Aruna Ramchandra Shanbaug vs Union Of India & Ors on 7 March, 2011

  1. Bench: Markandey Katju, Gyan Sudha Misra
    Verdict Refusing mercy killing of Aruna Shanbaug, a two-judge bench of Supreme Court comprising of justices Markandey Katju and Gyan Sudha Mishra, in a landmark judgement on 7th March 2011, allowed “passive euthanasia” of withdrawing life support to patients in (PVS) but rejected outright active euthanasia of ending life through administration of lethal substances. The apex court while framing the guidelines for passive euthanasia asserted that it would now become the law of the land until Parliament enacts a suitable legislation to deal with the issue. The bench also asked Parliament to delete Section 309 IPC (attempt to suicide) as it has become “anachronistic though it has become constitutionally valid.” “A person attempts suicide in a depression, and hence he needs help, rather than punishment,” Justice Katju writing the judgement said. The Apex Court noted that though there is no statutory provision for withdrawing life support system from a person in PVS, it was of the view that “passive euthanasia” could be permissible in certain cases for which it laid down guidelines and cast the responsibility on high courts to take decisions on pleas for mercy killings.
    Facts of the case
    Aruna Ramachandra Shanbaug was a staff nurse working at King Edward Memorial Hospital, Parel, and Mumbai. While changing her clothes the hospital ward boy sohanlal Valmiki attacked her. He tried to rape her but when he found out she was menstruating he sodomized her on. He choked her with a dog chain and on 27th November 1973 morning she was found by the sweeper in a very delicate condition. It was contended due to strangulation her body was fully paralyzed and her brain was damaged. She was in a very delicate situation. She had been surviving on a liquid diet for many years and her hands and legs couldn’t be moved.
    The respondents, KEM Hospital and Bombay Municipal Corporation filed a counter-petition. Since there were conflicts in the petitions filed by the petitioner and respondents, the court decided to appoint a team of three eminent doctors to investigate and report on the exact physical and mental conditions of Aruna Shanbaug. They studied Aruna Shanbaug’s medical history in detail and opined that she is not brain dead. Also, they did not find any suggestion from the body language of Aruna as to the willingness to terminate her life. Further, the nursing staff at KEM was volunteering in taking care of her so the doctors agreed that in this case euthanasia was not required.
    Contention Raised:
    • When a person is in a permanent vegetative state (PVS), should withholding or withdrawal of life-sustaining therapies be permissible or `not unlawful’?
    • If the patient has previously expressed a wish not to have life-sustaining treatments in case of futile care or a PVS, should his/ her wishes be respected when the situation arises?
    • In case a person has not previously expressed such a wish if his family or next of kin requests to withhold or withdraw futile life-sustaining treatments, should their wishes be respected?
    The Hon’ble Division Bench of the Supreme Court of India, consisting of Justice Markandey Katju and Justice Gyan Sudha Mishra, gave their judgment on this landmark case on March 7, 2011. The Court ‘s view according to the doctor’s report and the meaning of brain death under the Transplantation of Human Organs Act, 1994, Aruna was not brain dead. She could inhale without a helping machine, had emotions, and delivered an essential boost. Even though she is in a PVS, her condition was been steady. Along these lines, ending her life was unjustified.
    The choice to decide for the benefit was in the hands of the administration and staff of KEM hospital and not Pinki Virani. taking her out of ventilators and reducing her food intake wouldn’t be feasible. Taking her off life support wouldn’t cater to KEM hospital since they took care of her all these years.
    The Supreme Court allowed passive euthanasia in particular conditions, subject to the order passed by the high court. when an application for passive euthanasia is written to the Chief Justice of the High Court it ought to constitute a bench of not more than two judges who should choose to allow the application or not. Before taking the step they must consult three qualified and reputed doctors who are fit in counseling them in such a serious issue. The high court will pass notice to the patient’s guardianlike partner, sibling, and in their absence to the doctor. After successive hearing from their kith and kin, the high court must come up with a decision.
    However, Aruna Shanbaug was denied euthanasia as the court opined that the matter was not fit for the same. If at any time in the future, the staff of KEM hospital or the management felt a need for the same, they could approach the High Court under the procedure prescribed.
    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.

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