The Aruna Shanbaug Case

In March 2011, the Supreme Court of India passed a historic

judgement-law permitting Passive Euthanasia in the country. This
judgment was passed in the wake of Pinki Viranis plea to the highest
court in December 2009 under the Constitutional provision of Next
Friend. Its a landmark law which places the power of choice in the
hands of the individual, over government, medical or religious control
which sees all suffering as destiny. The Supreme Court specified two
irreversible conditions to permit Passive Euthanasia Law in its 2011
Law:

The brain-dead for whom the ventilator can be switched off.

Those in a Persistent Vegetative State (PVS) for whom the feed can
be tapered out and pain-managing palliatives be added, according
to laid-down international specifications.

Also read: Committees and Commissions in India

The same judgement-law also asked for the scrapping of 309, the code
which penalises those who survive suicide-attempts. In December
2014, the Government of India declared its intention to do so.

PIL filed by Common Cause

However on 25 February 2014, a three-judge bench of Supreme Court

of India had termed the judgment in the Aruna Shanbaug case to be
inconsistent in itself and has referred the issue of euthanasia to its
five-judge Constitution bench on a PIL filed by Common Cause, which
case is the basis of the current debate. Then, the CJI referred to an
earlier Constitution Bench judgment which, in the Gian Kaur case, did
not express any binding view on the subject of euthanasia; rather it
reiterated that the legislature would be the appropriate authority to
bring change. Though that judgment said the right to live with dignity
under Article 21 was inclusive of the right to die with dignity, it did not
arrive at a conclusion on the validity of euthanasia, be it active or
passive. So, the only judgment that holds the field with regard to
euthanasia in India is the ruling in the Aruna Shanbaug case, which
upholds the validity of passive euthanasia and lays down an elaborate
procedure for executing the same on the wrong premise that the
Constitution Bench in Gian Kaur had upheld the same, the CJI said.

Supreme Court disallows friend's plea for mercy killing of

vegetative Aruna.

Unaware of her unwanted fame, the 67-year-old became India's

metaphor for the right to life. The Supreme Court in Aruna
shanbaug case allowed passive mercy killing of a patient in a
permanent vegetative state (PVS) by withdrawing the life support
system with the approval of a medical board and on the directions
of the High Court concerned.

A Bench of Justices Markandey Katju and Gyan Sudha Misra,

however, did not accept the plea of Pinky Viranai seeking permission
to withdraw life support to her friend, Aruna Ramachandra
Shanbaug, who has been lying in a PVS in the KEM hospital Mumbai
for 37 years. Though it dismissed the petition filed by Ms. Pinky
Virani of Bombay on the ground that she did not have the locus
standi and that only the hospital could make such a request, the
Bench allowed passive euthanasia and laid down guidelines.

The Bench, however, held illegal active mercy killing of a patient

suffering acute ailment with a poisonous injection or by other
means.

Writing the judgment, Justice Katju said: There is no statutory

provision in our country as to the legal procedure for withdrawing
life support to a person in PVS or who is otherwise incompetent to
take a decision. We agree with Mr. T.R. Andhyarujina that passive
euthanasia should be permitted in our country in certain situations,
and we disagree with the learned Attorney General [G.E. Vahanvati]
that it should never be permitted.

The Bench pointed out that in the absence of a law against sexual
harassment at work places, the Supreme Court in the Visakha case
had laid down guidelines. Similarly, we are laying down the law in
 this connection which will continue to be the law until Parliament
makes a law on the subject. A decision has to be taken to
discontinue life support [to a patient in PVS] either by the parents
or the spouse or other close relatives, or in the absence of any of
them, such a decision can be taken even by a person or a body of
persons acting as a next friend. It can also be taken by the doctors
attending the patient. However, the decision should be taken bona
fide in the best interest of the patient.

The Bench said: If we leave it solely to the patient's relatives or to

the doctors or the next friend to decide whether to withdraw life
support to an incompetent person, there is always a risk in our
country that this may be misused by some unscrupulous persons
who wish to inherit or otherwise grab the property of the patient.
Considering the low ethical levels prevailing in our society today and
the rampant commercialisation 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.

In the present case, Aruna Shanbaug's parents are dead and other
close relatives have not been interested in her ever since she had
the unfortunate assault on her. It is the KEM Hospital staff, who
have been amazingly caring for her day and night for so many long
years, who really are her next friends, and not Ms. Pinky Virani,
who has only visited her on a few occasions and written a book on
her. Hence it is for the KEM Hospital staff to take that decision. The
KEM hospital staff have clearly expressed their wish that Aruna
Shanbaug should be allowed to live.

