilities served 621,100 people in 2000; of these, 85.5% died while in hospice care.  Nearly 80% of hospice patients were sixty-five years of age and older, and 26.5%were eighty-five years of age or older. Male hospice patients numbered 309,300, whereas 311,800 were female. The vast majority (84.1%) was white. Approximately half (46.6%) of the patients served were unmarried, but most of these unmarried patients were widowed. Nearly 79% of patients used Medicare as their primary source of payment for hospice services.

Even though more than half (57.5%) of those admitted to hospice care in 2000 had cancer (malignant neoplasms) as a primary diagnosis, patients with other primary diagnoses, such as Alzheimer’s disease and heart, respiratory, and kidney diseases, were also served by hospice.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes        

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons              

Expensive Medical College  seat- Is it worth it? 

Doctors in Israel Protest Violence against Medics


          Violence against doctors has become a serious issue in India. But problem is a global one to some extent. The underlying basic  reason for the omnipresent malaise is the altered doctor-patient equation globally and growing mistrust in the saviours. The mistrust is propagated by opportunist medical industry, media and law industry for their selfish motives as doctors are shown as front men for the failures.  Poor outcomes are projected because of medical errors and mistakes. Every death is thought to be because of negligence rather than a natural complication of the disease.  Because of the instigation and poor law enforcement in favour of doctors, the response of  lay public to these unfortunate incidents has become extremely erratic and out of proportion. As Governments remain more or less indifferent, and doctors have become punching bags for inept health systems.  Law industry has been enormously benefited financially due to medico-legal cases against doctors. Media has sold their news items not by good ground work, but by sensationalizing and mischaracterizing the real basic issues, airing one single incident as generalizations.  An atmosphere of mistrust has been generated against medical profession. Administrators and Industry have put themselves on higher pedestrian by selectively projecting the genuine failures and mistakes of doctors.  Local goons have blackmailed doctors over genuine complications and the natural deaths occurring in hospitals.    There is a little token action by police after routine incident of violence against doctors.

  Consequently violence (legal, verbal or physical) against doctor has acquired an epidemic proportion, omnipresent world-wide. As a result, medical business has thrived whereas medical profession is suffocated and art of medicine has been dying a slow gradual death.

   But in Israel, doctors seem to be united against this menace and their associations are actively pursuing the issue.

          Doctors in Israel to Protest Violence against Medics 

The strike was called after family members of a patient who died at a Jerusalem hospital on Monday attacked medical staff and caused significant damage to the intensive care unit after they were informed of his death.

The union said the hospitals and clinics would operate on a weekend schedule for 24 hours on Thursday, offering reduced services.

 

 

Union calls for attacks on medical staff to be treated as severely as attacks on police; action comes after patient’s relatives ran amok in Jerusalem hospital

Staff at public hospitals and clinics will strike on Thursday to protest violence against medics, the doctor’s union announced Tuesday.

The Israel Medical Association, announcing the strike, called for a police presence in every emergency room, and said hospitals and community clinics needed improved security systems. The association also urged a change in legislation so that an attack on medical staff would be viewed with the same severity as an attack on a uniformed police officer. The chairman of the Israel Medical Association, Prof. Zion Hagay, said that Thursday’s strike would be just the start of action taken by the medical establishment if changes were not made to protect workers.

“We have long announced that we will not accept any more incidents of violence in the health system, and it has unfortunately become a real epidemic,” Hagay said at the start of the association’s meeting on Tuesday evening. “The lives of doctors must not be abandoned, and this initial strike is only a warning.”

“As long as the Israeli government does not immediately take the necessary steps to increase the personal security of medical staff, we will not hesitate to increase  it.There has been no announcement from the nurses’ union on whether they will be joining the strike.

The strike comes in the wake of violence at the Hadassah Medical Center in Jerusalem after a patient died there on Monday.

An initial investigation found the patient died after taking an overdose, police said, without giving further details.

Relatives of the man arrived at the hospital and were notified of the patient’s death.

After they were given the news, a number of the patient’s relatives broke doors and windows in the unit, damaged the nurse’s station, computers, and equipment, and attacked staff. Two members of staff were lightly injured, requiring medical treatment.

Police said they arrested an East Jerusalem resident in his twenties on suspicion of being involved in the violent clash at the medical center.

