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Aruna Ramchandra Shanbaug v/s Union Of India

My Ultimate Aim Is To Make Euthanasia A Positive Experience.- Jack Kevorkian

Fundamental rights are essential for living a life of dignity and fulfilment. The Right to Life in Article 21 of the Indian Constitution is arguably the most significant Fundamental Right. It is a right that includes a myriad of other rights within its vast area, including the right to legal assistance and the right to a clean environment.

The issue that arose in the current case was whether or not this fundamental right includes the right to die, or if it is possible for someone to have control over their own demise and make the decision to end their life. The improvement in medical law and the potential for family members to abuse this privilege have made the right to die a crucial issue.

There is still ongoing discussion over whether this clause may be construed to include the "Right to Die." On the other hand, the idea of euthanasia in India has met with a variety of reactions as the medical sector places an increasing focus on patients' informed permission. The case continues by separating passive and active euthanasia.

Introduction
According to Article 32 of the Indian Constitution, the Hon'ble Supreme Court of India was consulted in this case to approve the death of Aruna Ramchandra Shanbaug, who was in a permanent vegetative condition. Ms. Pinki Virani, who identified herself as the petitioner's close friend, submitted the plea.

Since the Court has categorically rejected the right to die in prior judgments, there was no legal basis for the petitioner to file a lawsuit under Article 32 for a violation of a fundamental right. Nevertheless, the Supreme Court approved the petition after considering the seriousness of the issue at hand and the related public interest in determining whether euthanasia is lawful.

Background Of The Case
  1. Aruna Ramchandra Shanbaug, the petitioner in this case, was a nurse at King Edward Memorial Hospital in Parel, Mumbai. On the evening of November 27, 1973, a hospital sweeper assaulted her and used a dog chain to yank her back while around her neck. The sweeper attempted to rape her as well, but when he saw she was menstruation, he anally raped her instead. He tightened the chain around her neck in order to stop her from moving or causing any havoc.
     
  2. The following morning, a cleaner discovered her lifeless corpse covered in blood on the floor. Thirty-Six years have passed since the aforementioned occurrence. She was unable to move her hands or legs and had been living on mashed food. It was said that there was no chance for her health to get any better and that she was totally reliant on KEM Hospital in Mumbai.
     
  3. Later, journalist and activist Pinki Virani petitioned the Supreme Court under Article 32 of the constitution, claiming there was little chance of her reviving and recovering. The Respondents were prayed for to cease feeding Aruna and allow her to pass away peacefully. The petition asks the respondent to cease feeding Aruna and allow her to pass away quietly[2].

Issues Raised
  1. Is it acceptable to remove a person's life support systems and equipment if they are in a persistent vegetative state (PVS)?
  2. Should a patient's preferences be honoured 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 seek the withholding or removal of life-supporting measures if the individual has not made such a request already?

Results Of The Doctors Appointed By The Court
Aruna Shanbaug's medical history was thoroughly examined by doctors, who concluded that she is not brain dead. She responds differently depending on the scenario. She favours fish soups and gentle religious music, for instance.

If there are many people there, she feels uneasy and becomes upset. When there are less people around, she is at ease. The KEM Hospital personnel was 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.

In-Depth Analysis
The court defined euthanasia so that it might decide on the aforementioned problems. There are two forms of euthanasia, or mercy killing: active and passive. In active euthanasia, a person is killed by deadly means, such as a fatal injection given to a cancer patient who is in excruciating pain.

Withholding life-sustaining medical care, such as withholding antibiotics when a patient would die without them, or withdrawing a patient's heart and lung machine from a coma, constitutes passive euthanasia.
  1. Right To Die.
    1. All of its people have a right to life, according to our constitution and laws. When it comes to the right to life, there are no questions since it is an unquestionable right protected by Article 21 of the constitution.
       
    2. But anytime we discuss the right to die, there are always questions that come up since our legislators have never agreed on the subject. It was construed differently by the courts in several judgements, and they based their conclusions on that.
       
    3. The legality of Section 306 of the IPC, which punished aiding in suicide, was contested in the case of Gian Kaur v. State of Punjab[3]. In this case, P. Rathinam was overturned, but the court stated that a patient who is terminally sick or who is in the PVS has the right to die, not by ending their life prematurely, but by quickening the process of death that has already started[4].
       
    4. Furthermore, it was argued that in order for someone to die with dignity as opposed to continuing to suffer bodily and emotional anguish they must also have the right to live with dignity[5].
       
    5. In the case of State of Maharashtra v. Maruti Sripati Dubal[6], the Bombay High Court ruled that Article 21's right to life also includes the right to die. It was argued that as Section 309 of the Indian Penal Code (attempt to commit suicide) violates Article 21 of the Constitution, it is thus illegal.
       
