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Death by consent

Mercy killing ... the ball is now in Parliaments court to legalise the right to die with dignity
Last Updated 13 March 2011, 04:57 IST
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The Supreme Court’s historic verdict on Mumbai nurse Aruna Ramchandra Shanbaug has opened a window of hope for hundreds of terminally-ill patients and their relatives.

Even though it ruled in favour of letting Aruna live, a brain-damaged victim since a  brutal sexual attack in 1973, the Court decided to show civil society and others a way on the perplexing issue of legalising euthanasia or mercy killing. It laid down guidelines for passive euthanasia while holding active euthanasia illegal.

It was not an easy task and this amply came out in the remarks of Justice Markandey Katju, who said while writing the landmark judgement: “We feel like a ship in an uncharted sea.”

The verdict rather aptly begins with a couplet from noted Urdu poet Mirza Ghalib: Marte hain arzoo main marne ki, maut aati hai par nahi aati. (One longs to embrace death, it (end) comes but not as per wish).

The issue of mercy killing raised by author and writer Pinki Virani before the Court was not confined to Aruna only. The apex court bench also comprising Justice Gyan Sudha Mishra went deeper into the larger issue, instead of rejecting her plea simply on some technical ground.

The joy with which the verdict was celebrated by nurses and staff at KEM Hospital, where Aruna has spent almost 37 years of her life after the brutal attack in 1973, is perhaps not out of place.

The court gave due regard to the services rendered by them to the woman. The hospital told the court that Aruna accepts food in the normal course and responds by making facial expressions. She makes sounds when she has to pass stool and urine, it said.

This was rather in contrast to the stand taken by Virani, who contended Aruna is in a persistent vegetative state (pvs) and virtually a dead person.

“Aruna cannot be said to be a living person and it is only on account of mashed food which is put into her mouth that there is a facade of life which is totally devoid of any human element,” she claimed.

Virani wanted a direction to stop feeding her in order to let her die peacefully.
Due to the divergent views, the court itself constituted a panel of three distinguished doctors from Mumbai which showered praise on the KEM hospital.
“The care was of such an exceptional nature that she has not developed a single bed-sore or fracture in spite of her bed-ridden state since 1973,” the report said.
Endorsing further signs of life in 63-year-old Aruna, it added, “She appears to be happy and smiles when she receives her favourite food like fish and chicken soup. She accepts feeds she likes but may spit out food which she doesn’t like.”

“The whole country must learn the meaning of dedication and sacrifice from the KEM hospital staff,” the report points out.

Aruna knows

The devotional songs being played in her room has a soothing effect on Aruna,  who occasionally makes vocal sounds to show her distress when too many people are around.

In view of the overwhelming response from the doctors and hospital, the court rejected Virani’s plea saying that she had no locus standi to decide about Aruna’s fate.

But it is not that everyone hailed the verdict.

Ranjana Kumari, prominent activist and director, Centre for Social Research says that the Supreme court probably failed to see Aruna’s excruciating pain.

The court by its judgement recognises life with dignity but what sort of life are we promising her, she asks.

“For last 37 years, she has been lying in such a condition. Can you say we gave her a life with dignity? We can’t keep someone alive as a marketing package for our medical system,” she says rather angrily.

In the judgement, the court, however, laid down strict guidelines for passive euthanasia with a clarification that these measures would be treated as law till the Parliament passed a legislation in this regard.

But there are strong voices for legalisation of active euthanasia as well which the court said is for the Parliament to decide.

“I feel the right to life includes the right to die with dignity. I believe both active and passive euthanasia should be allowed. If a man or a woman is in great pain and distress, that person should be allowed to die,” says advocate Prashant Bhushan, who is known for his fight for public causes.

Attorney General G E Vahanvati, appearing for the Central Government, had strongly opposed any form of euthanasia before the court saying that it would be “cruel, inhuman and intolerable” and further Indian society was emotional and care-oriented.

Besides several factors, Shekhar Naphade, counsel for Virani, on the other hand, had referred to a Law Commission’s report of 2006 favouring passive euthanasia in case of terminally-ill patients to say that Aruna should be allowed to die.

Passive euthanasia only       

Senior Counsel T R Andhyarujina, who appeared as Amicus Curiae, favoured passive euthanasia but with the condition that the decision to discontinue life support system should come from responsible doctors.

In case of Aruna, he had said the opinion of the attending doctors and nursing staff was more relevant as they have looked after her for so many years.

Prof Anand Kumar of School of Social Sciences, Jawaharlal Nehru University says the Supreme Court’s judgement is a welcome initiative as far as recognition of passive euthanasia is concerned.

“It is a bold opening of mind in terms of socially created pressures. It also shows growing role and impact of market forces in our life,” he said.

The landmark verdict of the apex court spawned the debate on the issue which will continue in the times to come.

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(Published 12 March 2011, 16:55 IST)

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