Aruna Ramachandra Shanbaug v. Union of India

Case Summary: Aruna Ramachandra Shanbaug v. Union of India

Equivalent Citation: (2011), 4 SCC 454

Introduction:

All Indian people have the right to life, according to the country's constitution. The never-ending controversy over whether this provision can be construed to include the right to die still lingers in the air. On the other hand, with a growing emphasis in the medical industry on patients' informed consent, the concept of euthanasia has gotten a mixed response in India.

As we all know, euthanasia, also known as mercy killing, is the act or practice of putting to death people who are suffering from a painful and incurable disease or a physically incapacitating disorder without pain, or allowing them to die by withholding treatment or withdrawing artificial life-support measures. It comes in two types: Active Euthanasia and Passive Euthanasia.

The employment of a hazardous drug or lethal procedure to kill a person is known as active euthanasia. Passive Euthanasia refers to the withholding of medical treatment that would otherwise cause a person's death. Both voluntary and involuntary passive euthanasia is possible. When a patient's consent is obtained, it is voluntary; but, when a patient is unable to grant consent and a choice is made on his or her behalf by another person, it is involuntary.

Facts of the Case:

1. Aruna Ramchandra Shanbaug, the petitioner, in this case, used to work as a nurse at King Edward Memorial Hospital in Parel, Mumbai. 

2. She was attacked by a hospital sweeper on the evening of November 27, 1973, who placed a dog chain around her neck and yanked her back with it. He attempted to rape her, but when he discovered she was on her period, he sodomized her, stole her earrings, and immobilized her.

3. He wrapped the chain around her neck tightly to keep her from moving or causing any havoc. 

4. The next day, a cleaner discovered her body on the floor, unconscious and covered in blood. The supply of oxygen to the brain was thought to have been cut off due to the chain's strangling, causing the brain to be harmed.

5. The supply of oxygen to the brain was allegedly cut off as a result of the dog chain strangulation, causing the brain to be harmed. Her brain was irreparably damaged as a result, and she was forced into a Persistent Vegetative State (PVS).

6. It had been 36 years after the aforementioned incident. She couldn't move her hands or legs and was surviving on mashed food. It was claimed that there was no chance of her health improving and that she was completely reliant on KEM Hospital in Mumbai. It was requested that the Respondents stop feeding Aruna and allow her to die in peace.

Issues Raised:

• Is it lawful to remove life-sustaining systems and means from a person who is in a permanent vegetative state (PVS)?

• Should a patient's preferences be honored if he or she has previously said that he or she does not want life-sustaining measures in the event of futile treatment or a PVS?

• Is it possible for a person's family or next of kin to submit a request to withhold or withdraw life-sustaining systems if the person has not made such a request before?

Contentions Raised:

1. Pinki Virani, an activist, and journalist filed a suit in the Supreme Court under Article 32 of the constitution, stating that she had no chance of reviving and improving. As a result, she should be permitted to choose passive euthanasia and be relieved of her suffering. The respondent parties, KEM Hospital, and Bombay Municipal Corporation filed a counter-petition in response to this petition. As a result, the gaps between the two groups widened.

2. Because there were discrepancies, the Supreme Court authorized a team of three famous doctors to investigate and produce a report on Aruna Shanbaug's actual mental and physical state to gain a better picture of the issue. Doctors looked at her whole medical history and concluded that her brain was not dead. She understands and reacts to situations in her unique way.

3. Aruna's body language also did not indicate that she was willing to end her life. Neither the hospital's nursing personnel nor the hospital's medical team was sloppy in their treatment of her. As a result, the doctor believes that euthanasia is not required in this situation. She held this role for 42 years until she died in 2015.

Concept of ‘Right to Die’ with Case Laws:

To decide on the aforementioned issues, the court divided euthanasia into two categories: voluntary and non-voluntary. Voluntary euthanasia occurs when the patient's consent is obtained, but non-voluntary euthanasia occurs when the patient's consent is unavailable, such as when the patient is in a coma or otherwise incapable of giving consent.

1. The claim in State of Maharashtra v. Maruty Shripati Dubal was that Section 309 of the IPC was unconstitutional because it violated Articles 19 and 21 of the Constitution. The Bombay high court ruled in this case that "right to life" encompasses "right to die," and section 309 was repealed. In this case, the court stated unequivocally that the freedom to die is not unnatural; it is simply exceptional.

2. In the case of P.Rathinam v. Union of India, it was determined that Article 21 covers the "right to die." Article 21 contains good content, according to P. Rathinam, and its reach is not solely negative.

3. The legality of Section 306 of the IPC, which punishes abetment of suicide, was called into doubt in the case of Gian Kaur v. State of Punjab. This decision overruled P.Rathinam, but the court stated that the right to die in the context of a terminally sick patient or one in the PVS is not about ending a life prematurely, but rather about speeding up the process of death that has already begun.

Judgement:

On March 7, 2011, the Supreme Court of India's Hon'ble Division Bench, consisting of Justice Markandey Katju and Justice Gyan Sudha Mishra, handed down this decision.

1. The court ruled that Aruna is not brain dead, basing its decision on a doctor's report and the concept of brain death outlined in the Transportation of Human Organs Act of 1994. She was able to breathe without the assistance of a machine, she had sensations, and she used to exhibit certain symptoms.

2. Even though she was in a PVS, her status remained constant. As a result, the grounds stated here are insufficient to put an end to her life. It would be inexcusable. Furthermore, the court stated in its decision that the employees of the KEM Hospital, not Pinki Virani, would be next to the patient's family in this circumstance.

3. As a result, KEM Hospital has the legal authority to make such decisions on her behalf. It was the food that kept her alive in this situation. As a result, removing life-saving treatments would imply depriving her of food, which is not justified under Indian law. In some circumstances, the Supreme Court permitted passive euthanasia. However, to prevent future abuse of this provision, the court ruled that the power to decide on a person's death would be subject to approval by the High Court after a proper procedure.

4. Furthermore, to protect the ‘parens patriae’ concept, the Court has lodged the right to determine the termination of a person's life in the High Court. As a result, the Supreme Court approved passive euthanasia in specified conditions, subject to the High Court's consent following the proper procedure.

Aruna Shanbaug, on the other hand, was denied euthanasia because the court ruled that the situation did not warrant it. If the personnel or management of KEM hospital ever felt the need for anything similar, they might go to the High Court using the procedure outlined.

Conclusion:

This case highlighted the concerns surrounding euthanasia and also established standards for mass euthanasia. In addition, the court recommended that Section 309 of the Indian Penal Code be repealed.

This case is significant because it established the procedure to be followed in an area where no legislation exists. It marked the start of debates on the question of passive euthanasia, which had hitherto been rarely discussed. It defines the stance of the right to die with dignity and expands the scope of our constitution's Article 21. In the context of India, this is unquestionably a progressive decision.