Case Summary: Aruna Ramchandra Shanbaug v. The Union of India & Ors

1. Case Title : Aruna Ramchandra Shanbaug v. The Union of India & Ors.
2. Case Citation : (2011) 4 SCC 454
3. Court : Supreme Court of India (Constitution Bench)
4. Bench : Justice Markandey Katju and Justice Gyan Sudha Mishra
5. Date of Judgment : 7 March 2011
6. Relevant Statutes/Key Provisions: Article 21 & 32 of the Constitution of India, Sections 302, 304, 306, 309 of IPC, Section 482 of CrPC
7. Parties to the Case :

• Appellant: Aruna Ramchandra Shanbaug
• Respondent: The Union of India, State of Maharashtra,  Dean – King Edward Memorial Hospital

Introduction

Aruna Ramchandra Shanbaug v. The Union of India & Ors is a landmark case in the history of  India. This case led to the debate between the right to live and the right to die. Aruna faced a brutal assault in 1973 and was left in a persistent vegetative state. She remained in the same condition for 36 years. After that, Pinki Virani, an activist, filed a writ Petition under Article 32 of the Indian Constitution. The Supreme Court addressed whether the right to life under Article 21 also encompasses the right to die with dignity. In its judgment, the Court declared that active euthanasia remains illegal, but passive euthanasia shall be considered legal under strict safeguards.  It also stated that any such act of passive euthanasia will require the approval of the High Court, a medical board assessment, also the patient’s interest shall be taken into consideration. Even though the ruling did not allow Aruna to end her life, but laid the foundation for recognizing the right to die with dignity as part of Article 21. This judgment became a landmark precedent in the history of India and marked the way for later developments, including the 2018 Common Cause case.

Brief Facts

Aruna Ramchandra Shanbaug , the petitioner in this case was employed as a nurse in the King Edward Memorial (KEM) Hospital, Mumbai. On 27th November 1973, sweeper of the same hospital attacked the petitioner. He strangled her with a dog chain and attempted to rape her but later when he found she is menstruating , he ended up sodomising her. During the assault, the dog chain strangled on the neck of victim had cut off the oxygen supply to her brain , this resulted in severe and permanent brain damage. After the medical examination, doctors revealed extensive injury to her cortex, brain stem, and cervical cord, leaving her blind, deaf, and completely paralyzed. 

Aruna was completely dependent on others for her survival. She was unable to interact with the environment and had no awareness of her surroundings. No signs of improvement was seen in her health conditions, despite of the continuous care by the hospital staffs. After 36 years, activist and writer Pinki Virani, claiming to be Aruna’s “next friend,” filed a petition under Article 32 of the Constitution before the Supreme Court of India. The petition requested to withdraw Aruna’s life-support system, arguing that it was inhumane to prolong her suffering and that she should be allowed to die with dignity.

Before getting into conclusion, the Supreme Court, appointed a special medical board of three eminent doctors to conduct a thorough examination of Aruna’s condition and submit a detailed report to the court for further adjudication. This set the stage for a landmark judgment on euthanasia in India.

Issues raised 

The following issues were raised in the petition, 

1. Whether it is lawful and permissible to withdraw life support from a person who is in a permanent vegetative state?
2. Whether the willingness to live of such a patient be respected in such cases?
3. Does the family or next of kin of the patient have the right to request the withdrawal of life-supporting systems in case the patient cannot decide the same for himself?

Arguments 

• Arguments of Petitioner : 

Petitioner argued that as per the Supreme Courts judgement in Vikram Deo Singh Tomar v State of Bihar (1988) every individual has a right to live a life of quality consistent with human personality ensuring a dignified existence. And forcing a person to live in a condition devoid of awareness or autonomy is against the spirit of Article 21.

Further the petitioner relied on Gian Kaur v. State of Punjab (1996), where the court in it’s judgement stated that the right to life could include the right to die with dignity, particularly in the context of terminal illness and irreversible conditions. Applying this principle, the counsel highlighted Aruna’s state of being bedridden for over 35 years, unable to eat, speak, or perform any human functions. Thus, the petitioner argued that individuals should have a right to die with dignity in order to end their prolonged suffering where there is no scope for improvement. As doctors had declared her condition was irreversible and she was virtually dead, withdrawal of life supporting medical treatments won’t amount to killing her rather it would end her sufferings and provide her  with dignified and respectful death.

• Arguments of Respondent :

The respondent strongly opposed granting euthanasia to Aruna Shanbaug. The nurses and staff of the hospital has devotedly worked for her well being for over 35 years despite of her vegetative state. The respondents argued that since Aruna was over 60 years old now, she was likely to pass away naturally without medical intervention, making euthanasia unnecessary. They further stressed that allowing euthanasia would undermine the tireless efforts of the hospital staffs who had been committed to continuing her care with dedication and compassion. 

