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Friday, March 4, 2011

Is Mercy Killing Okay?


Even as the Supreme Court Wednesday reserved its verdict on a petition seeking mercy killing for Aruna Ramachandra Shanbaug, a nurse of the King Edward Memorial Hospital in Mumbai who is in coma for the past 38 years after she was raped by a staff sweeper, the hospital asked the court to reject the plea, saying its doctors alone had the right to decide her future.
"She is one of us. Not once in this long sojourn of 38 years has anybody thought of putting an end to her so-called vegetative existence. This should not be allowed and let her meet her natural end," the hospital told an apex court bench of Justice Markandey Katju and Justice Gyan Sudha Misra.
An affidavit filed by the Dean (Medical Education and Major Hospital), KEM Hospital, Sanjay Narhari Oak, said that the plea for mercy killing should not be entertained as India was not a mature society and it could have serious consequences.
While court-appointed lawyer T.R. Andhyarujina and senior counsel Shekhar Naphade favoured the passive mercy killing for Shanbaug, 63, saying that she was in a persistent vegetative state (PVS), Attorney General G. Vahanvati and the hospital opposed it.
The court wondered if passive mercy killing was permitted in the case of the patients who are in PVS condition and terminally ill, what could be the mechanism of going about it without making it vulnerable to abuse. The court will deliver its verdict Monday.
The team of three doctors, including Professor and Head of the Department, Critical Care and Pain, Tata Memorial Hospital, J.V. Divatia, Consultant Neurologist at P.D. Hinduja National Hospital J.V. Gursahani and psychiatry expert Nilesh Shah submitted their report to the court.
The court was also shown a 10-minute video on the condition of Shanbaug.
In their report, the doctors told the court that Shanbaug was in PVS and her case history revealed that she developed non-progressive and irreversible brain damage.
The report said that the damage to brain due to strangulation injury was irreversible after four weeks and with 37 years behind her she, perhaps, is the longest survivor in this situation.
Vahanvati said that the issues in the instant case were not just legal but involved larger moral, ethical and social issues.
"Ours is an old and caring society with strong ethos and emotional bonds," he said, adding that Indian family was based on strong values and strong organisation and was not a nuclear entity.
He said that Indian family was not based on individual decision-making.
Vahanvati told the court that withdrawing food and medical support to Shanbaug would be inhuman, cruel and intolerable.
Disagreeing with the attorney general, Andhyarujina said she could be put to passive euthanasia after the unanimous opinion of the doctors and her immediate relatives.
The court pointed to prevalence of greed in society which can put even a person who is not terminally ill to passive euthanasia.
The judges favoured introducing an element of judicial declaration in the course of deciding on passive euthanasia to terminally ill people.
The court said notwithstanding the old society with strong bonding and values, old people could be put to passive eunathasia for commercial consideration, if doctors join the wrongdoing.
Senior counsel Shekhar Naphade wanted the court to address the question whether the PVS condition of Shanbaug could be called a human life.
The case relates to a petition moved by Pinki Virani, a friend of Shanbaug, seeking mercy killing for the patient.
On the evening of Nov 27, 1973, Shanbaug was attacked by a sweeper in the hospital. The sweeper wrapped a dog chain around her neck and yanked her back with it. He tried to rape her but finding that she was menstruating, he sodomized her. To immobilize her during this act he twisted the chain around her neck.
On Nov 28, at 7.45 a.m. a cleaner found her in an unconscious condition on the floor. It is suspected that due to strangulation the supply of oxygen to her brain stopped and it got damaged.
The victim now has been reduced to a featherweight and her brittle bones could break if her hand or leg was awkwardly caught, even accidentally, under her lighter body, the petition said.
Her skin is now like papier mache stretched over a skeleton. She is prone to bed sores. Her wrists are twisted inwards. Her teeth have decayed causing her immense pain. She can only be given mashed food, on which she survives, it said.

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