Tag: euthanasia

Aruna Ramchandra Shanbaug v Union of India

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Case Number

WP (Criminal No.) 115 of 2009

Equivalent Citation

AIR 2011 SC 1290, 2011 AIR SCW 1625

Petitioner

Aruna Ramchandra Shanbaug

Respondent

Union of India, State of Maharashtra, Dean- KEM Hospital Mumbai

Bench

Justice Markandey Katju, Justice Gyan Sudha Misra

Decided on

March 07, 2011

Relevant Act/Section

Article 21 of Constitution of India, Section 309, 306 of Indian Penal Code

Brief Facts and Procedural History

Aruna Ramchandra Shanbaug, the petitioner in this case, was a nurse at the King Edward Memorial Hospital in Parel, Mumbai. On the evening of November 27, 1973, a sweeper from the same hospital attacked her and used a dog chain to yank her back while wrapping it around her neck. Additionally, the sweeper attempted to rape her; however, when he discovered she was menstruating, he sodomized her instead. He tightened the chain around her neck in order to stop her from moving or causing any havoc. A cleaner discovered her body the following day, unconscious and covered in blood. It was thought that the chain’s strangulation caused the brain’s oxygen supply to stop, which led to brain damage. She entered a permanent vegetative state as a result of this incident, which permanently injured her brain (PVS). Later, journalist and activist Pinki Virani petitioned the Supreme Court under Article 32 of the Constitution, claiming there was no chance of her being resurrected and recovering. She ought to be released from her suffering and allowed to die through passive euthanasia.

The respondent parties, KEM Hospital, and Bombay Municipal Corporation submitted a counter-petition in response to this petition. The gaps between the two groups widened as a result. Due to the discrepancies, the Supreme Court appointed a group of three distinguished doctors to conduct an investigation and provide a report on the precise mental and physical state of Aruna Shanbaug. They thoroughly researched Aruna Shanbaug’s medical background and concluded that she is not brain dead. She responds differently depending on the situation. She favors fish soups and gentle religious music, for instance. If there are many people there, she feels uneasy and becomes upset. When there are fewer people around, she is at ease. The KEM Hospital personnel were adequately caring for her. She was constantly kept tidy. Additionally, they found no indication from Aruna’s body language that she was willing to end her life. Additionally, the KEM Hospital nursing team was more than happy to take care of her. Thus, the doctors opined that euthanasia in this matter is not necessary. She held this job for 42 years before passing away in 2015.

Issues before the Court

  1. Is it acceptable to remove a person’s life support systems and equipment if they are in a permanent vegetative state (PVS)?
  2. Should a patient’s preferences be honored if they have previously said that they do not want to undergo life-sustaining measures in the event of futile treatment or a PVS?
  3. Does a person’s family or next of kin have the right to request the withholding or removal of life-supporting measures if the individual has not made such a request already?

Decision of the Court

This decision was made on March 7, 2011, by the prestigious Supreme Court of India Division Bench, which also included Justices Markandey Katju and Gyan Sudha Mishra. The Transportation of Human Organs Act of 1994’s definition of brain death and the doctor’s report were both used by the court to rule that Aruna wasn’t brain dead. She didn’t need the assistance of a machine to breathe. She used to exhibit various signs and felt things. She was in a PVS, but she was still in stable condition. The justifications offered here are insufficient to end her life. It wouldn’t be acceptable. In addition, the court stated during its discussion of the matter that Pinki Virani would not be the next-of-kin in this particular situation, but rather the personnel of the KEM Hospital. Therefore, KEM Hospital has the authority to make any such choice on her behalf. In this instance, it was the food that she was relying on for survival. As a result, removing life-saving measures, in this case, would entail denying her sustenance, which is not permitted by Indian law in any way.

The Supreme Court recognized passive euthanasia under specific circumstances. The High Court would have to approve the decision to end a person’s life after following the proper procedure, the court decided, in order to prevent future abuse of this option.

