The Supreme Court of India’s judgment allowing for passive euthanasia, or the right of citizens to refuse life-support and die with dignity may have begun with a PIL in 2005 filed by NGO Common Cause NGO 'Common Cause' seeking a law to allow terminally-ill persons to execute a living will opting for passive euthanasia, but the debate surrounding it became more prominent after the woeful case of Aruna Ramchandra Shanbaug.
A journalist activist Pinki Virani had filed a plea in 2009 seeking that Aruna Shanbaug, who lived in a vegetative state for decades after a brutal rape, be allowed the dignity to die through passive euthanasia. Here are details of the case.
Who is Aruna Ramchandra Shanbaug?
Aruna was a nurse in Mumbai’s King Edwards Memorial Hospital. She was sexually assaulted by a ward boy, Sohanlal Bhartha Walmiki, when she was changing her clothes in the basement of the hospital on November 27, 1973. During the extremely violent assault, Walmiki tied a dog chain around Aruna’s neck, and this cut off oxygen supply to her brain leaving her in a permanent vegetative state. She also suffered serious injuries to her spine. Shanbaug never recovered all through the 42 years of the rest of her life that she was taken care of by fellow nurses at KEM hospital in a room attached to ward no. 4 on the ground floor. Her only sustenance was mashed food that the nurses fed her. Aruna, who passed away in May, 2015 was probably one of the longest living comatose patients.
Journalist-Activist Pinki Virani, who published a book regarding this case titled Aruna’s Story, filed a writ petition in 2009 before the apex court under Article 32, seeking legalisation of mercy killing so that Aruna’s suffering could be brought to an end by the withdrawal of medical support. Her contention was that Aruna was not left with a chance at recovery as she had been in a permanent vegetative state for decades.
Supreme Court intervention
On January 24, 2011, the apex court set up a medical committee, which examined Aruna and concluded that she met most of the criteria of being in a permanently vegetative state. The three-doctor panel also reported that the patient was not brain dead and responded to some situations on her own. The top court thus turned down Pinki Virani’s plea on March 7, 2011, but it allowed “passive euthanasia” of withdrawing life support to patients who are in permanently vegetative state (PVS). It also distinguished between active and passive euthanasia. By rejecting outright the use of active euthanasia to end life through administration of lethal substances, the apex court thereby laid down stringent guidelines under which passive euthanasia would be legally allowed via a high court-monitored mechanism.
Aruna’s long-term association with KEM nurses
The KEM Hospital nurses were happy to look after Aruna as they had been doing for years. The hospital staff filed counter-petitions in the case, opposing mercy killing for Aruna as sought by Virani.
The legality of passive euthanasia in India was short-lived. It was observed that Aruna Ramchandra Shanbaug Vs. Union of India was decided based on an incorrect interpretation of the constitution bench’s judgment in Gian Kaur vs State of Punjab. This led to the case being referred to a larger constitutional bench for review and final judgment.
Ethics and the euthanasia debate
The Indian Constitution recognises the right to life with dignity but not the right to die. This further complicates the debate regarding the legality of such a wish by bringing in morality and ethics of such an act. With mercy killing, the law needs to consider ethics, which has left the medical fraternity divided.