    6. In this ruling, the court made it very clear that the right to die is only unusual, not against nature. In P. Rathinam v. Union of India[7], the Supreme Court subsequently acknowledged that Article 21 of our Constitution's Right to Life also encompasses the Right Not to Live.
       
  2. Right To Euthanasia
    1. As we all know, euthanasia, sometimes known as mercy killing, is the act or practise of putting to death without suffering those who have a physically debilitating illness or agonising, incurable condition, or allowing them to pass away by withholding treatment or removing artificial life support.

      What Is Euthanasia?
      1. It can be of two types Active or Passive. Active Euthanasia is the use of some hazardous substance or lethal methods to kill a person. Passive Euthanasia is stopping some medical treatment in the absence of which a person is likely to die. The passive euthanasia can be both voluntary and involuntary.
         
      2. When the consent from a patient is taken it becomes voluntary and in cases when a patient is not in a condition to provide consent and the decision on his/her behalf is taken by some other person, then it is involuntary.
      Report of the Law Commission on Euthanasia:
      1. The Legislation Commission of India issued its 196th Report in 2006[8], which made the recommendation that a law be passed to shield terminally ill individuals from Section 309 of the Indian Penal Code if they refuse medical care, artificial feeding, or hydration.
         
      2. Additionally, clinicians who follow a patient's decision or make decisions for incompetent patients in their best interests shall be shielded from legal action under Section 306 of the IPC (abetting suicide) or Section 299 of the IPC (culpable homicide). Additionally, any medical actions must be deemed "lawful."
      Untouched Evidences In Court
      1. Aruna Shanbaug was raped that evening at the hospital after changing into her civilian attire in an empty operating room, but the police records and FIR include no mention of rape anywhere, which is something that most people are also unaware of. After a "finger test," Shanbaug's medical examination attested that her virginity was still intact, but the court never considered the fact that she had been sodomised.
         
      2. The accused was never accused of rape, despite the fact that the verdict said that "the accused had gone there with the purpose to rape." Because he had taken her watch and earrings, he was found guilty of both robbery and attempted murder[9].

The Judgement
"I'm not afraid of being dead. I'm just afraid of what you might have to go through to get there."- Pamela Bone
  1. This landmark decision was issued on March 7, 2011, by the Supreme Court of India's First Division Bench, which was made up of Justices Markandey Katju and Gyan Sudha Mishra. According to the court's assessment of the medical report and the Transplantation of Human Organs Act, 1994's definition of brain death, Aruna was not brain dead
  2. She had sensations, could breathe without assistance, and provided the stimuli that was required. Despite being in a PVS, she had a stable state. Therefore, ending her life was not warranted.
     
  3. In the final decision, the Bench acknowledged that active euthanasia, which involves taking deliberate steps to bring about death, such as giving a fatal injection, was certainly going too far.
     
  4. "We cannot rule out the possibility that unscrupulous persons with the assistance of some unscrupulous doctors may fabricate material to show that it is a terminal case with no chance of recovery," the authors write, citing "the low ethical levels prevailing in our society today and the rampant commercialization and corruption."
     
  5. Furthermore, in support of the parens patriae concept, the 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.
     
  6. Immediately after receiving a request for passive euthanasia, the Chief Justice of the High Court should appoint a bench of at least two judges who will determine whether to approve the request or not. Prior to doing so, the Bench shall confer with any appropriate medical authorities or practitioners and appoint a committee of three reputable physicians, who will be chosen by the Bench.
     
  7. This case established criteria for passive euthanasia and highlighted the difficulties surrounding euthanasia. In addition, the court recommended that Section 309 of the Indian Penal Code be repealed. This case is significant because it established the protocol to be followed in a field where no laws have been established.

Conclusion
The patient decides when it's best to go.- Jack Kevorkian

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 of the right to a dignified death. A ruling that, in the context of India, we can categorically label as progressive.

End-Notes:
  1. (2011) 4 SCC 454
  2. K D Gaur, Textbook on Indian Penal Code, 749
  3. (1996) 2 SCC 648.
  4. Supra Note 3, 25.
  5. Vikram Deo Singh Tomar v. State of Bihar,1988 (Supp) SCC 734.
  6. 1987 (1) Bom CR
  7. 1994 SCC (3) 3944. (1996) 2 SCC 648
  8. Law Commission of India, 196th report on medical treatment to terminally ill patients (protection of patients and medical practitioners) (March, 2006), http://lawcommissionofindia.nic.in/reports/rep196.pdf
  9. Sandip Roy The rapist who never was: Let's not forget the man who destroyed Aruna Shanbaug's life, firstpost.

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