Background:

Aruna Shanbaug is a nurse from Haldipur, Uttar Kannada, Karnataka

in India. In 1973, while working at King Edward Memorial Hospital,
Parel, Mumbai, she was sexually assaulted by Sohanlal Bhartha
Walmiki, a ward boy at the hospital. Walmiki was motivated partly
by resentment for being ordered about and castigated by
Shanbaug.

On the night of 27 November 1973 he attacked her while she was

changing clothes in the hospital basement. He choked her with a
dog chain and sodomized her. The asphyxiation cut off oxygen
supply to her brain resulting in brain stem contusion injury and
cervical cord injury apart from leaving her cortically blind.
 The initial medical examination to verify rape as the crime found
that Aruna had no vaginal bruises and her hymen was intact. She
was menstruating on the day and therefore the rapist did not
penetrate her. Subsequent medical reports proved that she bled for
days together from the anus.

The police case was registered as a case of robbery and attempted

murder on account of the concealment of anal rape by the doctors
under the instructions of the Dean of KEM, the late Dr. Deshpande
perhaps to avoid the social rejection which might break her
impending marriage to Dr. Sundeep Sardesai.

Since the assault, she has been in a vegetative state. On 24th

January 2011, the Supreme Court of India responded to the plea for
Euthanasia filed by Aruna's friend journalist Pinki Virani, by setting
up a medical panel to examine her.

Pinki Virani, the journalist first brought her story to light. Ms Virani
campaigned for a legal end to her being force fed; and she took the
case all the way to India's Supreme Court.

The nurses of hospital, who successively tended to one of their own,

had a diametrically opposite opinion. They argued that Aruna
Shanbaug responded to stimulus and actually "relished" her fish
curry, albeit through tubes. Their stand was upheld in this landmark
Judgement.

Vegetative state

A vegetative state is a condition in which someone is awake, but not

aware. People usually emerge from a coma into a vegetative state
as their brains slowly recover from injury and they start to become
more alert and aware. From a vegetative state, a patient can move
into a minimally conscious state and then into a state of full
consciousness. However, sometimes patients do not recover from a
vegetative state because their brains are too badly damaged.

Aruna Ramchandra Shanbaug (1 June 1948 18 May 2015), alternatively spelled

Shanbhag, was an Indian nurse who was at the centre of attention in a court case on
euthanasia after spending 42 years in a vegetative state as a result of sexual assault.[2]
In 1973, while working as a junior nurse at King Edward Memorial Hospital, Parel, Mumbai,
Shanbaug was sexually assaulted by a ward boy, Sohanlal Bhartha Walmiki, and remained in
a vegetative state following the assault.[3] On 24 January 2011, after she had been in this state
for 37 years, the Supreme Court of India responded to the plea for euthanasia filed by
journalist Pinki Virani, by setting up a medical panel to examine her. The court rejected the
petition on 7 March 2011. However, in its landmark opinion, it allowed passive euthanasia in
India.[4]

Shanbaug died from pneumonia on 18 May 2015 after being in a persistent vegetative state
for nearly 42 years.[2][5][6]

Contents

[hide]

1 Victim

2 Attack

3 Perpetrator

4 Nurses' strike

5 Supreme Court case

o 5.1 Response

6 Death

7 In popular culture

8 Further reading

9 References

10 External links

Victim[edit]

Aruna Shanbaug was born in 1948 at Haldipur, Uttar Kannada, Karnataka.[7][8][9] She worked
as a nurse at the King Edward Memorial Hospital (KEM) in Mumbai. At the time of the
attack, she was engaged to a doctor at the same hospital.[10]

Attack[edit]

On the night of 27 November 1973, Shanbaug was sexually assaulted by Sohanlal Bhartha
Walmiki, a sweeper on contract at the King Edward Memorial Hospital.[11] Sohanlal attacked
her while she was changing clothes in the hospital basement. He choked her with a dog chain
and sodomized her. The asphyxiation cut off oxygen to her brain, resulting in brain stem
contusion injury, cervical cord injury, and cortical blindness.[12] She was discovered with
blood splattered around her at 7:45 am the next morning by a cleaner.[13]

The police case was registered as a case of robbery and attempted murder because of the
concealment of anal rape by the doctors under the instructions of the Dean of KEM, Dr.
Deshpande, perhaps to prevent Shanbaug from being socially rejected[14] or to avoid effects
on her impending marriage.[10]

Perpetrator[edit]

Sohanlal was caught and convicted for assault and robbery, and he served two concurrent
seven-year sentences. He was not convicted of rape, sexual molestation, or unnatural sexual
offence, the last of which could have required him to serve a seven-year sentence by itself.

