Aruna Ramachandra Shanbaug V. Union of India and Others (2011)
Facts
Aruna Ramachandra Shanbaug was a staff Nurse working in King Edward Memorial Hospital, Mumbai. On November, 1973 she was attacked by a ward boy named Sohanlal Bhartha Valmiki who was working on the same hospital.
He wrapped a dog chain around her neck and yanked her back with it. He also tried to rape her. To immobilize her during this act he twisted the chain around her neck. The next day on 28th November, 1973 at 7:45 cleaner of the hospital found her lying down in an unconscious condition and she was covered with blood.
After that incident, thirty year passed, she had been surviving on mashed food and could not move her hands or legs and paralysed.
It was believed that the improvement of her health condition was impossible and the KEM Hospital at Mumbai looked after her and she was totally depended upon the staff members of that hospital. It was prayed to direct the Respondents to stop feeding Aruna and let her die in peace.
Issues
- In case a person has not previously expressed such a wish, if his family or next of kin makes a request to withhold or withdraw futile life-sustaining treatments, should their wishes be respected?
- What is the patient’s best interest where he is in a persistent vegetative state (PVS)?
- When a person is in a permanent vegetative state (PVS), should withholding or withdrawal of life sustaining therapies be permissible or `not unlawful’?
- If the patient has previously expressed a wish not to have life-sustaining treatments in case of futile care or a PVS, should his/ her wishes be respected when the situation arises?
Judgement:
The Supreme Court of India, consist of the Justice Markandey Katju and Justice Gyan Sudha Mishra, held that earlier there was no right to die under the article 21 of the Indian Constitution which states no person shall be deprived of his life or personal liberty except according to procedure established by law. And section 309 of IPC also states the attempt to suicide is a crime.
However the court said in the case of a dying person who was terminally ill or in a permanent vegetative state he may be permitted to terminate it by a premature extinction of his life in the circumstances and it was not a crime.
Regarding the withdrawal of life support to a person in PVS or who was otherwise incompetent to take a decision in this connection, the Supreme Court in a two Judge Bench decision, Justice Markandey Katju and Justice Gyan Sudha Misra, laid down the law of passive euthanasia to continue till the law made by Parliament on the subject, as follows:
(1) A decision has to be taken to discontinue life support either by parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend. It can also be taken by the doctors attending the patient. However, the decision should be taken bona fide in the best interest of the patient.
(2) It was hospital staff taking care of the victim for a long, they were really her friends who could take such a decision but they clearly expressed their wish that the victim to be allowed to live. If the hospital staff at some future time changes its mind, it would have to apply to the Bombay High Court for approval of decision to withdraw life-support.
(3) A petition can be made to the High Court to pass suitable orders under Article 226 of the Constitution praying for an order or direction and not for any writ. Hence, Article 226 gives abundant power to the High Court to pass suitable orders on the application filed by the near relatives or next friend or the doctors/hospital staff praying for permission to withdraw the life-support to an incompetent person of the kind above-mentioned.