Name of the Case: Aruna Ramchandra Shanbaug v. Union of India
Citation: WP (Criminal No.) 115 of 2009
Year of the case: 2011
Respondent: Union of India and others
Bench/ Judges: Markandey Katju, Gyan Sudha Misra
What is the case about?
The case of Aruna Ramchandra Shanbaug is one of the most famous and intriguing cases in the Indian judicial history which legalized passive euthanasia and recognized that an individual has a ‘right to die with dignity’ and this right comes within the ambit of ‘right to life ‘guaranteed under Article 21 of the Constitution of India.
Passive euthanasia refers to the withdrawal of medical treatment with the deliberate intention to hasten the death of a terminally ill patient and thereby relieving him of the pain and agony of living live that is meaningless.
The case strengthened the demand for a sensible law on passive euthanasia and assisted suicide. Till that time the courts in India had on various occasions tried to dodge the issue. This case posed a series of uncomfortable questions to the people as a society which had till that time been perceived just as medico legal issues.
Facts of Aruna Shanbaug Case:
● The case is writ petition under the Article 32 of the constitution and has been filed on the behalf of the petitioner Aruna Ramchandra Shanbhug by one of ‘her next’ friend Ms Pinki Virani of Mumbai.
● The petitioner was a staff nurse, she was attacked by a sweeper who strangled her with a dog chain and sodomised her.
● The strangulation caused the ‘cut off’ of oxygen supply to the brain due to which the petitioner has been in a continuous vegetative state.
● There were certain variations regarding her condition because the court-appointed appointed a committee of doctors to analyse the condition of the petitioner.
● The Neurologist in the hospital found that the cortex of the brain was damaged with brain stem contusion injury, cervical cord injury.
● It is alleged that she is in a persistent vegetative state (PVS) and virtually a dead person and has no state of awareness and her brain is virtually dead. She can neither see, nor hear anything nor can she express herself or communicate in any manner whatsoever.
● It is alleged that there is not the slightest possibility of any improvement in her condition and her body lies on the bed in the KEM hospital, Mumbai like a dead body person and this has been in this position for the last 36 years.
The following were the issues before the Supreme Court:
1. Whether the withdrawal of life support for a person who is in permanent vegetative state (PVS) is lawful/ permissible?
2. Should a patient's living will be respected in such situations?
3. Does the family or next of the kin of a person have a right to make a request to withdraw life supporting systems in case a person himself has not made such a request previously?
CONTENTIONS OF THE PETITIONER
The journalist-activist Pinki Virani on behalf of the petitioner asked for the legalization of euthanasia so that Aruna’s continued sufferings could be brought to an end by withdrawal of medical support.
Her contention was that Aruna had no chance of recovery as she had been in the permanent vegetative state (PVS) for decades & thus she should be relieved of her pain and agony.
CONTENTIONS OF THE RESPONDENT
Responding to the petition filed by Pinki Virani, the respondent parties i.e. KEM Hospital & Bombay Municipal Corporation filed a counter petition opposing euthanasia for Aruna Shanbaug. Aruna had a long association with the nurses of KEM Hospital. They had been taking good care of her & were happy to do so for the remaining days of her life. They believed that allowing euthanasia for Aruna would put all their efforts into drain.
● The Hon’ble Division Bench of the Supreme Court of India, comprising Justice Markandey Katju and Justice Gyan Sudha Mishra, delivered this historic judgment on March 7, 2011.
● The Court opined that based on the doctors’ report and the definition of brain death under the Transplantation of Human Organs Act, 1994, Aruna was not brain dead. She could breathe without a support machine, had feelings and produced necessary stimuli. Though she is in a PVS, her condition has been stable. So, terminating her life was unjustified.
● Further, the right to take decisions on her behalf vested with the management and staff of KEM Hospital and not Pinki Virani. The lifesaving technique was the mashed food, because of which she was surviving. The removal of the life saving technique in this case would have meant not feeding her. Removal of ventilators and discontinuation of food could not be equated. Allowing of euthanasia to Aruna would mean reversing the efforts taken by the nurses of KEM Hospital over the years.
● In the final judgment, the Bench accepted that active euthanasia, by taking specific measures to cause death, for instance by administering a lethal injection, was indeed a step too far. Because of “the low ethical levels prevailing in our society today and the rampant commercialization and corruption we cannot rule out the possibility that unscrupulous persons with the help of some unscrupulous doctors may fabricate material to show that it is a terminal case with no chance of recovery”.
● They, however, agreed that passive euthanasia, i.e. withdrawing medical treatment with a deliberate intention of causing the patient’s death, had to be legalized. In a measure of abundant caution, this power was not released as an unfettered and blunt instrument to doctors and families. This is a power that can only be exercised on a case-by-case basis by a state or union territory High Court.
To be precise, the order states that “…Article 226 gives abundant power to the High Court to pass suitable orders on the application filed by the near relatives or next friend or the doctors/hospital staff praying for permission to withdraw the life support to an incompetent person of the kind above mentioned”. The mechanism would require that in patients seeking passive euthanasia, a Bench of at least two Judges should decide to grant approval or not, and this would be based on the opinion of an empanelled committee of three reputed doctors, preferably a neurologist, a psychiatrist, and a physician.
● Alongside, the court also made a recommendation to repeal Section 309 of the Indian Penal Code. This case is a landmark case as it prescribed the procedure to be followed in an area that has not been legislated upon.
This case marked the beginning of the discussions on the issue of Passive Euthanasia which was rarely even discussed earlier. It clarifies the position of the right to die with dignity and further enhances the ambit of Article 21 of our constitution. A judgement which we can definitely call a progressive one in the Indian context.
This article is written by Ananta Patra of Kiit School of Law.