Aruna's gift: Right to passive euthanasia

Forty-two years after a brutal sexual assault left her lying in a vegetative state, Aruna Shanbaug is free finally from suffering. She breathed her last on Monday morning and with that came freedom from the living death she was condemned to when a ward boy in Mumbai’s King George Memorial (KEM) hospital where she was working, brutally sodomised and strangulated her. That assault did not kill her but left her brain damaged, paralysed and cortically blind. Moved by comatose state, Pinki Virani, Aruna’s biographer, moved the courts to “end Aruna’s unbearable agony” and to press for her right to die a dignified death. The Supreme Court did not permit Virani’s plea that Aruna be allowed to die but ruled that passive euthanasia was permissible with certain safeguards. Unfortunately, Aruna could not benefit from the apex court ruling; her caregivers – the nurses at KEM hospital – insisted that she responded to them and refused to let her go. However, the court ruling permitting passive euthanasia, that is, withholding food, medicines, treatment etc to brain dead patients, is a gift that Aruna gave to other Indians suffering without any hope in sight. She contributed like few others to the euthanasia debate in the country.

Fearing the costs of medical treatment, Aruna’s family abandoned her. It was KEM Hospital’s nurses who took care of her. So exemplary and compassionate was their care that Aruna did not develop a single bed sore over the 42 years she lay strapped motionless to a bed. But what would have happened had she not had the care of the KEM nurses? Palliative care for the brain dead is prohibitively expensive in India and way beyond the reach of the overwhelming majority of our population. Aruna’s life should stir the government into making treatment and care for terminally ill patients affordable and accessible. They should be able to pass their last years with the best of care and the least of pain and worries.

Often families are reluctant to permit passive euthanasia as religious beliefs and fear of social opprobrium come in the way. It is imperative, therefore, that people be allowed to include ‘do not resuscitate’ requests in their wills. The courts must make ‘living wills’ legal. This will give people who wish to have a dignified death the option of accessing passive euthanasia when they need it. Euthanasia, whether active or passive, is a controversial issue. The state must lay out clear guidelines on who can take these decisions and create expert panels to monitor decisions and their implementation.