Open Access Research Article
ARUNA RAMCHANDRA SHANBAUG VS. UNION OF INDIA- CASE ANALYSIS
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Article Details
ARUNA RAMCHANDRA SHANBAUG VS. UNION
OF INDIA- CASE ANALYSIS
AUTHORED
BY - KANAK SHARMA, BA.LLB, 3rd year,
IIMT College of Law, Gr. Noida (U.P.)
INTRODUCTION
The Constitution of India guarantees ‘Right to Life’
to all its citizens. The constant, ever-lasting debate on whether ‘Right to Die’ can also be read into this
provision still lingers in the air. On the other hand, with more and more emphasis
being laid on the informed
consent of the patients in the medical field, the concept of Euthanasia in India has received a mixed response.
The Hon’ble Supreme Court of India, in the present matter, was approached
under Article 32 of the Indian
Constitution to allow for the termination of the life of Aruna Ramchandra Shanbaug,
who was in a permanent
vegetative state. The petition was filed by Ms. Pinki Virani, claiming to be the next friend of the
petitioner. The Court in earlier cases has clearly denied the right to die and thus legally,
there was no fundamental right violation that would enable the petitioner to approach the court under
Article 32. Nonetheless, the Supreme Court taking cognizance of the gravity of the matter involved and the allied
public interest in deciding about the legality of euthanasia accepted
the petition.
FACTS OF THE CASE
Aruna
Ramchandra Shanbaug was a staff nurse employed in King Edward Memorial Hospital, located in Mumbai. One of the
sweepers of the hospital attacked her on 27th
November 1973. He choked and strangulated her via a dog chain in order
to restrain any movement from her end
in an attempt to rape her. Upon realizing that Ms. Aruna was menstruating he sodomized her. The very
next day, on 28th November 1973 Ms. Aruna was
found lying on the floor with blood everywhere and all over her. One of
the cleaners found her in an
unconscious condition. The strangulation via the dog chain ceased the supply of oxygen to her brain causing severe damage
to the cortex of the brain. She sustained brain stem contusion too along with cervical cord injury. A petition
for the case was filed under article
32 of the Indian Constitution by a friend of Ms. Aruna in the year 2009, after
as many as 36 years of the
incident. For so many years Ms. Shanbaug has been in a "Permanent Vegetative State". She has
become extremely feeble and infirm.
ISSUES RAISED
1.
Does
Article 21 of the Constitution include the right to die embedded within the right
to life?
2.
What
is the difference between passive euthanasia and active euthanasia?
3.
Can
individuals be allowed to give a “Living Will”, i.e. directives on medical treatment,
if they become incompetent or unable to communicate in the future?
4.
Should
the right to die and the right to die with dignity be studied comparatively?
PETITIONER’S ARGUMENTS
A petition was filed by Ms.
Shanbaug's friend under article 32 of the Indian Constitution. The counsel for
the petitioner contended that the right to life guaranteed under article 21
includes the right to life with utmost dignity. It must therefore also include the
right to die with dignity. Any individual suffering from any terminal illness
or is in a permanent vegetative state must be included under the ambit of the
"right to die" in order to end the prolonged suffering and agony. She
lacks any awareness of her surroundings, is even devoid of the ability to chew
her food, can't express anything on her own, and is just bedridden for the past
36 years with no scope of improvement. The patient is virtually dead and the
respondents by not feeding Ms. Shanbaug won't be killing her.
RESPONDENT’S ARGUMENTS
The dean of the Hospital contended
that Ms. Shanbaug was being fed and taken care of by the nurse and hospital staff for as many as 36 years. The staff
had exceptionally and with utmost responsibility and willingness to take care of her. Therefore, they oppose and resent the idea of Ms.
Shanbaug being euthanized. Now that the patient has crossed as many as 60 years
of age she might naturally succumb to death.
They begged the court to not permit
the act of killing. The staff has been diligently and with respect taking care of all her fundamental
necessities and prerequisites. On the off chance that this is legitimized, the act of euthanasia can be profoundly inclined to abuse.
