Monday, March 7, 2011

Comment: Allow a dignified death or not

By R Shankar, India Syndicate, 07/03/2011

Comment: Allow a dignified death

Source : MSN

India has finally said a big no to mercy killing. The Supreme Court verdict on Monday in the Aruna Shanbaug case has finally laid to rest the debate on whether a patient lying in a "persistent vegetative state" can get a dignified death.

Comment: Allow a dignified death

The ruling came in the case of Aruna who has been lying in a painful and vegetative state in Mumbai's KEM Hospital for over 37 years after a brutal sexual assault.

Those who favoured mercy killing had pleaded before the court that feeding of the nurse should be stopped immediately so that she can have a dignified ending.

Aruna, a nurse from Haldipur, Shimoga, Karnataka, was brutally assaulted by Sohanlal Bhartha Walmiki, a ward boy at Mumbai's King Edward Memorial Hospital on Nov 27, 1973, as she was changing her clothes in the basement of the hospital. As she was having her periods, Walmiki sodomised her after choking her with a dog chain.

The asphyxiation caused due to the dog chain round Aruna's neck cut off oxygen supply to her brain resulting in `death' of a critical part of the brain stem and cervical cord injury leaving the nurse cortically blind and had reduced her to a vegetative stage.

Comment: Allow a dignified death

Walmiki attacked Aruna as she had ordered him about and had castigated him for sloppy work. The ward boy is now a man in his fifties, free man and is reportedly working in Delhi.

The apex court ruling came in a case filed by activist Pinki Virani who contended that Aruna cannot see or speak properly and keeping her alive violates her right to live with dignity.

As the case took various emotional twists and turns, the apex court appointed senior doctors to examine Aruna and present their views on euthanasia. Dr JV Divatia, Dr Roop Gurshani and Dr Nilesh Shah subsequently examined Aruna and submitted a report in which they said that the nurse responds to devotional music, gets upset when people crowd around her and is fond of certain food items. Hence, the panel said, Aruna may not be completely vegetative.

Though the Supreme Court has rejected Aruna's death wish, it is also not fair to keep terminally ill patients in excruciating pain and agony. The court should lay guidelines under which mercy killing should be an option in the following two circumstances:

1-Patient cannot decide: Mercy killing should be allowed in very special and extra-ordinary cases where hope of living is dead and the pain and agony are unbearable. If a panel of reputed senior doctors unanimously agree that there is absolutely no hope of a recovery, and if the patient cannot independently decide on the death wish, the patient should be allowed to die.

2-Patient can decide: If a patient who wants to die as he or she is suffering from a terminal ailment and doctors agree that there is no hope of recovery, doctors should be legally allowed to put the patient to permanent sleep.

Comment: Allow a dignified death


The official medical definition of euthanasia is: Deliberate and intentional killing of a human being by a direct action, such as a lethal injection, or by the failure to perform even the most basic medical care such as the provision of nutrition and hydration, necessary to maintain life.

Euthanasia is also called:

Voluntary Euthanasia: Mentally competent patients who want to end thier lives in order to relieve either physical or emotional distress which they declare unacceptable.

Medically Assisted Suicide: Patients are provided with the means and assistance to commit suicide.

Involuntary Euthanasia: Patients who are not in a position to give consent for a peaceful ending because of immaturity such as a newborn infants, mental disability, mental or physical illness or coma. In these instances, it is decided by others -- relatives or ativists -- that the person should be killed.

Euthanasia has, however been rejected by many countries. In 1996, the Australian House of Representatives quashed the Northern Territory Euthanasia Legislation that favoured mercy killing. Other nations who have strongly recommended against legalising euthanasia are: Canada 1982, Victoria 1987, Great Britain 1994, New York State 1994.


Euthanasia is legal in The Netherlands, Switzerland, Belgium, Norway, Sweden, Germany, Finland, Luxembourg, Albania and Thailand. A few States in the US too have what is called 'Death with Dignity Act'.

Comment: Allow a dignified death

DIGNIFIED END: Doctors of death or angels of mercy?

There are cases where doctors have `helped' terminally ill patients to meet a dignified end. Here are a few `doctors of dignified death':

Jack Kevorkian

Kevorkian, was infamously or famously (depending on which side of euthanasia you are) called `Dr Death'. An Armenian-American pathologist, he started off by photographing the eyes of dying patients. Seeing their agony, pain and suffering, he started offering 'death counselling'. He issued advertisements too. He is reported to have helped over 130 people to `have a peaceful and permanent death.' Though he has been hitting the headlines off and on, he was intensely debated when he made a film on Thomas Youk, a terminally ill patient who was put to death. The film was shown on the popular American TV series called '60 Minutes'.

John Bodkin Adams

Adams was an Irish-British general practitioner who allegedly 'killed' 160 patients between 1946 and 1956. He was put on trial and found guilty in 13 cases classified as prescription fraud, lying on cremation forms, obstructing a police search and failing to keep a dangerous drug registered. But a turn-around came in 1957 when Judge Devlin ruled that "causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome".


Switzerland-based Dignitas is probably the only 'recognised assisted dying group' that helps patients with terminal illness and severe physical and mental illnesses to die peacefully. The patients are assisted by qualified doctors and nurses. The group also renders help for assisted suicide if those seeking help are of sound judgement. These suicide seekers should obtain a detailed medical report from a qualified and recognised psychiatrist that endorses the patient's condition as fulfilling the specifications of the Federal Court of Switzerland.

Source: India Syndicate

Aruna Shanbaug will live, says Supreme Court

New Delhi: The Supreme Court Monday rejected a petition for the mercy killing of Aruna Shanbaug, who has been in a "persistent vegitative state" for the past 37 years after being sodomised by a hospital sweeper but permitted passive euthanasia subject to a declaration by a high court to this effect.

Aruna Shanbaug will live, says Supreme Court

An apex court bench of Justice Markandey Katju and Justice Gyan Sudha Misra delivered the ruling while rejecting a petition moved on Shanbaug's behalf by her friend and social activist Pinki Virani.

Justice Katju said that active euthanasia is illegal as there is no statutory provision to support it.

However, the court said: "Passive euthanasia is permissible under certain conditions with the approval of the high court."

It further said the high court will grant its approval after getting the opinion of three eminent doctors and hearing the government and the close relatives of the terminally ill patient sought to be put under passive euthanasia.

The court said though Virani is performing a laudable social service, the staff, doctors and nurses of Mumbai's King Edward Memorial Hospital, where Shanbaug is admitted have a greater right over her and only they can decide whether to opt for passive euthanasia or not.

"She (Virani) cannot claim to be as close and attached to Aruna Shanbaug as King Edward Memorial Hospital staff and nurses," the bench ruled.

Active euthanasia is a state where a patient is given a lethal injection to bring him to sleep, while passive euthanasia involves withdrawing the life support system from a patient.

Source: IANS

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