Section 15 in West Bengal Clinical Establishment (Registration, Regulation and Transparency), Rules, 2017
15. Discharge, Death and Terminal care.
(1)The clinical establishment shall ensure that any patient admitted in that establishment shall ordinarily be discharged by the consultant or RMO as and when further stay is not medically necessary and on issuance of a Discharge Certificate containing such particulars as may be notified:Provided that the patient may be discharged regardless of her physical condition on a request made by him or the patient party and on issuance of a 'Discharge against Medical advice Certificate' by the consultant or RMO subject to the following terms and conditions:(a)before such discharge, the patient and the patient party is informed adequately by her Primary Consultant of the medical consequences of her decision; and(b)before such discharge, the patient releases those involved in the treatment and care from any obligation relative to the consequences of the decision by signing a written declaration or bond in that regard by the patient or the patient party if the patient is unable to do so; and(c)such discharge will not prejudice public health and safety:Provided further that the patient may be discharged so, if he/she fails to comply the advice given by the Primary Consultant.(2)The patient or patient party shall have the right to be informed by the Primary Consultant or RMO of his/her continuing health care requirements following any kind of discharge, including instruction about home medications, diet, physical activity and all other pertinent information to promote health and well-being.(3)The clinical establishment shall make suitable arrangement for discharge of a patient at such a convenient time on the day of discharge so that the patient is not compelled for paying the bed-charge for the next day.(4)The clinical establishment shall ensure that all cases of death, which have taken place there, are being declared as soon as possible and are issued with a proper death certificate and all such cases are recorded in a death register thereof:Provided that the clinical establishment is not compelled to issue a death certificate in case of 'brought-dead' patient.(5)As a part of mandatory record keeping, the clinical establishment shall generate and maintain a death register containing relevant particulars like unique identification number of every patient cause of death and such other particulars in such manner as may be notified.(6)Until it is released, the clinical establishment shall preserve the corpse in an appropriate manner without showing any disregard for it and shall release and hand over it to the patient party forthwith subject to observation of all the legal formalities. The clinical establishment should also abide by the conditions laid in section 7 sub-section(3) (k).(7)The clinical establishment shall provide terminal care to the patients suffering from terminal illness which includes an array of services offered by team of doctors, nurses, therapists, social workers, and volunteers which provide active total care directed at maintaining or improving the comfort of a person suffering from terminal illness, including the management of pain and physical symptoms, and the provision of spiritual, psychological and emotional support for the patient and his/her family or any such care as may be notified.Explanation 1. Terminal Illness is an illness or condition resulting in death within the foreseeable futureExplanation 2. Terminal Phase is the stage of terminal illness when there is no real prospect of recovery or remission of symptoms on either a permanent or temporary basis(8)The patient shall have a right to execute an 'Advance Directive' on consultation with the primary consultant and patient party which includes, but is not limited to, a health care proxy or a living will in such a manner as may be notified and such Advance Directive directs health care providers to administer terminal care when the person executing such directive reaches the terminal phase of her terminal illness as may be notified.Provided that (a) patient is informed of the medical consequences of his/her choice; (b) patient releases those involved in his/her care from any obligation relative to the consequences of her decision; (c) patient's decision will not prejudice public health and safety.Explanation. Advance Directive is a document with written instructions made by a person before he/she reaches the terminal phase of a terminal illness or a persistent vegetative state and incapable of making decisions about medical treatment when the question of administering the treatment arises.(9)The clinical establishment shall discharge patients maintaining the medico legal formalities.
