Nurse Aruna Shanbaug gave the gift of passive euthanasia to the country and brought patients’ rights into focus, even though the system failed her, said writer Pinki Virani, who filed a euthanasia petition before the Supreme Court in 2009.
Passive euthanasia allows a patient, who is terminally ill or in a permanent vegetative state, to die by withholding treatment.
“Aruna’s gift to the country is the passive euthanasia law. She also started a dialogue about patient’s rights though her own rights were denied to her. The people of India have gained from a woman who we left bereft. In the end, only nature opened a door, not god, not the medical system and not the judiciary. She wanted to be a wife, she wanted to be happy and above all she wanted a life, which is why she came from a village [in Karnataka] to become a nurse. But the system broke her will,” Ms. Virani, author of Aruna’s Story, told The Hindu .
‘She died 42 years ago’ “Aruna died a legal death today, [May 18, 2015] which will be on her death certificate, but her real death was on November 27, 1973, when she was brutally sodomised. He [assaulter] made her blind, deaf, dumb, he killed her brain. From that day till today, Aruna died a million times,” the author said.
It was the utter hopelessness of Ms. Shanbaug’s condition that prompted Ms. Virani to knock on the court’s door. “For the next 10 years after I wrote the book, I saw her die several times. She fell ill and was revived. Each time I looked at her, I asked myself what I was supposed to do. I did not want to be someone who wrote a book on her and felt bad. So I went to the Supreme Court,” she said.
According to Ms. Virani, while the initial medical care was “brilliant,” over the years it deteriorated. “After 20 to 25 years, there was medical mismanagement. Only the nurses and the staff were pushed around, but they cannot decide on medication or a new treatment. At appropriate times, doctors were required to give instructions to the nurses, which was not done. Aruna was not brought out of her room into the sunlight. When I wanted to take her to a private hospital for extensive tests, I was denied permission at the last minute.”
‘Landmark verdict’ In 2011, the Supreme Court allowed passive euthanasia, though it dismissed Ms. Virani’s plea.
Ms. Virani’s lawyer Shubhangi Tuli said: “It was difficult for us to initiate anything as euthanasia was not permitted in our country. We have to research international laws on the subject. The question before the court was human life under Article 21 of the Constitution, which does not just guarantee right to life but also the right to live with dignity. We raised this question: ‘Did her life amount to living with dignity?’ The judgment does not completely answer the question but made passive euthanasia available. It was a landmark judgment as it laid down a new law, which will help people in a vegetative condition.” The judgment provided some legal recourse to patients in persistent vegetative state (PVS). However, medical professionals believe the law still has a long way to go in ensuring the rights of patients in a similar condition.
‘Not a single bedsore’ “Aruna was the world’s first known survivor. She was in a persistent vegetative state, not brain dead. She had effectively regressed into a state of a newborn. She had no sense of anything except pain and taste. She was able to swallow. When I examined her in 2011, she did not have a single bedsore. I have never heard of that. But she is also a symbol of the failure to evolve a legal act for end-of-life patients. We need a legal framework which allows you to control your life and death when you know you will lapse into an incurable condition,” said Dr. Roopkumar Gursahani, consultant neurologist, who was among the team of doctors nominated to examine Ms. Shanbaug during the hearing of the petition.
Supreme Court guidelines on Euthanasia
Active euthanasia: Administering of lethal injection to snuff out life is illegal in India
Passive euthanasia: Withdrawing life support, treatment or nutrition that would allow a person to live, was legalised by way of SC guidelines in 2011.
Parents, spouse, close kin, "next friend" can decide, in best interests of the patient, to discontinue life support. The decision must be approved by a HC. In dealing with such a plea ,
- Chief Justice of High Court must create a Bench of at least 2 judges to reach a decision.
- Bench must nominate three reputed doctors
- A copy of the doctors's panel report must be provided to close kin and State govt. Only then can verdict be reached.
- - Aruna Shanbaug was brutally assaulted and raped by a wardboy-cum-sweeper of the hospital, Sohanlal Bharta Valmiki who throttled her with a dog chain. The brutal assault cut off blood and oxygen supply to key parts of her brain.
- - Valmiki is sentenced to six years in prison. He is released in 1980.
- - Pinki Virani, author of 'Aruna's Story', moves court seeking a peaceful death for Aruna and that the force-feeding be stopped
- - Supreme Court rejects petition. The petition was opposed by the hospital's management and nursing staff.
- - Aruna Shanbaug dies
>To live and to let go
Even as the Supreme Court considers the need for living wills, a new documentary film looks at the factors that haunt the issue of passive mercy killing.
>Of mercy and ending life
"We could have dismissed the petition [because]… the right to life guaranteed the Constitution does not include right to die"
>Who has the last word?
Legal experts and medical activists share their thoughts on the implications of the landmark judgment.
>The right to death
There is no point referring to ‘our values', since values are not to be seen as ours, yours or theirs; they are humane in essence.