When a request for passive euthanasia is made to the High Court, the Chief Justice of the High Court must convene a Bench of at least two justices to decide whether the request should be accepted or denied. Before rendering a decision, the Bench should take into account the advice of a panel of three reputable physicians. The Bench also proposes these physicians after consulting with the pertinent medical professionals. Along with appointing this committee, the court also has to notify the state, kin, family, and friends and provide them a copy of the committee of doctors’ report as soon as it is practical. After the court has heard from all parties, it should then issue its ruling. In India, this method must be followed up till relevant legislation is passed.

Aruna Shaunbaug was refused euthanasia in the end after taking into account all of the relevant facts of the case. The High Court further ruled that if the hospital staff ever feels the need for the same thing, they may petition the High Court in accordance with the established procedures. By giving a comprehensive framework of standards that must be fulfilled, the decision in this case has helped to clarify the concerns surrounding passive euthanasia in India. The court also suggested that Section 309 of the IPC be repealed. Every aspect of the case has been covered in detail. Now, let’s talk about the appearance of two crucial characteristics that emerged in this situation and have been addressed previously. The court also advocated for the abolition of IPC Section 309.

India is now among the nations that have legalized passive euthanasia. However, there are still flaws in the way passive euthanasia is carried out. It was a laborious process because it was mandated that every case obtain approval from the High Court after the Shanbaug case. Passive euthanasia is now more difficult to put into practice thanks to the new ruling, which calls for the execution of the directive in the presence of two witnesses, verification by a judicial magistrate, approval from two medical boards, and a jurisdictional collector. The fundamental goal of passive euthanasia is to terminate the suffering of the person in question, therefore this delay is a significant obstacle. On the other hand, if the process is made too liberal and simple, it is always open to serious abuse.

The Supreme Court established standards for passive euthanasia in the case of Aruna Shanbaug. These regulations allowed for the removal of a person’s life support system, which might ultimately result in death. Passive euthanasia is now legal in India under certain circumstances that will be ruled by the High Court. Later in 2018, the Supreme Court issued a new ruling in the case of Common Cause v. Union of India1, reinstating the right to a dignified death, legalizing passive euthanasia, and granting permission to remove life support from patients who are terminally ill and in a life-long coma. The Court also introduced the idea of “living wills” along with this. In these cases, the directions to be followed are-

  1. A Passive Euthanasia application must be pending with the relevant High Court. In any case, two appointed authorities must make up the Bench that the Chief Justice of the High Court appoints, and they will decide whether or not to approve the grant.
  2. The Bank must first consider the opinions of a three-person medical committee that it will select before making a decision. One of the three professionals should be an expert in the nerve system, while the other two should be specialists and therapists.
  3. When a person goes missing, the High Court Bench will notify the State and those closest to the missing individual, such as guardians, companions, siblings, and sisters.
  4. When it becomes available, the Court must send them a copy of the expert council report.
  5. After hearing from each gathering, the High Court’s seat must announce its decision.
  6. The Supreme Court must make a decision immediately. The court expressed its extreme gratitude to the KEM staff for their dedication over an extended period of time.

This case clarified the euthanasia-related concerns and established criteria for widespread euthanasia. In addition, the court recommended that Section 309 of the Indian Penal Code be repealed. The subject of passive euthanasia, which was previously hardly ever considered, started with this case. It significantly broadens the scope of Article 21 of our Constitution and explains the stance on the right to a dignified death. In the Indian context, this decision is hailed as progressive.

REFERENCES

  1. WP © 215/2005

This article is written by Sanskar Garg, a last year student of School of Law, Devi Ahilya University, Indore.

EUTHANASIA: PERSPECTIVE TO DEATH

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The article has been written by Nikhilesh Koundinya a student of Symbiosis Law School, Pune. In this article, he has spoken about the concept of euthanasia. Furthermore, he has discussed the decisions taken by the Indian judiciary with regards to this practice. He has gone onto to the law commission report and provides suggestions for the practice. He would like to thank Grishma Mahatme for her support on this article. 