Recent months have seen an increased wave of attacks against medical teams and facilities across the country.

In November, nurses at Haifa’s Rambam Medical Center held a strike for several hours in protest of a violent incident in which staff members were beaten and threatened by the family of a dying cancer patient.

Earlier the same month Rambam said it had to forcibly remove dozens of people who gathered outside the facility after a victim of violence was brought there for treatment. According to hospital officials, riot police were called to the scene to prevent the crowd from entering the hospital.

And in Beersheba, four people were hurt and 19 were arrested in a massive brawl outside Soroka Medical Center that included gunfire.

In 2017, in one of the most severe cases in recent years, a man burned 55-year-old nurse Tova Kararo to death at the Holon clinic at which she worked.

Nurses already held multiple strikes this year and last year over severe staff shortages during Covid, which resulted in additional state funding. 

A doctor and three nurses at Rambam Medical Center in Haifa were assaulted last month by relatives of a cancer patient. Staff were beaten and threatened by the family of the patient, who eventually died, The Times of Israel reported.

Chairwoman of the National Association of Nurses, Ilana Cohen, said at the time that if the government did not take action to fight such violence, “we’ll hold a strike throughout the entire health care system.”

“War has broken out here,” Benny Keller, the head of Rambam’s security, told the Kan public broadcaster Wednesday, according to The Times of Israel

“Two or three times a week, the hospital turns into a battlefield between warring clans.”

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

The Book-‘At the Horizon of Life & Death’:Blackmail of Doctors by opportunist goons, legal industry, Vulture Journalism


      While doctors are usually blamed for any mishap, be it natural poor prognosis or genuine complications, rarely people get to know their side of the story — how a dying patient affects their psyche, how they deal with these patients and their kith and kin, what are the kinds of abuse and threats made when they are not able to save a life despite their best efforts.  Book describes stories the blackmail doctors face from opportunist goons, legal industry and vulture kind of journalism. Every day blackmail by legal industry, journalist and local goons, similar to what Dr Archana Sharma went through and others doctors are  facing have been described.

         Dr Pankaj Kumar, Director Critical Care at a Delhi Hospital, India has come out with an insightful account of these very aspects of a doctor’s life.

    The 300-page book (English) contains 20 stories divided into three parts viz – Larva & Pupa Syndrome, Hope & Fear & Medical Lawsuits. The book is available worldwide on Kindle Amazon, Apple, Barnes & Noble, Tolino, Kobo, Scibd, BorrowBox, Baker & Taylor , Vivilo, Overdrive  etc.

         His book ‘At the Horizon of Life & Death’ is a Reality Fiction that reflects the sensitivity involved in dealing with patients facing death.

     Through the eyes of its protagonist Dr Anand, the book captures significant moments in the treatment trajectory of critical patients. The book tries to create awareness regarding pertinent issues faced by the medical professionals like demoralisation, expensive medical education, the extreme pressure and suicidal ideation, the plight of the nurses and support staff, assaults and violence and the medico-legal intricacies involved in day-to-day practice among others. The author has also taken care to guide aspiring doctors to make well-informed career decisions.

     Part One (Larva & Pupa Syndrome)-  talks about the expensive medical education, and the issues students face in medical college.

    Part Two (Hope & Fears) talks about the beginning of doctors’ professional journey, the disease demons they face while dealing with critical patients, dilemmas of doctors and patients near death situations.

    Part Three (Medical Lawsuits) is about how doctors are always working under the threat of medico-legal lawsuits.

        While stories are fictional, the scenarios and the problems in them are very real — things that he faced or saw his colleagues facing.

     Medical profession has become victim of mistrust generation and blame culture. Everyone keeps harping about the few black sheep in the community, while larger good work of doctors is not highlighted enough.

    The stories span from Dr Anand’s initial days in the emergency room and capture his struggles in complex medico-legal scenarios over the next four decades. This book is an effort to bring back focus on the treatment of the patient as opposed to the mistrust, legal frameworks and policies surrounding the healthcare practice.

Suicide by Dr Archana Sharma has exposed the blackmail; medical professionals are going through in current era. Doctors have become sitting ducks for punishments complaints, blackmail, and legal complexities besides every day harassment. Negligent police, indifference of Government and venomous media has made it impossible for health care workers to work in a peaceful environment.  It may not be a good idea to opt for a medical career any more.