Journalist and human-rights activist Pinki Virani tried to track down Sohanlal; she was led to
believe that Sohanlal had changed his name after leaving prison in 1980 but continues to
work in a Delhi hospital. Since neither the King Edward Memorial Hospital nor the court that
tried Sohanlal kept a file photo of him, Virani's search failed.[15] Other reports claimed he had
subsequently died of AIDS or tuberculosis.[16]

Shortly after Shanbaug's death was announced, however, Sohanlal was traced to his father-in-
law's village of Parpa in western Uttar Pradesh, where he was found to be still living and
married with a family.[16] After his release from prison, he returned to his ancestral village of
Dadupur in western Uttar Pradesh before moving to Parpa in the late 1980s. He found
employment as a labourer and cleaner at a power station 25 kilometers from the village.[16]
Still working in his late sixties (or early seventies) when he was rediscovered, Sohanlal lives
with his wife and two sons, a daughter and three grandchildren in a two-room house; he
continues to travel to his job at the power station by bicycle, earning a daily wage of Rs. 261.
His sons, also labourers, earn Rs 200-300 a day. One of his two daughters is married and lives
elsewhere.[16] He reportedly views his subsequent life as "penance." "I gave up non-vegetarian
food, bad habits like smoking bidis and drinking. I had a daughter before I was sentenced,
and she died while I was in jail. She died because I made a mistake. For many years after my
release, I didn't touch my wife. A son was born 14 years after I left jail." He said, "Mujhe
bahut pachchtava hai. Main unse aur apne bhagwan se maafi maangna chahata hun." ("I
have deep regret, I want to seek forgiveness from her and God").[16]

Sohanlal said he only learnt of Shanbaug's death after Mumbai based journalist Dnyanesh
Chavan from marathi daily Sakal came looking for him earlier that week. The television in
their two-room house was not working at the time due to power cuts and the family does not
read newspapers. "I leave home at 6 am for work and return by 8 pm. I have to cycle nearly
25 km to work. Where is the time to read newspapers?" Sohanlal said. "I could barely sleep
for 10 years after the incident. How was it possible for anyone to go back to the hospital after
such a thing? I left Mumbai, why would I go back to the hospital to see her?"[16]

Described as deeply regretful and tired of life, Sohanlal was quoted as saying "I wish I had
died. My sons would have taken care of her [my wife]. I am tired of the memories, I want to
die now."[16]

When interviewed, Sohanlal described his version of the assault, claiming it had been
committed in a fit of rage and that he had no clear recollection of when it had taken place or
what he may have done, though he denied raping her. Prior to that night, Sohanlal, then a
hospital janitor, had had a difficult relationship with Shanbaug, his superior and then working
with the hospital's animal experimentation unit. "Aruna didiji (Sister Aruna) was always
picking on me. She knew I was scared of dogs there were other sweepers, but she picked
me each time the dogs had to be fed or their cages swept. I told the doctor in charge and my
supervisor to transfer me, I complained about her but no one listened. Who listens to a
chamadar (sweeper)?"[16]

"Everything happened in a fit of rage. There was a fight, it was dark, and I panicked. We both
hit each other, I may have pulled the ornaments they said I stole during the scuffle. There was
no rape they beat me up in the police station and kept saying it was rape. I did not rape her,
it must have been someone else. That night I had gone to ask Aruna didiji for leave for a few
days. My wife's mother, who then lived in the house where I now live, was very ill. My wife
wanted to visit her but Aruna didiji refused. She said if I took leave, she would complain
about me in writing, saying I did no work, that I stole dog food, and still wanted leave," he
said.[16]

"I had not done any such thing. I was scared of dogs, so how could I steal their food? I had
seen Aruna didiji playing cards with ward boys and other nurses during duty hours. When she
threatened to complain and not give me leave, I told her I would tell her supervisor about her.
After that, there was an argument and a physical fight. I don't know what I did in rage."[16]

Eldest son Kishan says that four years ago, he told his father about the rejection of the
euthanasia plea on behalf of Shanbaug. "My father prays twice a day, but that day after I told
him, he prayed five-six times. I told him what the papers said, that her family was gone, that
she had been living in the hospital. He was agitated and began trembling. When the Supreme
Court rejected the plea, he became stable again."

