<p>March, 2011. The waiting room outside the dean’s office at King Edward Memorial (KEM) Hospital in Mumbai was brimming with journalists. And the battle lines were drawn. The health reporters v/s the law reporters. Journalist and activist Pinki Virani had filed a petition for mercy killing on behalf of Aruna Shanbaug, the hospital’s erstwhile nurse and then patient for close to four decades.<br /><br /></p>.<p>“Once you are brain dead, you are dead for all practical purposes. What’s the point of prolonging the agony?” a health journo wondered aloud. Aruna had been in a vegetative state – unable to see, speak, walk or respond in any way – ever since she was sodomised while being strangled with a dog-chain on the fateful night of November 27, 1973.<br /><br />A law journo was quick to respond that such pedestrian opinions can only cause more damage. “Why don’t they at least read up on the Indian Constitution or the Indian Penal Code?” was the sharp rebuke. When it came to Aruna – the face of Indian debate on euthanasia – it was hard not to have strong opinions. <br /><br />The medical angle: Aruna died of pneumonia and septicemia on May 18, 2015. Not too long before, she had a near-fatal episode of lung infection. Years before, her gums had started to rot, the teeth had given way. She was being fed with a nasal pipe. The brutal sexual assault had left her in a permanent vegetative state as blood supply to her brain was lost for a very long time. Ward No 4 at KEM Hospital had been Aruna’s world for 42 years. <br />Argument then, was: Could Aruna be cured? Medical experts had been unanimous in their view that there was no cure for her. But, yes, she could be cared for. And that she was, by the many nurses – old and new – at the hospital. The medical report submitted to the Supreme Court in 2011 stated that Aruna didn’t have a single bed sore. Anyone who has cared for a bed-ridden patient for a long time would know that’s no mean feat. <br /><br />However, there’s no way of knowing if Aruna – then 25 and engaged to be married to a doctor from KEM – would have preferred to die and end the agony earlier. Think of it, do we ever discuss end-of-life preferences at home? Sure, we would like to go in peace. But what if the hospital says one needs to be put on life support? Would we prefer that? In the West, the ‘do not resuscitate’ option is commonplace. Although it doesn’t have a legal standing in India, shouldn’t we at least be discussing matters related to end-of-life care?<br /><br />The legal approach: Thanks to Aruna, there is a law in place now that allows for passive euthanasia (withholding of drugs or other life-sustaining treatment) under strict conditions. Nevertheless, there are still many unanswered legal questions waiting for a constitution bench to take up the matter.<br /><br />Simply put, the right to life under Article 21 of the Constitution of India does not include the right to die. In fact, attempt to suicide is a criminal offence under Section 309 of the Indian Penal Code, punishable with imprisonment up to one year, or with fine, or both. It’s only recently that the government decided to decriminalise the Act. <br /><br />In the case of abortions, too, the law is pretty clear. According to the Medical Termination of Pregnancy (MTP) Act of 1971, pregnancy cannot be terminated after the 20th week, unless there is a health risk to the mother. However, many congenital defects and chromosomal anomalies in the foetus, say doctors, can be confirmed only after 20 weeks. So, what does a couple do once they learn that the unborn baby has a debilitating medical condition? <br /><br />Mumbai-based Niketa and Haresh Mehta had filed a petition in the Bombay High Court in 2008, asking for permission to abort their 23-week-old foetus, after a routine test revealed that it had a complete congenital heart blockage and malpositioned arteries that, doctors said, could require a pacemaker implantation soon after birth. The court turned down the plea as the petitioners had failed to establish grounds fit enough for the court to make an exception for them by exercising its extraordinary jurisdiction. In other words, whether it’s the life of a comatose woman or an unborn baby, under the Indian law, there are strict provisions in place to ensure justice. <br /><br />The human factor<br /><br />According to Pinky Virani’s book Aruna’s Story: The True Account of a Rape and its Aftermath, published in 1998, Sohanlal Bhartha Walmiki, the ward boy who assaulted her, was angry with Aruna; she had accused him of stealing the food of the dogs used in medical experiments and threatened to report him. So, he decided to take revenge. Because she was menstruating on the day of the assault, he sodomised her instead of going ahead with the rape. And in the process, managed to strangle her so hard that by the time she was found unconscious the next morning, Aruna was almost brain dead. <br /><br />Sohanlal was convicted of attempted murder and robbery (he had stolen a watch and her earrings). He could have been charged under Section 377 (carnal intercourse against the order of nature), if the matter hadn’t been hushed up to protect Aruna’s ‘honour’ (and that of her doctor fiancé). It could have added another 10 years to the culprit’s seven-year sentence. <br /><br />He is said to have changed his identity, got married and bagged a job in a hospital in Delhi, while Aruna continued to lie in her hospital bed in ward no 4 for 42 years of her 67 years on earth. Would it have been more humane to let her die earlier? The debate continues…</p>