More naïve would be to pay millions to be a doctor.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

Mother blames & sues social media addiction (Instagram and Snapchat) for   daughter’s suicide


Social media has helped people communicate more and instantly. The use of social media among children has increased tremendously. But without doubt, it has great addictive potential and one such case as mentioned is reflecting just the tip of the iceberg.  The side effects can be manifold, like psychiatric illness, loss of education, disconnection from the reality and loss of time are only a few, which are evident.  

Connecticut mother sues Meta and Snap, alleging they contributed to suicide of 11-year-old daughter who had ‘extreme addiction’ to social media

  • A woman in Connecticut is suing Meta and Snap, alleging their platforms played a role in her 11-year-old’s suicide.
  • Tammy Rodriguez claims her daughter killed herself in July after “struggling with the harmful effects of social media.”

A Connecticut mother is suing Meta, the company formerly known as Facebook, and Snap, alleging their “dangerous and defective social media products” played a role in her 11-year-old daughter’s suicide.

The complaint, filed by Tammy Rodriguez in San Francisco federal court earlier this week, claims Selena Rodriguez suffered from depression, sleep deprivation, eating disorders, and self-harm tied to her use of Instagram and Snapchat.

According to the filing, Selena began using social media roughly two years before her death by suicide in July 2021, during which time she developed “an extreme addiction to Instagram and Snapchat.” The filing also claims the 11-year-old missed school multiple times because of her social media use and that she was asked to send sexually explicit content by male users on both platforms.

Rodriguez wrote in the filing that she attempted to get her daughter mental health treatment several times, with one outpatient therapist saying she had “never seen a patient as addicted to social media as Selena.” At one point, Selena was hospitalized for emergency psychiatric care, according to the complaint.

In a statement, Snap said it couldn’t comment on the specifics of an active case but told Insider “nothing is more important to us than the wellbeing of our community.”

“We are devastated to hear of Selena’s passing and our hearts go out to her family,” a Snap spokesperson told Insider. “Snapchat helps people communicate with their real friends, without some of the public pressure and social comparison features of traditional social media platforms, and intentionally makes it hard for strangers to contact young people.”

The spokesperson continued: “We work closely with many mental health organizations to provide in-app tools and resources for Snapchatters as part of our ongoing work to keep our community safe.”

Meta and lawyers for Rodriguez did not respond to requests for comment.

Internal Facebook documents leaked to The Wall Street Journal last year revealed the company is aware Instagram can be harmful to the mental health of teenagers, with one document stating that “32% of teen girls said that when they felt bad about their bodies, Instagram made them feel worse.”

Karina Newton, Instagram’s head of public policy, wrote in a September blog post that the Journal’s story “focuses on a limited set of findings and casts them in a negative light.”

In other documents retrieved by Facebook whistleblower Frances Haugen, the company found 13.5% of teen girls said Instagram makes thoughts of suicide worse, while 17% of teen girls said Instagram exacerbates eating disorders.

After Haugen gave an interview with “60 Minutes” about the findings, Facebook previously issued this response: “It is not accurate that leaked internal research demonstrates Instagram is ‘toxic’ for teen girls. The research actually demonstrated that many teens we heard from feel that using Instagram helps them when they are struggling with the kinds of hard moments and issues teenagers have always faced. This research, like external research on these issues, found teens report having both positive and negative experiences with social media.”

Earlier this month, Angela Underwood Jacobs, the sister of a federal officer killed last year, sued Meta, alleging the company “knowingly promoting extremist content” that contributed to her brother’s death.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

The Book-‘At the Horizon of Life & Death’: Doctors’ struggle with death


The 300-page book contains 20 stories divided into three parts viz – Larva & Pupa Syndrome, Hope & Fear & Medical Lawsuits. The book is available worldwide on Kindle Amazon, Apple, Barnes & Noble, Tolino, Kobo, Scibd, BorrowBox, Baker & Taylor , Vivilo, Overdrive  etc.

      While doctors are usually blamed for any mishap, be it natural poor prognosis or genuine complications, rarely people get to know their side of the story — how a dying patient affects their psyche, how they deal with these patients and their kith and kin, what are the kinds of abuse and threats made when they are not able to save a life despite their best efforts. Dr Pankaj Kumar, Director Critical Care at a Delhi Hospital, India has come out with an insightful account of these very aspects of a doctor’s life.

