Dying with Dignity- Free from Machines.

be addressed with the patient and his family. In the movie The Wrath of Khan (1982), Spock in his usual logical way says “the needs of the many outweigh the needs of the few” (“or the one”). Doctors have a moral obligation to not just the patient in front of them but also to the larger society. They have to wrestle with questions whether the medical resources currently devoted to their patient could be better utilized for care of other potentially salvageable patients. But a doctor should never forget that in the patient or family member’s eye “the needs of the one may outweigh the needs of the many”. Case 1 : A-85-year old lady, diagnosed with a brain tumor (glioma) 3-4 months back and on antiepileptics, presented to the casualty with recurrent seizures. On presentation, she had a Glasgow Coma Scale (GCS) score of 3. She was loaded with IV antiepileptics. Though she warranted admission to the intensive care unit , she was admitted to the neurology floor respecting the wishes of her family who declined intubation a n d m e c h a n i c a l v e n t i l a t i o n . S u r p r i s i n g l y h e r s e n s o r i u m improved the next day and she s t a r t e d t o c o m m u n i c a t e a n d accept orally. She though again declined. Respecting her and the family’s wishes, palliative care and comfort care measures were instituted. She went into a sudden cardiorespiratory arrest on day 3 and passed away peacefully with her family by her side. Case 2 : A-87-year old lady,