Feb 27, 2011
When life is woe,
And hope is dumb,
The World says, “Go!”
The Grave says, “Come!”
- Arthur Guiterman.
Life, which all creatures love and strive to keep
Wonderful, dear and pleasant unto each,
Even to the meanest; yea, a boon to all.
- Edwin Arnold.
The conflict between pro-life and pro-death as also the quality (or lack of it) of life are starkly brought out in the case of Aruna who has been in a state of living dead for the last 37 years. Now the judgment time has come with the Supreme Court of India set to resume final hearing of a case, filed in December 2009, on March 2, 2011. But, first the background facts.
As Anuradha Raman notes in a moving article, aptly titled Comma, Period? in Outlook (28-2-11), in a room strictly off bounds for all except those attending on her, Aruna Ramachandra Shanbaug, now 60, lies alone. Her eyes are open and staring vacantly into space. She has been lying in this vegetative way, in the twilight zone between life and death, since the night of November 27, 1973, when she was attacked by a ward boy who tied a dog chain around her neck, cutting off air supply to parts of her brain, and sodomised her in the basement of Mumbai’s sprawling King Edward Memorial (KEM) Hospital, Parel, where she worked as a nurse. It is said that due to strangulation by the chain, the cortex was damaged and she also had brain stem contusion injury associated with cervical cord injury. Aruna is unable to speak, see, walk or even move voluntarily, though she could still feel the pain. She has been lying in this state with twisted form, rotting teeth and nails growing into her clenched palms, kept alive by mashed food which she automatically swallows.
The Supreme Court admitted Aruna’s petition through her ‘next friend’, Pinki Virani, the journalist-activist, who first brought Aruna’s cruel fate to light through a book on her and has since kept her in the public domain. Her petition in the Supreme Court, being heard by a Bench comprising Justices Markandey Katju and Gyan Sudha Misra, argues that since Aruna had consistently been denied the right guaranteed in Article 21, she asked the Court to define ‘life with dignity’ and that her face-feeding to be stopped. Her petition highlights Aruna’s “persistent vegetative state” for the last 37 years and states that there is no possibility of improvement in her condition. It points out that she “lives in sub-human conditions” and is “lying in a hospital bed like a dead animal”. It goes on to argue that to keep her in this state by feeding her “violates the right to live with dignity” guaranteed by Article 21 of the Constitution. The petition also says that there is no up- to- date medical records of her condition and that no scans have been done to ascertain what medicines can be administered to make her comfortable.
When the Court asked KEM Hospital, its Dean, Sanjay Oak, brazenly responded with some PR-type insensitive statement claiming that Aruna ‘accepted food in the normal course’ and is ‘led’ to the toilet by nurses when she makes indicative sounds. He said: “It is our foremost duty to take care of her. The way she has been taken care of also speaks volumes about the nursing at the hospital. She is really precious. Unless the ailing person himself or herself expresses such a desire, who are we to decide that he or she should no longer live?” KEM has issued a factual affidavit stating, among other things, that Aruna is ‘haemodynamically stable’, ‘her blood pressure, pulse rate are normal’ and that she is in the hospital care because her relatives refused to look after her.
It is at this stage that the Supreme Court, in January 2011, appointed a three-member medical team comprising Dr. JV Divatia, Dr. Roop Gurshani and Dr. Nilesh Shah with direction to examine the patient and submit a report. The team submitted its report, along with a CD, on February 17. On perusing these, the Bench said: “We have noted that there are many technical terms which a non-medical man would find it difficult to understand. We, therefore, request the doctors to submit a supplementary report by the next date of hearing (by e-mailing a copy two days before the hearing) in which the meaning of these technical terms is also explained”. The Bench has asked the government to make air travel, staying, conveyance and other arrangement for the team for its appearance in the Court on March 2.
Apart from Dr. Sanjay Oak, his colleague in KMC, Dr. Ravi Bapat, who was the first doctor to attend on Aruna after she was molested, asks: “Why don’t you leave her alone?…The million dollar question is whose wish, whose pity, who decides and who puts the person to death? Who is to label anyone terminally ill? Medicine is not a mathematical science where 2+2=4. How much inner joy we have of saving human life? Don’t take it away from us. Hope these proponents do not want death clinics to mushroom.” Others of his ilk ask as to how doctors can reconcile mercy killing with the Hippocratic oath they take: “I’ll give no deadly medicine to anyone if asked, nor suffer any such counsel”.
There are others who stand for mercy killing or euthanasia. For instance, Dr. Ravindra Dhelia, a member of the Society for the Right to Die with Dignity, which pleads for assisted death for individuals who wish to die after all medical help has failed them, fully agrees with Pinki Virani’s arguments. He says: “Voluntary euthanasia is not about ending a life but it is about ending a deadened survival. As far as Aruna is concerned, mercy killing is a dignified exit.”
Mercy killing or euthanasia petitions have hitherto been filed in High Courts and the President – with no consent granted. This is the first time that the Supreme Court has admitted such a petition. Among other things pro-life lobby has been harping at is the locus standi of Pinki Virami who has filed the petition as ‘next friend’. In most cases, the terminal patients are beyond making a rational choice. The Supreme Court has to rule on euthanasia per se and also who can sponsor euthanasia and under what safeguards so that this exit route is not abused – say to grab the assets of the mercy-killed. In Aruna’s case, because of the wide media interest, the Court might declare it as ‘a rarest of rare’ case - as it uses the expression to justify death sentences.
It is apt to conclude with John Dryden:
Death in itself is nothing; but we fear
To be we know not what, we know not where.
For Aruna, in her present state, it won’t make a difference.
John B. Monteiro, author and journalist, is editor of his website www.welcometoreason.com (Interactive Cerebral Challenger).
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