Further, the counsel expressed concerns about the broader social implications of legalizing euthanasia in India. India is a country of values, we have a deep rooted society which believes in compassion and caregiving, permitting euthanasia will lead to misuse and abuse setting it to be the most dangerous precedent. They concluded by saying that permitting euthanasia would contradict India’s deeply ingrained ethical and cultural respect for preserving life.

Judgement 

The Supreme Court of India, in Aruna Ramchandra Shanbaug v. Union of India & Others (2011), delivered a landmark judgment on the use of euthanasia. The Division Bench including Justice Markandey Katju and Justice Gyan Sudha Mishra in their judgement stated that there is no statutory provision in India for withdrawing life support from patients in a permanent vegetative state or unable to make such decisions themselves. The Supreme Court agreed with the contentions put forth by the petitioner and held that passive euthanasia could be permitted under exceptional circumstances, subject to strict safeguards.

The Court ruled that such decisions could be made by the patient’s parents, spouse, or close relatives. In their absence, a “next friend” or the attending doctors could decide in the best interest of the patient but approval from the High Court of the concerned state was mandatory. There were certain requirements made in order to prevent the misuse of euthanasia by unscrupulous individuals seeking property or assets of the patient. The Court relied on the principle of parens patriae, in which the State has a duty to protect the individuals who are unable to care for themselves.

In the Aruna Shanbaug’s case, the Court noted that her parents were deceased and her relatives had not visited her since the assault. She had been in the exceptional care of KEM Hospital staff for decades. The Supreme Court relied on the report of doctors appointed by court to examine Aruna , it stated that she was not “brain dead” as per the Transplantation of Human Organs Act, 1994, ”because she breathed without machines and responded to stimuli. Although in a permanent vegetative state, she was medically stable. Terminating her life, therefore, would be an infringement of her fundamental right to life.

Hence, the Court denied euthanasia to Aruna Shanbaug, but it established guidelines for use of passive euthanasia. It stated that applications must be made under Article 226 before the High Court, which would appoint a Bench of at least two judges, seek medical board opinion, and issue notices to relatives or next friends before deciding. Court also stated that if anytime in future, the staff of the KEM hospital felt a need to use euthanasia to Aruna, then they can approach the high court and follow the prescribed procedure. Thus, the judgment laid the foundation for passive euthanasia in India, while protecting Aruna’s right to life.

Ratio Decindi 

• Passive Euthanasia is permitted in India till parliament enacts any legislation on this issue but only after following all the prescribed guidelines and under strict safeguards.
• Active euthanasia is still considered illegal and it’s practice will lead to severe punishments under the Indian Penal Code.
• Decisions regarding withdrawal of life support must receive a prior approval from the High Court under Article 226 and the application should be made by close relatives, or in their absence, by the “next friend” or doctors.
• The High Court must constitute a bench of two judges. A committee of three reputed doctors should be made who can examine the patient and provide their opinion to the matter. The court must issue notice to the relatives, next friends, or any other concerned authority.

All these guidelines will hold the effect until Parliament makes a law on euthanasia.

Obiter Dicta 

• The Court insisted on having broader discussions on use of euthanasia practice within the Indian society. It also emphasized on securing the society’s cultural and social values of caregiving.
• The court observed that the definition of death has been evolving since the past decades. Now it includes brain function and not just cardiopulmonary activity, it can be seen in the Transplantation of Human Organs Act, 1994.
• It discussed the parens patriae doctrine, which observed  that the State has a duty to protect citizens unable to care for themselves.
• The Court noted the KEM Hospital staff provides dedicated care to the patient as a model of compassion, which influenced its decision to deny euthanasia in Aruna’s specific case.
• Legislation by Parliament is the most suitable way to comprehensively regulate this matter. It will create a balance between securing society’s values and the patients right to die.

Final Decision

In this case , the court dismissed Pinki Virani’s petition and held that Aruna Shanbaug will be continue to be cared for by the KEM Hospital. The court recognized the use of passive euthanasia only under certain circumstances and strictly adhering to the guidelines, making it a landmark case in the India’s euthanasia jurisprudence.

References

1.  ‘Articles – Manupatra’ (articles.manupatra.com) <https://articles.manupatra.com/article-details/Case-analysis-of-Aruna-Ramchandra-Shanbaug-vs-Union-of>
2. Garg R, ‘Aruna Ramchandra Shanbaug vs. Union of India & Others (2011) – IPleaders’ (iPleaders13 September 2024) <https://blog.ipleaders.in/aruna-ramchandra-shanbaug-vs-union-of-india-others-2011/>