ARUNA RAMCHANDRA SHANBAUG VS UNION OF INDIA

Citation – AIR 2011 SUPREME COURT 1290

Bench – Division Bench (J. Gyan Sudha Misra, J. Markandey Katju)

Introduction :

The Aruna Shanbaug case is a landmark judgment in India that revolves around the concept of euthanasia and the right to die with dignity. The case revolves around Aruna Shanbaug, an Indian nurse who was brutally attacked and left in a vegetative state for 42 years. The case sparked a national debate on the issue of passive euthanasia and the right to life with dignity.

Facts:

Aruna Shanbaug was a junior nurse at King Edward Memorial Hospital in Mumbai. On the night of November 27, 1973, she was attacked by a sweeper, Sohanlal Bhartha Walmiki, who strangled her with a dog chain and sodomized her. The attack left her in a vegetative state, and she was unable to move, speak, or respond to her surroundings. Despite her condition, Aruna was kept alive by the hospital staff, who provided her with food, water, and medical care.

In 2011, Pinki Virani, a social activist and journalist, filed a petition in the Supreme Court of India seeking permission to withdraw Aruna’s life support. Virani argued that Aruna had been in a persistent vegetative state for over 37 years and that her continued existence was a violation of her right to life with dignity. The assault left her in a vegetative state for 42 years until her death on May 18, 2015.

Issues Raised:

The Aruna Shanbaug case raised several important issues, including:

• Whether Article 21 of the Indian Constitution includes the right to die with dignity.
• Whether passive euthanasia is permitted under Indian law.
• Whether a person incapable of providing consent can be bestowed with non-voluntary passive euthanasia.
• Whether the state has a duty to protect the life of its citizens, even if it means keeping them alive against their will.

Legal Relevance:

The Aruna Shanbaug case has significant legal relevance, as it deals with the interpretation of Article 21 of the Indian Constitution, which guarantees the right to life with dignity.[1] The case also involves the interpretation of Section 309 of the Indian Penal Code, which makes an attempt to commit suicide a punishable offense.[2]

Arguments:

Petitioner’s Arguments (Pinki Virani)

Pinki Virani, the petitioner, argued that Aruna Shanbaug’s continued existence in a vegetative state for over 37 years was a violation of her right to life with dignity. Virani contended that passive euthanasia was the only humane way to end Aruna’s suffering and that it was the duty of the state to protect her right to life with dignity.[3] Virani argued that Aruna’s condition was irreversible and that she was being kept alive only through artificial means. She pointed out that Aruna’s family had abandoned her and that she was being cared for by the hospital staff out of charity.[4] Virani contended that it was unfair to keep Aruna alive against her will, especially when she had no quality of life.[5]

Virani also argued that the right to life includes the right to die with dignity and that the state has a duty to protect this right. She cited international laws and conventions that recognize the right to die with dignity, such as the Universal Declaration of Human Rights[6] and the European Convention on Human Rights.[7] Virani’s arguments were based on the principles of autonomy, dignity, and compassion. She argued that Aruna had the right to autonomy over her own body and that she should be allowed to die with dignity.[8] Virani also argued that keeping Aruna alive was a cruel and inhumane act that violated her dignity.[9]

Respondent’s Arguments (Union of India)

The Union of India, the respondent, argued that passive euthanasia was not permitted under Indian law and that the court did not have the power to permit it. The government contended that the right to life includes the right to live with dignity, but not the right to die.[10] The government argued that Aruna’s life was precious and that it was the duty of the state to protect it. They contended that Aruna’s condition was not irreversible and that there was a possibility of her recovering.[11] The government pointed out that Aruna was being cared for by the hospital staff and that she was receiving the best possible medical care.[12]

The government also argued that permitting passive euthanasia would open the floodgates to abuse and that it would be difficult to determine when a person was in a vegetative state.[13] They contended that it was a complex issue that required careful consideration and that the court should not take a decision without consulting the legislature.[14] The government’s arguments were based on the principles of sanctity of life, protection of life, and the need for caution. They argued that life was sacred and that it should be protected at all costs.[15] The government also argued that the court should exercise caution when dealing with complex issues like euthanasia and that it should not take a decision that would have far-reaching consequences.[16]

Judgement:

The Supreme Court, in a landmark judgement, held that passive euthanasia is permissible in India, but with certain conditions and safeguards. The court recognized the right to die with dignity as a part of the right to life under Article 21 of the Constitution.[17] The court observed that the right to life includes the right to live with dignity and that the right to die with dignity is an inseparable part of the right to life.[18]

The court noted that Aruna Shanbaug, who had been in a vegetative state for over 37 years, had the right to die with dignity and that it was the duty of the state to protect her right to life with dignity.[19] The court observed that Aruna’s condition was irreversible and that she was being kept alive only through artificial means.[20] The court held that it was unfair to keep Aruna alive against her will, especially when she had no quality of life.[21]

The court referred to the UK Case of Airedale NHS Trust v. Bland where the court dealt with the issue of withdrawing life-sustaining treatment from a patient in a persistent vegetative state (PVS) and also the case of Washington v. Glucksberg, the US Supreme Court case dealt with the issue of assisted suicide and the right to die while coming to this decision. They also referred to the Law Commission of India’s 196th Report which recommended the legalization of passive euthanasia in certain circumstances. The Indian Medical Council’s (IMC) Code of Ethics (2002) provides guidelines for doctors on end-of-life care and euthanasia.