         His book ‘At the Horizon of Life & Death’ is a Reality Fiction that reflects the sensitivity involved in dealing with patients facing death.

     Through the eyes of its protagonist Dr Anand, the book captures significant moments in the treatment trajectory of critical patients. The book tries to create awareness regarding pertinent issues faced by the medical professionals like demoralisation, expensive medical education, the extreme pressure and suicidal ideation, the plight of the nurses and support staff, assaults and violence and the medico-legal intricacies involved in day-to-day practice among others. The author has also taken care to guide aspiring doctors to make well-informed career decisions.

     Part One (Larva & Pupa Syndrome)-  talks about the expensive medical education, and the issues students face in medical college.

    Part Two (Hope & Fears) talks about the beginning of doctors’ professional journey, the disease demons they face while dealing with critical patients, dilemmas of doctors and patients near death situations.

    Part Three (Medical Lawsuits) is about how doctors are always working under the threat of medico-legal lawsuits.

        While stories are fictional, the scenarios and the problems in them are very real — things that he faced or saw his colleagues facing.

     Medical profession has become victim of mistrust generation and blame culture. Everyone keeps harping about the few black sheep in the community, while larger good work of doctors is not highlighted enough.

    The stories span from Dr Anand’s initial days in the emergency room and capture his struggles in complex medico-legal scenarios over the next four decades. This book is an effort to bring back focus on the treatment of the patient as opposed to the mistrust, legal frameworks and policies surrounding the healthcare practice.

           The book is self-published, available worldwide on Kindle Amazon, Apple, Barnes & Noble, Tolino, Kobo, Scibd, BorrowBox, Baker & Taylor , Vivilo, Overdrive  etc.

Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Doctor’s death: saved uncountable lives- still not counted


In an era, where Reel Heroes are worshipped and Real Heroes are not    counted even after sacrificing their lives, is an unfortunate  and disheartening for  the whole community of doctors and nurses. It is surprising that  doctors, who saved uncountable lives, did not move the administrators enough  to get them counted.  Such  incidents  are not only  painful to the medical fraternity but also expose the hypocritical  attitude of the administrators as well as  the insensitive approach of society towards health care workers, although everyone expects doctors and nurses to be sensitive towards everyone else. Such indifferent   attitude demoralizes and causes deep discouragement to the front line doctor and nurses, but sadly remains a routine business for administrators. The pain of being  treated like a dispensable disposable remains as  a deep hurt within.

         But at the same time, mere tokenism as an expression of concern is also not desirable. What is really required is a sincere effort to reduce the mortality of health care workers, to provide them better working conditions. An honest effort to find the cause of mortality among doctors and reducing it, help to the families of the health care workers is required. Due acknowledgement and true  respect to their sacrifice  is expected from civilized society.

“382 Doctors Died Of Covid”: Medical Body Says Centre “Abandoning” Heroes

Indian Medical Association has shown its displeasure over  the Government  statement on coronavirus in parliament, which had no word on the doctors who died in the line of duty, and the  statement that the Centre had no data as health is a state subject.  Accusing the government of “indifference”, “abdication” and “abandonment of heroes”, the country’s top body of medical practitioners said in such a circumstance, the government “loses the moral authority to administer the Epidemic Act 1897 and the Disaster Management Act”.

So far, 382 doctors have died of coronavirus, the IMA said. In the list it released, the youngest doctor to lose his life was 27 years old and the oldest was 85.

But while acknowledging the contribution of healthcare workers during the pandemic, the health minister made no mention of the medical professionals lost to the disease, the IMA said.  

“To feign that this information doesn’t merit the attention of the nation is abominable,” the IMA statement read. “It appears that they are dispensable. No nation has lost as many doctors and health care workers like India,” the statement added.

The IMA pointed to Union minister Ashwini Kumar Choubey’s statement that the Union government does not have any compensation data as public health and hospitals comes under the states.

“This amounts to abdication of duty and abandonment of the national heroes who have stood up for our people. IMA finds it strange that after having formulated an unfriendly partial insurance scheme for the bereaved families to struggle with the ignominy of the Government disowning them altogether stares at them,” the statement read.

Such a circumstance also exposes the “hypocrisy of calling them corona warriors on one hand and denying them and their families the status and benefits of martyrdom,” the IMA said.

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