<p>March, 2011. The waiting room outside the dean’s office at King Edward Memorial (KEM) Hospital in Mumbai was brimming with journalists. And the battle lines were drawn. The health reporters v/s the law reporters. Journalist and activist Pinki Virani had filed a petition for mercy killing on behalf of Aruna Shanbaug, the hospital’s erstwhile nurse and then patient for close to four decades.<br /><br /></p>.<p>“Once you are brain dead, you are dead for all practical purposes. What’s the point of prolonging the agony?” a health journo wondered aloud. Aruna had been in a vegetative state – unable to see, speak, walk or respond in any way – ever since she was sodomised while being strangled with a dog-chain on the fateful night of November 27, 1973.<br /><br />A law journo was quick to respond that such pedestrian opinions can only cause more damage. “Why don’t they at least read up on the Indian Constitution or the Indian Penal Code?” was the sharp rebuke. When it came to Aruna – the face of Indian debate on euthanasia – it was hard not to have strong opinions. <br /><br />The medical angle: Aruna died of pneumonia and septicemia on May 18, 2015. Not too long before, she had a near-fatal episode of lung infection. Years before, her gums had started to rot, the teeth had given way. She was being fed with a nasal pipe. The brutal sexual assault had left her in a permanent vegetative state as blood supply to her brain was lost for a very long time. Ward No 4 at KEM Hospital had been Aruna’s world for 42 years. <br />Argument then, was: Could Aruna be cured? Medical experts had been unanimous in their view that there was no cure for her. But, yes, she could be cared for. And that she was, by the many nurses – old and new – at the hospital. The medical report submitted to the Supreme Court in 2011 stated that Aruna didn’t have a single bed sore. Anyone who has cared for a bed-ridden patient for a long time would know that’s no mean feat. <br /><br />However, there’s no way of knowing if Aruna – then 25 and engaged to be married to a doctor from KEM – would have preferred to die and end the agony earlier. Think of it, do we ever discuss end-of-life preferences at home? Sure, we would like to go in peace. But what if the hospital says one needs to be put on life support? Would we prefer that? In the West, the ‘do not resuscitate’ option is commonplace. Although it doesn’t have a legal standing in India, shouldn’t we at least be discussing matters related to end-of-life care?<br /><br />The legal approach: Thanks to Aruna, there is a law in place now that allows for passive euthanasia (withholding of drugs or other life-sustaining treatment) under strict conditions. Nevertheless, there are still many unanswered legal questions waiting for a constitution bench to take up the matter.<br /><br />Simply put, the right to life under Article 21 of the Constitution of India does not include the right to die. In fact, attempt to suicide is a criminal offence under Section 309 of the Indian Penal Code, punishable with imprisonment up to one year, or with fine, or both. It’s only recently that the government decided to decriminalise the Act. <br /><br />In the case of abortions, too, the law is pretty clear. According to the Medical Termination of Pregnancy (MTP) Act of 1971, pregnancy cannot be terminated after the 20th week, unless there is a health risk to the mother. However, many congenital defects and chromosomal anomalies in the foetus, say doctors, can be confirmed only after 20 weeks. So, what does a couple do once they learn that the unborn baby has a debilitating medical condition? <br /><br />Mumbai-based Niketa and Haresh Mehta had filed a petition in the Bombay High Court in 2008, asking for permission to abort their 23-week-old foetus, after a routine test revealed that it had a complete congenital heart blockage and malpositioned arteries that, doctors said, could require a pacemaker implantation soon after birth. The court turned down the plea as the petitioners had failed to establish grounds fit enough for the court to make an exception for them by exercising its extraordinary jurisdiction. In other words, whether it’s the life of a comatose woman or an unborn baby, under the Indian law, there are strict provisions in place to ensure justice. <br /><br />The human factor<br /><br />According to Pinky Virani’s book Aruna’s Story: The True Account of a Rape and its Aftermath, published in 1998, Sohanlal Bhartha Walmiki, the ward boy who assaulted her, was angry with Aruna; she had accused him of stealing the food of the dogs used in medical experiments and threatened to report him. So, he decided to take revenge. Because she was menstruating on the day of the assault, he sodomised her instead of going ahead with the rape. And in the process, managed to strangle her so hard that by the time she was found unconscious the next morning, Aruna was almost brain dead. <br /><br />Sohanlal was convicted of attempted murder and robbery (he had stolen a watch and her earrings). He could have been charged under Section 377 (carnal intercourse against the order of nature), if the matter hadn’t been hushed up to protect Aruna’s ‘honour’ (and that of her doctor fiancé). It could have added another 10 years to the culprit’s seven-year sentence. <br /><br />He is said to have changed his identity, got married and bagged a job in a hospital in Delhi, while Aruna continued to lie in her hospital bed in ward no 4 for 42 years of her 67 years on earth. Would it have been more humane to let her die earlier? The debate continues…</p>
