The Supreme Court of India has given yet another landmark judgment on the Euthanasia plea of Pinki Virani on behalf of Aruna Shanbaug. Full Text of the Supreme Court judgment is available at http://ibnlive.in.com/news/full-text-supreme-courts-judgment-on-aruna-ramachandra-euthanasia-petition/145201-53.html .
The judgment document starts by quoting a Ghalib couplet – “Marte hain aarzoo mein marne ki, Maut aati hai par nahin aati” (I die in the wish of dying/ Death comes but doesn’t come.)
While the SC dismissed Pinki Virani’s petetion on the ground that she had no locus standi on this case, it appreciated the noble sentiments behind Pinki’s plea. What makes it a landmark judgment is the fact that the Supreme Court judgment goes beyond Pinki Virani’s euthanasia plea and lays down guidelines for future cases, as mentioned below –
(a) If the doctors treating Aruna Shanbaug and the Dean of the KEM Hospital, together acting in the best interest of the patient, feel that withholding or withdrawing life-sustaining treatments is the appropriate course of action, they should be allowed to do so, and their actions should not be considered unlawful.
(b) In other cases, where a person has been in a vegetative state for a long time, passive euthanasia may be allowed by the High Court on a case to case basis provided a panel of doctors has given its nod for such measure;
(c) We (Supreme Court) are of the opinion that although Section 309 Indian Penal Code (attempt to commit suicide) has been held to be constitutionally valid in Gian Kaur’s case (supra), the time has come when it should be deleted by Parliament as it has become anachronistic. A person attempts suicide in a depression, and hence he needs help, rather than punishment. We therefore recommend to Parliament to consider the feasibility of deleting Section 309 from the Indian Penal Code.
Doctors and Nurses of the KEM Hospital who had been taking care of Aruna for the last 37 years have welcomed the judgment of the Supreme Court as they want Aruna to live her full life.
Aruna’s case has sparked off an emotional debate in the country as most people have very strong opinions for and against euthanasia. But do we really know what is Aruna’s case? I tried to search the internet to get some details but to my surprise I found that although a lot of defragmented information on Aruna’s Case is available on the internet, there was hardly any single site which contained all the details in one place. I therefore decided to consolidate as much information as possible for the benefits of those who are interested but don’t have the time and patience to check out tens and hundreds of websites.
Aruna’s Shanbhag’s Case
’’I met a big learned pujari (astrologer) who said I had a sau mein ek patrika (a one-in-hundred horoscope), that I’d be a success, will live long & would go abroad. But even if he was talking rubbish it does not matter because I know that I will become known in my field’’.
Aruna Shanbhag had uttered these words to her cousin about her plans to pursue her dreams of studying abroad. Little did she know that what waits for her is something so unimaginable, a future so horrid that even the best of pujari wouldn’t look forward to predicting!
Aruna was born in a small village Haldipur in the Uttara Kannada district of Karnataka. She studied up to Class X at the Rural Education Society School in this village, and after the death of her parents, left for Mumbai to live with elder brother, Balakrishna. She completed a nursing course and joined the KEM Hospital at Parel in Mumbai. The lively, pretty and dedicated Aruna soon became very popular amongst the hospital staff.
Then 25 year old, Aruna was planning to get married to Dr. Sandeep Sardesai, a resident doctor in the same hospital. Aruna had planned a party on November 30 (2 days after the attack) for her colleagues — including the sweeper Sohan Lal, whom she disliked intensely.
She and Sohan Lal both worked in what was called the “dog lab” of the hospital — a laboratory in the basement where unclaimed street dogs were kept for experimental purposes. Sohan Lal was in charge of keeping the area clean and for getting dogs from their cages to the operating theatre.
Aruna used to hate Sohan Lal as she had found him mistreating the animals and stealing ‘dog food’ and medicines. She had warned him several times and had even reported the matter to her superiors.
Sohan Lal was obviously very piqued with Aruna for this. On 27th November, 1973 Aruna told him that she was going to send a written complaint to the Dean about him. Sohan Lal thought this was the limit and he must teach this daring nurse a lesson.