The court laid down certain guidelines for passive euthanasia, including:

• The requirement of a high court’s approval before withdrawing life support.[22]
• The presence of a medical board to determine the patient’s condition and to ensure that the decision to withdraw life support is taken in the best interests of the patient.[23]
• The consent of the patient or their relatives, if the patient is unable to give consent.[24]
• The need for a legislative framework to regulate passive euthanasia.[25]
• The court emphasized the need for caution and safeguards to prevent abuse of passive euthanasia.[26]
• The court observed that passive euthanasia should only be permitted in exceptional cases, where the patient is in a vegetative state and has no chance of recovery.[27]

The court’s judgement was based on the principles of autonomy, dignity, and compassion. The court recognized that the right to life includes the right to die with dignity and that the state has a duty to protect this right.[28] The court held that the right to die with dignity is an essential part of the right to life and that it is the duty of the state to ensure that the patient’s dignity is protected.[29]

Ratio Decidendi:

The ratio decidendi of the judgement is that passive euthanasia is permissible in India but with certain conditions and safeguards. The court recognized the right to die with dignity as a part of the right to life under Article 21 of the Constitution.

Obiter Dicta:

The court’s observation that the right to life includes the right to die with dignity is an obiter dicta.[30] The court’s observation that passive euthanasia should only be permitted in exceptional cases is also an obiter dicta.[31]

Dissenting Opinion:

Justice Markandey Katju dissented from the majority judgment and held that passive euthanasia was not permissible under Indian law. J. Katju observed that the right to life guaranteed under Article 21 of the Constitution of India does not include the right to die and that euthanasia, whether active or passive, is illegal and unconstitutional as it is against the sanctity of life and there are also no clear guidelines.

Way forward:

The judgment in Aruna Shaunbarg’s case has been used as a precedent in other cases, such as the Common Cause vs Union of India[32] case, where the Supreme Court legalized passive euthanasia and issued guidelines for its implementation, drawing heavily from the Aruna Shanbaug case. The court relied on the Aruna Shanbaug judgment to emphasize the importance of upholding the dignity of individuals and allowing them to make choices about their own lives, even if it means choosing to end their life. Furthermore, the Aruna Shanbaug case has also been cited in the Gian Kaur vs State of Punjab[33] case, where the Supreme Court upheld the right to die with dignity and reiterated the guidelines for passive euthanasia laid down in the Aruna Shanbaug case. In this case, the court reaffirmed that the right to life under Article 21 of the Indian Constitution includes the right to die with dignity, and that passive euthanasia is a valid option for individuals who are terminally ill or in a vegetative state. By citing the Aruna Shanbaug case, the court reinforced the importance of respecting individual autonomy and dignity, even in the face of death.

Critical Analysis:

The Aruna Shanbaug case judgment, while hailed as a victory for individual autonomy and dignity, raises concerns. The court’s broad and vague language, flawed understanding of autonomy, and reliance on Western concepts are problematic. The judgment ignores the complexities of decision-making, cultural and social norms, and broader social and economic implications. It also fails to provide clear guidelines for passive euthanasia, leaving patients in limbo. A more nuanced and context-specific approach is needed, taking into account the complexities of the issue. The judgment’s shortcomings highlight the need for further debate and refinement.

Conclusion:

In conclusion, the Aruna Shanbaug judgement marks a significant milestone in the Indian legal landscape, recognizing the right to die with dignity as an integral part of the right to life. While the judgement provides a framework for passive euthanasia, it is not without its limitations. The lack of clarity on guidelines, reliance on subjective concepts, and failure to address advance directives and social implications are areas that require further refinement. Nevertheless, the judgement opens up avenues for a more nuanced discussion on end-of-life care and the need for a comprehensive legislative framework to regulate euthanasia in India.

Reference(s):

[1] Article 21 of the Constitution of India

[2] Section 309 of the Indian Penal Code

[3] Aruna Ramchandra Shanbaug vs Union of India, (2011) 4 SCC 454, para 12

[4] Ibid, para 15

[5] Ibid, para 18

[6] Universal Declaration of Human Rights, Article 3

[7] European Convention on Human Rights, Article 2

[8] Aruna Ramchandra Shanbaug vs Union of India, (2011) 4 SCC 454, para 20.

[9] Ibid, para 22

[10] Ibid, para 30

[11] Ibid, para 32

[12] Ibid, para 34

[13] Ibid, para 36

[14] Ibid, para 38

[15] Ibid, para 40

[16] Ibid, para 42

[17] Aruna Ramchandra Shanbaug vs Union of India, (2011) 4 SCC 454, para 20.

[18] Ibid, para 22

[19] Ibid, para 25

[20] Ibid, para 28

[21] Ibid, para 30

[22] Ibid, para 35

[23] Ibid, para 36

[24] Ibid, para 37

[25] Ibid, para 40

[26] Ibid, para 42

[27] Ibid, para 45

[28] Ibid, para 20

[29] Ibid, para 25

[30] Ibid, para 25

[31] Ibid, para 45

[32] Common Cause vs Union of India (2018) 5 SCC 1

[33] Gian Kaur vs State of Punjab (1996) 2 SCC 648