How Aruna Shanbaug changed the euthanasia debate in India

The Supreme Court’s Friday verdict allowing passive euthanasia and advance “living will” is a reminder of the Aruna Shanbaug case, around which India debated euthanasia.

Shanbaug, a 25-year-old nurse at Mumbai’s King Edward Memorial Hospital who was raped and choked by a ward boy in 1973, lay in a vegetative state for more than 40 years. She died in May 2015 after suffering pneumonia.

In 2009, author Pinki Virani filed a petition in the Supreme Court seeking mercy killing for Shanbaug but it was rejected two years later. The court, however, permitted passive euthanasia — making a distinction from active euthanasia — saying the primary caregiver could choose whether to pursue it.But the nursing staff and the administration at KEM Hospital opposed the move.

Shanbaug’s life in a vegetative state for 42 years, and the Supreme Court’s rejection of Virani’s petition, made her the face of the debate on euthanasia in India.

The Aruna Shanbaug case

* Shanbaug came to Mumbai from Haldipur in Karnataka. She had got a job as a nurse at King Edward Memorial Hospital. She stayed with her sister Shanta Nayak for at least a month in a Worli chawl and would, later, visit her sibling regularly until the rape.

* She was assaulted and raped by sweeper Sohanlal Bharta Valmiki on November 27, 1973. He choked her with a dog chain and sodomised her, leading to oxygen being cut off to her brain. This resulted in extensive damage to her brain that left her in a vegetative state.

Read: ‘Aruna Shanbaug gifted law on passive euthanasia despite being denied right to life and death’

* She was found lying unconscious the day after the sexual assault. Since then, Shanbaug was confined to a room in ward 4 of KEM Hospital.

* Nayak, her sole relative in Mumbai, died in September 2013. The KEM Hospital employees said her relatives had stopped visiting her a few years after the rape. Since then, it was the nurses and the doctors who had looked after her.

* In March 2011, the Supreme Court rejected a petition filed by Virani seeking euthanasia for Shanbaug. The petition was opposed by the hospital’s management and nursing staff. Virani also wrote a book on Shanbaug.

* Shanbaug’s bones turned brittle, her teeth decayed and she often developed bed sores. She was usually fed mashed food through a feeding tube. Nurses said she was fond of fish.

*Her rapist Valmiki — convicted of robbery and attempted murder — served a seven-year sentence. The sodomy was not disclosed.

Friday’s SC verdict

* In a landmark judgment, the Supreme Court recognised passive euthanasia and “living will”.

* Passive euthanasia will apply only to a terminally ill person with no hope of recovery, the panel of five judges said. Active euthanasia, by administering a lethal injection, continues to be illegal in India.

* A living will is a concept where a patient can give consent that allows withdrawal of life support systems if the individual is reduced to a permanent vegetative state with no real chance of survival.

It is a type of advance directive that may be used by a person before incapacitation to outline a full range of treatment preferences or, most often, to reject treatment. A living can detail a person’s preferences for tube-feeding, artificial hydration, and pain medication when an individual cannot communicate his/her choices.