Author: Vedika Mishra, a student at KC Law College
Abstract
The landmark judgement of Aruna Ramchandra Shanbaug v. Union of India & Others (AIR 2011 SC 1290), was the first to open doors for passive euthanasia in India. Being a country, popularly known for its sacred history and rich culture, India has witnessed an ever-lasting debate on the legal, ethical and moral correctness of euthanasia. This judgement served as a legal framework and played a significant role in the legalization of passive euthanasia in the country. It also aided in the interpretation of the Article 21 of The Constitution of India, which established that Article 21 not only encompasses the right to life but also the right to die with dignity. It played a crucial role in understanding that dying with dignity is as important as living with dignity. This article aims to understand the evolution of euthanasia in India and the difference between active and passive euthanasia through this landmark judgement.
To The Point
Euthanasia refers to mercy killing. In simple language, it is a practice of deliberately ending an individual’s life to eliminate pain and suffering. It can be done either through injecting a lethal substance inside the person’s body or through withdrawing the treatment or discontinuing the life support of the person. It is done when a person is in a persistent vegetative condition and there is no hope of any recovery or betterment in the person’s health conditions.
In 1973, Aruna Shanbaug was sexually assaulted and molested in the KEM Hospital and this unfortunate incident adversely affected her and changed her life completely as she was in a persistent vegetative state until her death. In 2009, Pinki Virani, a journalist and an activist filed a writ petition for passive euthanasia after almost 36 years of this tragic event. The question before the court was whether mercy killing is legally, ethically and morally correct or not. The Hon’ble Supreme Court of India, comprising of Justice Markandey Katju and Justice Gyan Sudha Mishra, ruled a judgment on 7th March, 2011.
Background of Aruna Shanbaug
Aruna Ramchandra Shanbaug was a twenty-five years old nurse working in King Edward Memorial (KEM) Hospital situated in Mumbai. On 27th November, 1973, she was changing her clothes in the basement of the hospital.
She was attacked by a sweeper of the same hospital. He wrapped her neck with a dog chain and strangled her. He tried to rape her, but finding that she was menstruating, he sodomized her.
The next day, she was found in an unconscious condition with blood all around her. The supply of oxygen had stopped resulting in her brain getting damaged. She was surviving on mashed food and remained in a persistent vegetative state in KEM Hospital until her death.
Use of Legal Jargon
Article 21 of the Constitution of India
This landmark judgement aided in the interpretation of Article 21 of the Constitution of India, which established that Article 21 not only encompasses the right to life but also the right to die with dignity. It explored whether this dignity extends to the right to die when a person is in a permanent vegetative state with no hope of recovery or improvement in the health conditions of the person. It focused on mercy killing as a legal step of helping a person eliminate pain and suffering. Thus, it comes under the right to die with dignity.
Filing of a Writ Petition
Pinki Virani, a journalist and an activist filed a writ petition for passive euthanasia in the year 2009, after almost 36 years of this unfortunate and tragic incident. As next friend, she claimed passive euthanasia as Aruna was in a persistent vegetative state.
It primarily focused on the significance of right to die with dignity as a fundamental right of an Indian citizen under the Article 21 of The Constitution of India (Right to Life and Personal Liberty).
She claimed that Aruna was not conscious and couldn’t chew her food and could not live without the life support and backing of the medical staff of the hospital. There was no hope for any recovery in her health conditions.
It referred that right to life includes right to die with dignity and dying with dignity is as important as living with dignity.
Active and Passive Euthanasia
Euthanasia refers to mercy killing. It is an action which is deliberate in nature and help a person to eliminate pain and suffering when there is no room for improvement in the patient’s health conditions. Active euthanasia is when a substance which is lethal in nature is injected inside the patient’s body, resulting in the death on the spot. On the other hand, Passive euthanasia is when a patient is withdrawn from the treatment, nutrition or water intake or even can include discontinuation of life support.
Filing of a counter petition
To this petition, KEM Hospital filed a counter petition claiming that it was legally, ethically and morally incorrect to go for passive euthanasia as Aruna is not capable of taking any kind of decision for herself and it would be wrong to let someone else decide for her.
It would be wrong to do so as the medical staff of KEM Hospital had been looking after Aruna since the last 36 years for her.
The nurses were the caretakers of Aruna and they strongly opposed passive euthanasia.
Opting for passive euthanasia would mean reversing all the efforts taken by the nurses of the KEM Hospital.
Parens patriae
This term means “parent of the nation”. It is a legal doctrine that explains the significance of the State in making a decision for the people who are incapable to do so. Since, Aruna was not in an appropriate condition to take any decision for herself, it was important for the court to not let anyone take any kind of undue advantage of this situation. Thus, the ultimate power to take decision regarding her life support was taken by the Supreme Court.
The Proof
The Supreme Court of India held that active euthanasia is illegal unless there is a legislation permitting it, but passive euthanasia is legal even without legislation. Basically, active euthanasia was considered as illegal and passive euthanasia could be permitted under special circumstances.
Judgement of the Supreme Court of India
The Hon’ble Supreme Court of India, comprising of Justice Markandey Katju and Justice Gyan Sudha Mishra, ruled a judgment on 7th March, 2011. Active euthanasia was held illegal and passive euthanasia was permitted in special circumstances. The court held this decision on the basis of the following:
The law and judgements of several countries, including, Switzerland, UK, USA, France and Canada.
