A Division Bench of the Supreme Court of India comprising their Lordships, Hon'ble Mr.Justice Markandey Katju and Hon'ble Mrs.Justice Gyan Sudha Mishra delivered a landmark judgement recently on a very sensitive issue, euthanasia (painless killing to relieve suffering).
In the preliminary paragraphs of this judgement, their Lordships have briefly visited the thought of dismissing the writ petition as not maintainable, on the ground that Article 21 of the Constitution of India guarantees the right to live, but not to die. On this score alone the petition filed by Ms.Pinky Virani could have been dismissed. However, as their Lordships have rightly felt that there is a need to answer larger questions on this subject, the Court has gone into a very detailed exploration of euthanasia, keeping in mind the case on hand, that of Aruna Shaunbaug, a hapless young nurse who was sodomised on a dark November night in 1973 by a devil in human form. Thereafter, Aruna is in a permanent vegetative state (PVS) and thankfully is completely unaware of the wide media glare her frail existence is deriving.
His Lordship Markandey Katju opens the judgement with a couplet of Mirza Ghalib.
“Marte hain aarzoo mein marne ki
These lines, perhaps, best portray the mute mind of Aruna Shanbaug who awaits the elusive end. There is still so much life in her lifeless form. A few gasps of breath still cling on to a few bones and meagre flesh.
The Court, being presented with contradicting set of facts by the petitioner, Ms.Virani and the Dean of the KEM hospital, where Ms.Shanbaug lies in misery, constituted a team of three eminent Doctors to go investigate and submit a report about the actual physical and medical condition of Aruna. Upon a reading of the text of the judgement one finds that the report submitted by this three member panel of eminent experts is comprehensive, the least to say. It has gone into all aspects of the condition that Aruna is in today and has concluded that she is in a permanent vegetative state and that there are no medicines to cure her present condition.
The judgement has also gone into euthanasia laws in other countries and discussed the merits and demerits thereof. It is evident that only a very few countries have legalised euthanasia, while most others have opted not to do so. Our country does not permit euthanasia. As mentioned earlier, the Constitution, under Article 21 has only guaranteed a right to life and not to death.
However, keeping in mind the pressing need for relief from the misery of not being able to die a dignified death that thousands of terminally ill patients cannot even speak of, the Bench has formulated certain guidelines to be followed in such cases. Of course, only the Parliament can enact a law legalising euthanasia. Till such time, this judgement has given an option to the patients like Aruna Shanbaug to decide, either on their own or in through their kith and kin or friends to end their misery by embracing death.
The Bench has also observed that the moral fabric of our country is very precarious. The following extract from paragraph 127 of the judgement is a must read:
"Considering the low ethical levels prevailing in our society today and the rampant commercialization and corruption, we cannot rule out the possibility that unscrupulous persons with the help of some unscrupulous doctors may fabricate material to show that it is a terminal case with no chance of recovery. There are doctors and doctors. While many doctors are upright, there are others who can do anything for money (see George Bernard Shaw’s play ‘The Doctors Dilemma’). The commercialization of our society has crossed all limits. Hence we have to guard against the potential of misuse (see Robin Cook’s novel ‘Coma’). In our opinion, while giving great weight to the wishes of the parents, spouse, or other close relatives or next friend of the incompetent patient and also giving due weight to the opinion of the attending doctors, we cannot leave it entirely to their discretion whether to discontinue the life support or not."
Keeping the above in mind, the Bench has laid down guidelines for enabling passive euthanasia, or in simple terms, withdrawal of medical attention being already provided to hasten death. Some of the guidelines are:
- Petition to the be presented to the Chief Justice of the High Court concerned
- Chief Justice to constitute a Bench to hear such petition
- The Bench (of at least two Judges) to decided on grant of approval or otherwise
- Bench should seek the opinion of a panel comprising three Doctors (where one should be preferably a neurologist, one a psychiatrist and the other a general physician)
- The High Court to prepare a panel of such Doctors in every city
- The Committee of Doctors should very carefully examine the patient and all relevant past medical records and also obtain views of the Doctors treating the patient, and the hospital staff attending to the patient and submit a report to the High Court.
- When the Committee of Doctors is appointed, the High Court shall give notice to the State Government concerned, relatives of the patient, if there are no relatives then to the next friend and hear them.
- After considering the report of the Committee of Doctors and hearing the views of the relatives/next friend, the High Court shall give its verdict as expeditiously as possible.
- The decision of the High Court should give a complete background for arriving at such a decision.
Thus, a cruel moment in the life of a spirited and dedicated young nurse at Mumbai has, after 37 years, paved way for succour to a million sufferings. As citizens of this country, we can be proud of the very noble institution that our Supreme Court is and be reassured that there is a forum that will come to our rescue when needed.