Sohanlal's elder son Kishan said his father, "does not talk about the case, and we don't feel
comfortable asking him. In our culture, you cannot ask a father what he did to a woman. But
my uncles have told me so many times how he destroyed our lives. We could have lived in
Mumbai" His younger son Ravindra said his mother told him about the case when he was
12. "She told me I should forgive my father, that the papers were exaggerating his crime. She
said my brother was angry with my father but I should love him because he had made a
mistake. But he never even sent me to school. I cannot even write my name, how do I forgive
him?"[16]

Nurses' strike[edit]

Following the attack, nurses in Mumbai went on strike demanding improved conditions for
Shanbaug and better working conditions for themselves.[17] In the 1980s, the Municipal
Corporation of Greater Mumbai (BMC) made two attempts to move Shanbaug outside the
KEM Hospital to free the bed she had been occupying for seven years. KEM nurses launched
a protest, and the BMC abandoned the plan.[18]

Supreme Court case[edit]

See also: Euthanasia in India

Shanbaug remained in a vegetative state from 1973 until her death in 2015.

On 17 December 2010, the Supreme Court, while admitting the plea to end the life made by
activist-journalist Pinki Virani, sought a report on Shanbaug's medical condition from the
hospital in Mumbai and the government of Maharashtra.[19][20] On 24 January 2011, the
Supreme Court of India responded to the plea for euthanasia filed by Aruna's friend,
journalist Pinki Virani, by setting up a medical panel to examine her.[21] A three-member
medical panel was established under the Supreme Court's directive. After examining
Shanbaug, the panel concluded that she met "most of the criteria of being in a permanent
vegetative state".[22]

While it turned down the mercy killing petition on 7 March 2011, the court, in a landmark
decision, allowed passive euthanasia in India. While rejecting Pinki Virani's plea for
Shanbaug's euthanasia, the court laid out guidelines for passive euthanasia. According to
these guidelines, passive euthanasia involves the withdrawing of treatment or food that would
allow the patient to continue living.[23][24]

On 25 February 2014, while hearing a PIL filed by NGO Common Cause, a three-judge
bench of the Supreme Court of India said that the prior opinion in the Aruna Shanubaug case
was based on a wrong interpretation of the Constitution Bench's opinion in Gian Kaur v.
State of Punjab. The court also determined that the opinion was internally inconsistent
because although it held that euthanasia can be allowed only by an act of the legislature, it
then proceeded to judicially establish euthanasia guidelines. The court referred the issue to a
larger Constitution Bench for resolution, writing:
In view of the inconsistent opinions rendered in Aruna Shanbaug (supra) and also considering
the important question of law involved which needs to be reflected in the light of social,
legal, medical and constitutional perspective, it becomes extremely important to have a clear
enunciation of law. Thus, in our cogent opinion, the question of law involved requires careful
consideration by a Constitution Bench of this Court for the benefit of humanity as a whole.[25]

Response[edit]
Following the Supreme Court decision rejecting the plea, the nursing staff at the hospital
who had opposed the petition and had been looking after Shanbaug since she had lapsed into
a vegetative statedistributed sweets and cut a cake to celebrate what they termed her
"rebirth". A senior nurse at the hospital later said, "We have to tend to her just like a small
child at home. She only keeps aging like any of us, does not create any problems for us. We
take turns looking after her and we love to care for her. How can anybody think of taking her
life?"[10]

Pinki Virani's lawyer, Shubhangi Tulli, decided not to file an appeal, saying "the two-judge
ruling was final till the SC decided to constitute a larger bench to re-examine the issue." Pinki
Virani said, "Because of this woman who has never received justice, no other person in a
similar position will have to suffer for more than three and a half decades."[26]

Death[edit]

A few days before her death, Shanbaug was diagnosed with pneumonia. She was moved to
the medical intensive care unit (MICU) of the hospital and put on a ventilator. She died the
morning of 18 May 2015.[6] Her funeral was performed by the hospital nurses and other staff
members.[27]

In popular culture[edit]

A non-fiction book titled Aruna's Story was written about the case by Pinki Virani in 1998.
Duttakumar Desai wrote the Marathi play Katha Arunachi in 199495, which was performed
at college level and subsequently staged by Vinay Apte in 2002.[28][29]

A Gujarati fiction novel, Jad Chetan, was written by popular author Harkisan Mehta in 1985
based on Aruna Shanbaug's case.

Anumol played Aruna in the 2014 Malayalam film Maram Peyyumbol.[30][31]

Aruna Shanbaug: The face in every euthanasia debate

In the basement of KEM Hospital, he strangled Aruna with a dog chain; left her
brain dead after brutally raping her.