On the same day, at around 4.50 pm, Aruna came down to the basement to change out of her hospital uniform. There are two conflicting versions on why Aruna was changing clothes in the basement. One version says that she had ignored the advice of the hospital matron to use the designated change room for changing clothes. However, another version published in the Indian Express says that there was no place allotted for the staff nurses for changing clothes. Three months before the incident, the then security officer I C Sisodiya had written to the assistant dean and matron on making it mandatory for non-resident nurses to change only in nurses’ quarters, he said. “Non resident nurses would change in any empty corner of the hospital. Shanbaug and colleague Mary Joseph regularly used the basement unit, which would be empty in the evening and unsafe for nurses. Had the nurses been using the quarters, this would have never happened,” Sisodiya said after the attack on Aruna.
When Aruna was changing in the basement, Sohan Lal was lurking in the shadows waiting for the right opportunity to take his revenge. He attacked Aruna in the basement. She fought like a tigress, biting him, scratching him, kicking him, but he managed to throw her on the ground.
He first tried to rape her but finding that she was menstruating, he sodomized her. To immobilize her during this act he twisted the chain around her neck. The asphyxiation (strangulation) cut off oxygen supply to her brain resulting in brain stem contusion injury and cervical cord injury apart from leaving her cortically blind.
The next day on 28th November, 1973 at 7.45 a.m., Pramila Kushe, a cleaner in the KEM Hospital, found her lying on the floor with blood all over in an unconscious condition. Recounting the horrible experience Pramila says, “I was the first one to find Aruna in the empty operation theatre in this hospital’s basement after she had been raped and brutally assaulted by that animal Sohan Lal. She was sitting, leaning against a stool with a dog-chain around her neck. There was blood around her. I ran out and brought the matron. As soon as she saw matron Bellimal, her eyes welled up and tears streamed down her face. She tried to say something but could not… only her lips moved. And then, slowly she lost consciousness..”
Sohan Lal was subsequently arrested from Pune and a police case was registered against him for robbery and attempted murder but not for rape or sexual molestation or “unnatural sexual offence” as hospital officials had deleted parts of her medical report that proved Aruna been sodomized. This was done to ensure that she did not face any ostracism after her recovery. Sohan Lal was convicted for 7 years in jail in 1974. It is believed that had he been charged for rape, he might have got a longer jail term (up to 10 years).
Sohan Lal’s brutality did not end with the horrible assault on Aruna on 28 November 1973. After his release from prison, Sohanlal tried to attack Aruna a second time in the hospital bed by pulling down the bed railings in the hope that she would fall down and die. The hospital authorities then shifted Aruna to a secure room which is locked most of the time with access only to the doctors who treat her and the nurses who go in to feed and bathe her.
Sohan Lal’s whereabouts have been kept a closely guarded secret since then. Howsoever ironical it may sound; it is believed that he went on to work in a private hospital in Delhi for many years. According to another rumour Sohanlal’s is believed to have died recently due to AIDS.
Aruna’s fiancée, Sundeep Sardesai, waited patiently for Aruna to revive for four years — visiting her every day and talking to her for hours and crying by her bedside. He eventually moved on, got married and settled down in the US. On Sunday night — hours before the Supreme Court verdict — Sundeep had called KEM matron M.P. Khaladkar. “He called again on Monday after the verdict. He spoke very little, asked how she was. He seemed very relieved with the judgment,” said Khaladkar, unwilling to give out more details.
37 years have expired since the incident and now Aruna is about 60 years of age. Though she survived the horrible attack, she never fully recovered from the trauma and brain damage resulting from the assault and strangulation. She has been in a vegetative state for all these years. However, contrary to the common confusion, she is neither in Coma nor is she Brain Dead. Her family and relatives used to visit her initially for some time but later abandoned and left her entirely to the KEM Hospital staff.