INTRODUCTION 

Every human being has a right to live a desirous and happy healthy life until he dies. This is a fundamental right that is even guaranteed by the constitution in Article 21. But sometimes the person may not want to live the years granted to him/her and would want to end his life voluntarily. This way of ending life is considered to be unnatural and the person committing the act is termed as someone who has a mental problem or abnormality. There are two ways in which a person can end his/her life. One way is by killing oneself by committing acts which will lead to death eventually. There are many ways such as shooting yourself, hanging yourself or consuming substances which may cause death and many others. This action of a person is predominantly categorised as “suicide”. 

But there is another way by which a person can end his life which is requesting someone else to take his life. This under the law is categorised as “Euthanasia” or in layman’s term as “mercy killing”. The context of how India and other countries have dealt with this phenomenon will be addressed in the paper but first, we must observe the origins of this practice. 

The term euthanasia was derived from the Greek word “eu” and “Thanatos” which means “good death” or “easy death”. Euthanasia or mercy killing is an act of painlessly putting one’s life to death who is suffering from extreme pain and incurable disease by withholding treatment or withdrawing artificial life support measures. Euthanasia was first legalized in Holland, Netherlands in the year 2008.

According to the Black’s Law Dictionary (8th edition), euthanasia means the act or practise of killing or bringing about the death of a person who suffers from an incurable disease or condition, esp. a painful one, for reasons of mercy. 

The understanding of the definition provides us with the rationale of committing the act of euthanasia. The practice is limited to doctors taking their patient’s life when requested to avoid the irresistible pain and terminal illness. Therefore, the rationale is that a patient can be killed today rather than having ongoing pain for years to come. 

TYPES OF EUTHANASIA

  1. Active or Positive– In this kind of practice the person directs somebody else to take his life. This is essentially the patient making a request to be dead. Since the patient suffering makes the request for death from the doctor this is covered as active euthanasia as the patient plays an active role. 
  2. Passive or Negative- Passive euthanasia as a practice differs from active euthanasia as this process is affected by omission of a person to do something. So the doctor may not administer certain medicines he should have or will remove the support which he should have which will lead to the person’s death. Hence in this practice the result of death is not promulgated by the patient but due to the intentional omission on part of the doctor or any other person. 
  3. Voluntary– The most important term under this ambit would refer to willingness to die and consenting to die. This means that a person who is conscious and can make a decision states that he wants to be killed and this will classify as active euthanasia. 
  4. Involuntary– This kind of euthanasia may also amount to an offence under criminal law. If a doctor without taking consent of the patient who is fully conscious to take the decision kills him, it would classify as murder. But the offence would represent the concept of involuntary euthanasia. 
  5. Non-voluntary– If a patient is fully incapacitated and isn’t conscious enough to tell his wish and is undergoing a lot of pain, a close family member can make the call to relieve that person from the pain and provide for euthanasia to be performed and this will also classify as passive euthanasia as even in this case the doctors may remove the life support which would lead the person to die. 

There are various ways for performing the practice of euthanasia and the most popular ones are: –

  1. Lethal Injection– Injection of a lethal dose of a drug, such as a known poison, KCl, etc.
  2. Asphyxiation– The most popular gas used is Carbon monoxide (CO). Nerve gases like sarin & tabun etc. are also added in small amounts to fully ensure death.