681 5 Google +2

By: Press Trust of India | Mumbai | Updated: May 18, 2015 9:54 pm

In the basement of KEM Hospital, he strangled Aruna with a dog chain; left her
brain dead after brutally raping her. (Photo Express Archives)

Aruna Shanbaug, the young nurse who was raped and gagged with a dog chain
that left her in a coma for 42 years and made her the face of a debate on
euthanasia in India, died on Monday, bringing to an end one of the most tragic
journeys of a victim of sexual assault.

It also brought to a close the painstaking, selfless service rendered by the fellow
nurses of Mumbais King Edward Memorial (KEM) Hospital who never gave up
hope and nursed her despite the Supreme Court verdict allowing passive
euthanasia.

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Aruna, 66, probably one of the longest living comatose patients, was on
ventilator support in the ICU of KEM Hospital after she suffered a serious bout of
pneumonia last week.

Aruna, whose dream of nursing the infirm and the ailing back to health had died
young on November 27, 1973, when she was sexually assaulted, battered and
strangled by ward boy Sohanlal Bhartha Walmiki, could not survive the infection
and died early this morning.

She had also suffered grave injuries to her spine, while the stifling cut off oxygen
supply to her brain, endering her to a vegetative state for life.

Sohanlal was caught and convicted, and served two concurrent seven-year
sentences for assault and robbery, but neither for rape nor sexual molestation,
nor for the alleged offence of unnatural sex.

Aruna, who was ever since be confined to a hospital bed, occupied a room
attached to ward No.4 on the ground floor of KEM Hospital and the hearts of the
staff and nurses there who foiled an attempt by the citys Municipal body to evict
her in the 1980s.

As the KEM nurses toiled to keep her alive, a journalist Pinki Virani moved the
Supreme Court with a euthanasia plea to rid Aruna of unremitting agony.

On January 24, 2011, the Supreme Court set up a medical panel to examine her.
The committee concluded that Aruna met most of the criteria of being in a
permanently vegetative state.

While turning down the plea of mercy killing on March 7, 2011, the apex court,
however, allowed passive euthanasia of withdrawing life support to patients in
permanently vegetative state (PVS). It rejected outright active euthanasia of
ending life through administration of lethal substances.

Refusing to grant permission for mercy killing of Aruna, the court had laid down a
set of tough guidelines under which passive euthanasia can be legalised through
a high court-monitored mechanism.

That day, the nurses of KEM Hospital rejoiced and cut a cake to mark Arunas
rebirth.

Last Tuesday, Aruna was wheeled out of her room one last time when the nurses
attending on her saw she had difficulty breathing. She never came back.
Reacting to the news of her death, Virani said, Aruna got justice after all these
painful years. She has found

release and peace.

While going, Aruna gave India the landmark passive euthanasia law, she said.

Virani had narrated the harrowing lifestory of Aruna in her 1998 non-fiction book
called Arunas Story, while

Duttakumar Desai wrote the Marathi play, Katha Arunachi in 199495, which
was staged under director Vinay Apte in 2002.

As the news of her death spread, condolences poured in.

The news of the demise of Aruna Shanbaug is extremely painful. One feels as if
one has lost a family member. The incident of the brutal attack on Aruna
Shanbaug that forced her to live in a vegetative state for all these years was
heart wrenching for the entire society. May her soul rest in eternal peace,
Maharashtra Governor C Vidyasagar Rao said in a condolence message.

Chief Minister Devendra Fadnavis praised the humanity shown by KEM nurses
who took Arunas care after her own sister expressed inability due to financial
hardship.

My deepest condolences on the sad demise of Aruna Shanbaug. It was painful

to see her suffering. I salute the humanity shown by KEM nurses, Fadnavis
tweeted.

Aruna dreamt of nursing but had to spend her entire life on a hospital bed. It
was cruel fate but she fought fate with determination. With her death, the
struggle has ended, read a pithy message from state Congress chief Ashok
Chavan.

Later, the mortal remains of the gritty former nurse were consigned to flames at
the Bhoiwada crematorium, where mourners included fellow nurses who tended
to her during the last four decades.

The funeral was preceded by a row over who should perform her last rites.

The nurses, according to reports, insisted on performing the last rites given their
long association with Aruna.

The KEM Hospital dean as well as Arunas nephew later lit her funeral pyre.

Her body was kept for public viewing at the KEM Hospital before being taken to
Bhoiwada crematorium.