One of the medical attendants has even been willing to take
care of her without being renumerated. The petitioner unlike the clinic staff neglects to have such a close-to-home
association with the patients and lacks the necessary emotional attachment.
Since the staff diligently and with
utmost dignity took care of Mrs. Shanbaug for many years. They
looked after her basic needs and requirements. Legalization of passive
euthanasia can be prone
to misuse by family members, relatives, etc. they pleaded with the court to
reject the allowance of practice of
euthanasia. The hospital staff has an emotional connection with the patient to the extent that one of the
nurses is ready to look after Mrs. Shanbaug for the rest of her life without being renumerated.
Terminating Ms. Shanbaug's life would
be immoral and inhuman since she has a right to live. Moreover, the hospital's staff's exceptional and selfless service
must also be taken into consideration.
Furthermore, since the patient herself is not in a condition to give consent
for withdrawal from the life support
system the next big question to come into the picture Is who would consent
for Ms. Shanbaug.
JUDGEMENT
The court in the Aruna Shanbaug Vs
Union of India case, distinguished between active and passive euthanasia. Active
euthanasia can be seen
as the positive and deliberate termination of one’s life by injecting and administering
lethal substances. It is considered to be a crime worldwide except permitted
by legislation. In India, active euthanasia is a straight
infringement of Section 302 and Section 304 of the IPC.
The
High Court, under
article 226, was entitled
to make decisions regarding the withdrawal of the life support system.
The apex court
enlisted a proper
procedure and guidelines for granting passive euthanasia in the “rarest of rare
circumstances” while rejecting the plea made by the petitioner. A bench was constituted by the Chief Justice of the High Court when an application was received, before which a committee of three reputed doctors
nominated was referred. A thorough
examination of the patient, state, and family members was conducted along with
a notice issued by the bench. Therefore, in support of the
“Parens Patriae” concept, the Supreme Court
entrusted the authority
to decide the end of a person’s
life in the High Court
in order to avoid any abuse.
As a result, in certain circumstances and with the High Court’s consent
after following the proper procedure, the Supreme Court permitted passive
euthanasia. However, Supreme
Court opined that passive euthanasia could be allowed in exceptional and rare cases with due approval from the
patient’s family members and doctors. Supreme Court held that it should be sparingly used and not become a tool for eroding Article
21 of the Indian
Constitution. Therefore, the court’s assessment of the medical report and the definition of brain death provided in the Transplantation of Human Organs Act, 1994, clearly explains that Ms. Aruna’s brain was not dead. Despite being in a Permanent Vegetative State, she had a stable state. She had sensations and could breathe without assistance. Therefore, ending her life was not warranted.
Constitution. Therefore, the court’s assessment of the medical report and the definition of brain death provided in the Transplantation of Human Organs Act, 1994, clearly explains that Ms. Aruna’s brain was not dead. Despite being in a Permanent Vegetative State, she had a stable state. She had sensations and could breathe without assistance. Therefore, ending her life was not warranted.
RATIO DECIDENDI
The
Supreme Court stated
the following reasoning for its judgment
in the Aruna Shanbaug Vs Union of India Case:
1.
It
is pretty implied that all over the world, active euthanasia has been stated as
illegal in the absence of any legislation permitting it. In contrast, even in
the absence of legislation, passive euthanasia has been stated as legal.
2.
The
report presented by the committee of doctors stated that Ms. Shanbaug’s brain
was then responsive to likes and dislikes, which she can express through small
gestures and sounds like smiling and blinking eyes. Therefore, she was responding
to the outside environment.
3.
The
potential threat of misuse of passive euthanasia cannot be ruled out, which holds
every chance of breaching Article 21 of the Constitution of India in the event
of low ethical standards prevailing in our society and with increasing corruption.
Therefore, there is a dire need for a balanced approach in such a sensitive issue,
which includes a person’s death and life
ANALYSIS OF THE CASE
Euthanasia,
defined as mercy killing, encompasses acts that painlessly end the lives of
those with incurable diseases or paralysis, including
withdrawal of treatment
or life support.