She is featherweight, and her brittle bones could break if her hand or leg is awkwardly caught, even accidentally, under her lighter body. She has stopped menstruating and her skin is now like papier mache’ stretched over a skeleton. She is prone to bed sores. Her wrists are twisted inwards. Her teeth had decayed causing her immense pain. She can only be given mashed food, on which she survives.
Although Aruna is not very much aware of herself and her surrounding, she somehow recognizes the presence of people around her and expresses her like or dislike by making certain types of vocal sounds and by waving her hands in certain manners. She appears to be happy and smiles when she receives her favorite food items like fish and chicken soup. She accepts feed which she likes but may spit out food which she doesn’t like. She was able to take oral feeds till 16th September 2010, when she developed a febrile illness, probably malaria. After that, her oral intake reduced and a feeding tube (Ryle’s tube) was passed into her stomach via her nose. Since then she receives her major feeds by the Ryle’s tube, and is only occasionally able to accept the oral liquids. Malaria has taken a toll in her physical condition but she is gradually recuperating from it.
Occasionally, when there are many people in the room she makes vocal sounds indicating distress. She calms down when people move out of her room. She also seems to enjoy the devotional songs and music which is played in her room and it has calming effect on her.
In an annual ritual, each and every batch of nursing students is introduced to Aruna, and is told that “She was one of us”; “She was a very nice and efficient staff nurse but due to the mishap she is in this bed-ridden state”.
The entire nursing staff member and other staff members have a very compassionate attitude towards Aruna and they all very happily and willingly take care of her. They all are very proud of their achievement of taking such a good care of their bed-ridden colleague and feel very strongly that they want to continue to take care of her in the same manner till she succumbs naturally. They do not feel that Aruna is living a painful and miserable life.
In his submission to the Supreme Court, Dr. Sanjay Oak, Dean KEM Hospital, has said –
“It would be incorrect to say that Smt. Aruna Shanbaug is an appropriate case for Coma. It appears that for a crucial, critical period her brain was deprived of Oxygen supply and this has resulted in her present state similar to that of Cerebral Palsy in the newborn child. It is a condition where brain looses it’s coordinatory, sensory as well as motor functions and this includes loss of speech and perception. This has resulted into a state which in a layman’s words “Aruna lives in her own world for last 37 years”. She is lying in a bed in a single room for 33 years. She has not been able to stand or walk, nor have we attempted to do that of late because we fear that she is fragile and would break her bones if she falls. Her extremities and fingers have developed contractures and subsequent to non-use; there is wasting of her body muscles. Her eyes are open and she blinks frequently; however, these movements are not pertaining to a specific purpose or as a response to a question. At times she is quiet and at times she shouts or shrieks. However, I must say that her shouts and shrieks are completely oblivious to anybody’s presence in her room. It is not true that she shouts after seeing a man. I do not think Aruna can distinguish between a man and a woman, nor can she even distinguish between ordinate and inordinate object. We play devotional songs rendered by Sadguru Wamanrao Pai continuously in her room and she lies down on her bed listening to them. She expresses her displeasure by grimaces and shouts if the tape recorder is switched off. All these years she was never fed by tube and whenever a nurse used to take food to her lips, she used to swallow it. It is only since September 2010 she developed Malaria and her oral intake dropped. In order to take care of her calorie make need, nurses cadre resorted to naso-gastric tube feed and now she is used to NG feeding. However, if small morsels are held near her lips, Aruna accepts them gladly. It appears that she relishes fish and occasionally smiles when she is given non-vegetarian food. However, I am honest in admitting that her smiles are not purposeful and it would be improper to interpret them as a signal of gratification. I must put on record that in the world history of medicine there would not be another single case where such a person is cared and nurtured in bed for 33 long years and has not developed a single bed sore. This speaks of volumes of excellence of nursing care that KEM Nursing staff has given to her.”
The Supreme Court in its judgment has expressed its deep appreciation towards the KEM Hospital staff who has provided her an excellent nursing care for the last 37 years which included feeding her by mouth, bathing her and taking care of her toilet needs. The care was of such an exceptional nature that she has not developed a single bed-sore or fracture in spite of her bedridden state since 1973.