SILICONEER | VERDICT: Mercy Killing: Apex Court Sanction | APRIL 2011

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VERDICT:
Mercy Killing: Apex Court Sanction

Passive euthanasia is a practice of medically terminating the life of a very old or very sick person when the person is in a vegetative state over a very long period of time and is conducted after a careful medical review. In a landmark ruling, the Supreme Court of India now allows this practice but many argue about the misuse of passive euthanasia, writes Priyanka Bhardwaj.

Congress Party general secretary Rahul Gandhi

Aruna Shanbaug is 60 years old. She smiles and laughs and loves mangoes and fish. Her only problem is that she lies incapacitated for the last thirty-seven years at King Edward Medical (KEM) Memorial Hospital in Mumbai, India.

While on duty on the tragic night of November 27, 1973, a ward boy, Sohanlal Bartha Walmiki, sexually assaulted Aruna and choked her with a dog chain that left her cortically blind and reduced to a vegetative state.

Circa 1998, activist-journalist Pinki Virani’s “Aruna’s Story” heralded the debate over euthanasia and mercy killing garnering national and legal attention.

Soon after, Virani legally appealed for mercy killing of Aruna, claiming to speak on behalf of the woman and many others like her who remain unable to see or speak properly of their predicament. The call was for allowing an end to a life that is bereft of any iota of basic dignity.

Remarking on immensity of euthanasia or mercy killing an apex court judge said, “euthanasia is one of the most perplexing issues…we feel like a ship in an uncharted sea.”

Finally on March 7, 2011 Indian Supreme Court came up with its ruling.

For the first time in the annals of Indian legal history passive euthanasia or assisted mercy killing and under “exceptional circumstances” as well as in cases reviewed by a panel of doctors and experts was recognized.

However no legal sanction for Aruna’s life to be ended by any such means was categorically denied.
In fact, the court applauded the KEM nurses who with their zealous dedication have established an exemplary record in keeping Aruna healthily alive over so long a period.

Despite Aruna’s parents being dead for several years now and most of her family withdrawing their ties with her, the onerous responsibility has been shouldered by the KEM nurses.

KEM nurses were ecstatic with the verdict as Aruna would be ‘allowed to live.’

Tidi Makhwana, a former employee of KEM Hospital, said, “I stayed with her for many years. She should not die as she is not creating any problems for anyone.”

Such has been the love and support for Aruna that another care giver, Champa Mausi, at the occasion of her felicitation asked for a better bed be given to Aruna rather than issue a certificate for her efforts.

Commenting on Aruna’s condition, none other than the former dean of KEM Hospital Dr Pragna Pai notes, “Aruna is not in a coma…I used to go and talk to her and when you tell some story, she would start laughing or smiling or when you start singing some prayers or ‘shlokhas,’ she would look very quiet and peaceful, as if she is also joining the prayers.”

Loosely defined passive euthanasia means withdrawing medical treatment with deliberate intention of causing patient’s death.

Yet for the likes of Virani who had initialed the debate, the court’s verdict is certainly not enough.

Reacting to the verdict Virani said, “Aruna still does not, after more than 3½ decades, receive justice.”

Her stand point is shared by Dr. Surendra Dhelia, joint secretary of Society for the Right to Die With Dignity, a Mumbai-based civic group, who vehemently claims that “it will help others in a similar situation…in cases where it’s this bad, you’re not prolonging life, you’re prolonging agony and suffering.”

Attorney Shekhar Nafde, petitioning on behalf of Virani explained, “the request for mercy killing could not be construed as a plea for euthanasia…this is no human right…her life is worse than animal existence.”

The credibility accorded to sanctity of life and right to life as a whole can be directly inferred from the fact that Indian legal laws do not allow a person to die or even commit suicide.

Till recent times the idea to legalize euthanasia had been discarded on the premise that euthanasia involves intervention of a third person and that would indirectly amount to a person aiding killing of another which comes under purview of Section 306 of the Indian Penal Code.

However, ‘euthanasia,’ coming from Greek word ‘euthanatos’ (meaning ‘good death’), has been recurring in national discourse for want of public approval.

From time to time sporadic cases of passive euthanasia despite the absence of legal mandates in India have been reported by the media.

In 2002, an India Today report talked of the case of Neena Bonarji, an international bridge player, whose daughter Nisha Bhambani, took her mother off supplementary life support during the end stage. Bonerji was suffering from progressive lung disease for three years and Nisha claims that this was what her mother had wished for.

With this judgment, India is in the league of nations such as Albania, Belgium, Germany, Luxembourg, the Netherlands and Switzerland — and U.S. states of Oregon and Washington, that have passed similar rulings on euthanasia or with varying clauses.

But in the Indian context only a legislative passage will give the court ruling a legal status.

India’s law minister, Veerappa Moily said, “there is no question of concurring or not with the judgment. But in fact, the Supreme Court are right that without a law you cannot resort to this kind of a decision with a judicial order….the Right to Life is a right vested with a person…therefore, there is a need for a serious debate into the matter. It has to be examined,…such petitions cannot be used as ‘an instrument’ to kill somebody.”

The debate takes us to a point where the idea of mercy killing may appear morally justifiable, especially in brain-dead patients.

But the trepidation that the medical fraternity by and large feels is that the law, if passed could be flouted massively.

The central point of argument as forwarded by those against the concept of mercy killing is that it is never a one hundred percent foolproof scenario to predict life expectancy of a given individual.
A mistaken prognosis especially in the Indian context cannot be ruled out.

Bengaluru based cardiologist Devi Prasad Shetty said, “India is not mature enough to handle euthanasia...it will result in many more premature deaths and people trying to take advantage of euthanasia. Financial constraints and inability to look after cannot be the reason to ask someone to terminate life. This is unacceptable. I am concerned with the fact that our country does not have the infrastructure to prevent the misuse.”

Echoing the same sentiment, B.K. Goyal, chief cardiologist, Bombay Hospital said, “it is a very emotional subject. We call it mercy killing; but there cannot be mercy and then killing...we are still premature to accept active euthanasia and it may have very dangerous consequences.”

Opponents of mercy killing argue that in an era when medical and technological advancement have progressed to such high levels and pain alleviation has been achieved to high degrees, mercy killing should not be allowed.

The country needs more old age care and sympathy rather than the old and infirm being shown the door to death.

Just as the court ruling invites reactions and counter reactions, Aruna can be assured of all the love and care that KEM nurses have poured on her, well living to the ‘Nightingale Oath’ of the nursing profession. As for the other not so lucky ones, mercy of the care givers will be most required for them to escape from “mercy killing.”