Specific guidelines from the High Court detail
the lawful procedure
for passive euthanasia, legalizing it in India under certain conditions. In the 2018 Common Cause v. Union of India
case, the Supreme Court
emphasized the right to die with dignity under Article 21 of the Constitution, supporting withdrawal of life support for terminally ill patients. Additionally, the case introduced the
concept of a "living will," allowing patients to express advance
consent for medical decisions in case of future
incapacity.
Right to Die v. Right to Die with Dignity
The Constitution expressly guarantees the right to life
under Article 21, but
the right to die has been
a subject of debate and isn't explicitly mentioned. However, courts have
interpreted it diversely. The Bombay High Court in State of
Maharashtra v. Maruti Sripati Dubal included the right to die under the right to life in Article 21 and
declared Section 309 of the IPC unconstitutional. Later, the Supreme Court in P. Rathinam v. Union of
India recognized the right not to live as part of the right to life under Article
21. But in Gian Kaur v. State of Punjab, the Supreme Court ruled against
including the right to die within the right to life. Instead, it acknowledged the right to die with
dignity, differentiating it from the right to die, particularly in cases of passive euthanasia for
patients in a Permanent Vegetative State or coma. This distinction is crucial, and recent legal developments have
legalized passive euthanasia to end the suffering of patients with
incurable conditions.
Medical
Ethics
The Supreme
Court addressed informed
consent and the right to bodily integrity, citing the US Nancy Cruzan case. Informed consent
entails full awareness of treatment options, recovery chances, and side effects. Failure to obtain informed consent
can lead to legal consequences for
the physician. In Aruna's case, since she couldn't provide consent, the
decision was based on beneficence,
acting in the patient's best interest. The court considered public interest and state concerns, wary of potential
misuse if euthanasia were legalized, and explored jurisprudence to establish safeguards.
Global Approach
Passive
euthanasia is generally legal worldwide without specific legislation, whereas
active euthanasia requires
legislation. Some countries, like the Netherlands,
regulate euthanasia with strict
criteria. Switzerland allows assisted
suicide under certain conditions, including for non- Swiss nationals and without physician involvement. In the USA, active euthanasia is illegal nationwide, but physician-assisted dying
is legal in certain states. Other countries have also legalized euthanasia,
while some, like Spain and the UK, do not support it.
Report of the Law Commission
The 196th Report issued by the Legislation Commission of India in 2006 recommended
the enactment of a law to protect
terminally ill individuals who refuse medical care, artificial feeding,
or hydration from Section 309 of the Indian
Penal Code. It also proposed
safeguarding clinicians who
respect a patient's decision or make decisions for incompetent patients in
their best interests from legal
action under Section 306 (abetting
suicide) or Section 299 (culpable homicide)
of the IPC. Additionally, the report emphasized the necessity for medical
actions to be deemed lawful under the proposed
legislation.
CONCLUSION
The Aruna Shanbaug v Union of India
case marked a turning point in India's legal landscape regarding euthanasia, triggering a national dialogue
on the moral, ethical, and legal dimensions of end-of-life care. The Supreme Court's ruling permitted
passive euthanasia under specific circumstances,
emphasizing the right to die with dignity. This decision prompted calls for comprehensive legislation on euthanasia
and heightened awareness of compassionate end-of- life choices. While the case provided a crucial framework, ongoing discussions reflect
the need for responsive legal and ethical
frameworks amid evolving societal attitudes and medical technologies. Overall, it underscores the importance of balancing respect
for life with individual autonomy,
shaping a society
that prioritizes the well-being and dignity of its citizens
until the end.
Article Information
ARUNA RAMCHANDRA SHANBAUG VS. UNION OF INDIA- CASE ANALYSIS
Authors: KANAK SHARMA
- Journal IJLRA
- ISSN 2582-6433
- Published 2024/05/10
- Issue 7
About Journal
International Journal for Legal Research and Analysis
- Abbreviation IJLRA
- ISSN 2582-6433
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