Judgement of Airedale NHS Trust v. Bland
Judgement of P Rathinam v. Union of India
Judgement of Gian Kaur v. State of Punjab
The 196th Law Commission Report (Article 21 of the Constitution of India includes the right to die with dignity and recommended passive euthanasia to be legal).
A report of a Medical Board stated that:
Aruna Shanbaug was not brain dead as per the Transplantation of Human Organs Act, 1994.
She could breathe without the support of the ventilator.
She could respond to stimuli.
Despite being in a persistent vegetative state, she had been in a stable condition.
Considering all these points, it would be unfair to withdraw her life support and let her die as it was very clear that she intended to live.
Thus, she was not allowed to go ahead with passive euthanasia. After being in a persistent vegetative state for a period of forty-two years, she eventually died on 18th May, 2015 due to pneumonia following a cardiac arrest.
Active euthanasia permitted in special circumstances
The Supreme Court of India held that active euthanasia could be in permitted in special circumstances and the power would be exercised with caution and only on a case-by-case basis in the following manner:
An application must be filed by the parent, spouse, close relative, next friend or any medical staff to withdraw the life support of such patient.
A bench of at least two judges of the High Court shall have the power to grant such approval.
The decision will be taken on the basis of the opinion made by a committee of three reputed doctors, comprising of the following:
A neurologist
A psychiatrist
A physician
Case Laws
Airedale NHS Trust v. Bland:
Tony Bland was a young man who suffered a severe damage in his brain. He swas in a permanent vegetative state. In this case, it was held that a patient could go for passive euthanasia. The patient was allowed to die by withdrawing his life support through passive euthanasia as it was not considered a positive act to cause death, but rather allowing nature take its course.
P Rathinam v. Union of India:
This case challenged that Section 309 of the Indian Penal Code was constitutionally invalid as it criminalized attempted suicide and it also claimed that the right to die with dignity was a part of right to live. The Court held that suicide was a personal choice and not a criminal offence and Section 309 of the Indian Penal Code was not constitutionally valid. It also held that the right to life includes the right to die with dignity.
Gian Kaur v. State of Punjab
In this case, the court overruled the P Rathinam case, and held that the right of life does not include the right to die with dignity and abetment to suicide is a criminal offence. It left a small window open for passive euthanasia in special circumstances.
Conclusion
The landmark judgment of Aruna Ramchandra Shanbaug v. Union of India & Others (AIR 2011 SC 1290), was the first to open doors for passive euthanasia. This case allowed passive euthanasia only through the approval of the High Court on a case-by-case basis. This acted as a comprehensive legal framework for the 2018 Common Cause v. Union of India, which legalized passive euthanasia in India. Basically, this landmark judgement did not legalize passive euthanasia in India, but only acted as a catalyst for its legalization. On the other hand, passive euthanasia was only made legal in the 2018 common cause case. It allowed passive euthanasia in India by considering acted as a revolutionary step towards mercy killing in India and aided the elimination of pain and suffering of numerous patients who are in a permanent vegetative condition. Therefore, Aruna Shanbaug case played a significant role in the legalization of mercy killing in India.
FAQS
Q1: When was the judgement delivered?
The landmark judgement of Aruna Ramchandra Shanbaug v. Union of India & Others (AIR 2011 SC 1290), was the first to open doors for passive euthanasia. The Hon’ble Supreme Court of India, comprising of Justice Markandey Katju and Justice Gyan Sudha Mishra, ruled a judgment on 7th March, 2011.
Q2: What is the core ruling of the Aruna Shanbaug case?
The Supreme Court of India held that active euthanasia is illegal unless there is a legislation permitting it, but passive euthanasia is legal even without legislation. Basically, active euthanasia was considered as illegal and passive euthanasia could be permitted under special circumstances.
Q3: What was Aruna’s medical condition?
In 1973, Aruna Shanbaug was sexually assaulted and molested in the KEM Hospital and this unfortunate incident adversely affected her and changed her life completely as she was in a persistent vegetative state until her death. . After being in a persistent vegetative state for a period of forty-two years, she eventually died on 18th May, 2015 due to pneumonia following a cardiac arrest.
Q4: What is active and passive euthanasia?
Euthanasia refers to mercy killing. It is an action which is deliberate in nature and help a person to eliminate pain and suffering when there is no room for improvement in the patient’s health conditions. Active euthanasia is when a substance which is lethal in nature is injected inside the patient’s body, resulting in the death on the spot. On the other hand, Passive euthanasia is when a patient is withdrawn from the treatment, nutrition or water intake or even can include discontinuation of life support.
Q5: What legal changes did the judgement bring and how did the case influence the 2018 Common Cause v. Union of India judgement?
The landmark judgment of Aruna Ramchandra Shanbaug v. Union of India was the first to open doors for passive euthanasia. This case allowed passive euthanasia only through the approval of the High Court on a case-by-case basis. This acted as a comprehensive legal framework for the 2018 Common Cause v. Union of India, which legalized passive euthanasia in India. Basically, this landmark judgement did not legalize passive euthanasia in India, but only acted as a catalyst for its legalization. On the other hand, passive euthanasia was only made legal in the 2018 common cause case. It allowed passive euthanasia in India by considering acted as a revolutionary step towards mercy killing in India and aided the elimination of pain and suffering of numerous patients who are in a permanent vegetative condition.