EUTHANASIA IN INDIA

The practice of euthanasia was not recognised for a long time in the Indian scenario. But then the landmark judgement of the supreme court came about which was called “Aruna Shanbuag v Union of India”. The facts of the case are as follows: 

  1. The Aruna Shanbuag was a nurse in King Edward Memorial Hospital located in Mumbai in the Parel area. On 27th November 1973 when she was changing clothes in the basement a sweeper named Sohanlal tries to molest and sexually assault her but when he failed to do so he strangled her with a chain and sodomized. 
  2. The perpetrator was later tracked and was sentenced to jail but the case of rape was never filed due to the lack of police investigation. Thus, the mention of sexual assault and anal rape wasn’t presented in the court. 
  3. When the incident took place, the court observed that due to strangling of the neck with a metallic chain the oxygen to the body did not pass and thus she was left in a vegetative state ever since. After the incident she was taken to KEM hospital for treatment and was kept alive using a feeding tube. 
  4. Pinky Virani who was a social activist wanted to help her and thus instituted a case in the Supreme court to end the life of Aruna because she was in a vegetative state and this violated her fundamental right to live a life with dignity. The court rejected the petition as the court realised that the doctors and the staff working with Aruna did not want to take her life. Thus, the court while rejecting the petition allowed the practice of passive euthanasia in India. 
  5. Aruna died of pneumonia in 2015 being in a coma and vegetative state for the past 42 years. 
  6. The judgement was considered to be against the fundamental right under article 21 which is right to life and thus in a case in 2014 the court directed the decision of passive euthanasia to be reheard under a constitution bench. 
  7. The government in the same year on 23rd December 2014 the government stated that it agrees with the decision of the Supreme court with regards to passive euthanasia and because the guidelines have already been issued by the Supreme court they would be followed.

LEGAL ASPECTS OF EUTHANASIA IN INDIA

Euthanasia has not been completely legalized in the Indian subcontinent. Only the concept of passive euthanasia has found support from the court and from the law makers. There have been various decisions passed in relation to euthanasia under Indian law: 

  1. State of Maharashtra v Maruty Shripati Dubal– In this case, the main contention raised was the fact section 309 of the Indian Penal Code (IPC) is violative of articles 19 and 21 of the constitution. The court held that this section would be scrapped and held that there is nothing illegal in trying to end one’s life. In fact, when article 21 of the constitution gives a right to live it must also give a right to die. The court held that though it is abnormal to end one’s life yet it is not illegal to do it. 
  2. Gian Kaur v State of Punjab– In this case, the court held that a person who is terminally ill or is in a constant vegetative state is not being killed and nobody is infringing on his right to life whereas we are only accelerating the process of death so that the person doesn’t undergo untoward pain. 
  3. In the case of Airedale NHS Trust v Bland for the first time right to die was allowed in English law system where life support services were cut out for the patient. This case was a landmark case because it gave powers to the judiciary to decide what to do and when to allow passive euthanasia after judging and coming to a conclusion on the patient’s state. 
  4. In the case of Mckay v Bergsted the court for the patient and state interest removed the breathing system from the patient’s mouth. Thus, even in this case, the patient’s interest was taken into consideration. 

GUIDELINES REGARDING EUTHANASIA 

After the Aruna case there were several guidelines issued by the Supreme court in relation to what steps are to be followed to conduct the procedure of passive euthanasia:

  1. First of all, for the process of euthanasia to be administered the high court must allow the practice only after observing that the due procedure has been followed. 
  2. Whenever a petition is raised for the grant of passive euthanasia for a person who is terminally ill or in a vegetative state the chief justice of the high court will appoint two judges to loom into the matter presented before the court and then take a decision on whether to approve or disregard the petition. 
  3. Before arriving at the decision, the two-judge bench must consult with at least three doctors to know the exact repercussions of their decision and also the patient’s present state and the hope for recovery. In the meantime, a letter will also be issued to the close relatives of the patient and a copy of the doctor’s report will be made available to them as soon as the report is completed. On the basis of all this the high court will make a decision regarding the person’s request. 

LAW COMMISSION OF INDIA AND ITS RECOMMENDATIONS

The law commission of India had recommended few changes with regards to the law related to suicide where suicide should not be looked like an offence but it should rather be defined as a disease and required treatment should be provided to the concerned person. Furthermore, it had also recommended repealing section 309 of the Indian Penal Code, 1860.

Accordingly, keeping these factors in mind, the Law Commission of India in one of its report has laid down certain necessary guidelines which should be considered.

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