Aruna Ramachandra Shanbaug, a former nurse who had been lying in a Permanent Vegetative State (PVS) for the last 42 years after she was gagged with a dog chain and sexually assaulted by a ward boy, died at the KEM Hospital here on Monday. Aruna’s case also became the focus of a debate on euthanasia in the country.
She had been on ventilator support in the ICU of the Brihanmumbai Municipal Corporation-run KEM Hospital for the past six days and breathed her last at 8 am, thus bringing an end to the most agonising saga of a chirpy and bubbly woman, who had been confined to the hospital bed from her age of 25 years to nearly 67 years.
Dr Avinash Supe, the Dean of KEM Hospital, said that Aruna’s condition had shown some improvements after she was moved to the ICU last week for treatment of Pneumonia. Confirming the cause of her death, he said, “She died of Pneumonia and Septicemia”.
The doctors, nurses and staff members of the BMC-run hospital — who had come in for immense praise from the Supreme Court in its landmark verdict March 2011 (when it rejected former journalist Pinky Virani’s plea for granting euthanasia for the sexual assault victim) for taking care of Aruna day and night willingly — bade her emotional adieu, as her body was taken for funeral from the hospital premises to Boiwada crematorium amid slogans like ‘Aruna Shanbaug Amar Rahe… Aruna Shanbaug Amar Rahe…”.
Dr Supe lit the funeral pyre of Aruna — who would have turned 67 on June 1, 2015 had she continued to exist in a comatose condition — at the Boiwada crematorium, as the eyes of the hospital staff members, who had been extremely compassionate and caring towards her till the very end, turned misty.
Hailing from Haldipur in Shimoga district of Karnataka, Aruna was a staff nurse with the KEM Hospital when she was assaulted and “sodomised” by a ward boy Sohanlal Bhartha Walmiki on the evening of November 27, 1973.
“On that evening, she (Aruna) was attacked by a sweeper in the hospital who 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. The next day on 28th November, 1973 at 7.45 am. a cleaner found her lying on the floor with blood all over in an unconscious condition,” former journalist Pinki Virani summed up in her writ petition filed in the Supreme Court on behalf of Aruna in 2009. Virani had earlier in 1998 authored a book “Aruna’s Story: The true account of a rape and its aftermath” on the ordeal underwent by Aruna during and after the much-discussed ghastly incident.
With the police failing to book Walmiki for rape or sexual molestation or even “unnatural sexual offence” - as sodomy is described as in legal parlance, Walmiki got away with lighter sentence - seven years’ jail term -- for attempt to murder and for robbing Aruna’s earrings, in 1974 and he walked out of the jail in 1980, a year early as the trial court had taken into consideration that he had served one year in lock-up before he came to be sentenced.
By then, Aruna had long gone into PVS. Sometime after 1980, the BMC made at least two attempts to shift Aruna out of the KEM Hospital to free the bed she had been occupying for seven years, but nurses there successfully resisted the BMC’s attempts her from ward no. 4 of Asia’s biggest civic hospital.
Virani, after writing about Aruna’s plight in a Mumbai newspaper, intervened in early 1998 and obtained permission to move her to Jaslok Hospital for a MRI scan. However, the KEM Hospital administration, apprehending that such a scam would result in Aruna’s death, denied Virani the permission. Virani’s book on Aruna, meanwhile, got published and helped her focus the media’s attention on Aruna’s continued ordeal.
Eleven year later, Virani moved the Supreme Court seeking euthanasia for Aruna - a petition that the apex duly admitted on December 18, 2009. In her petition, Virani urges the court to direct the authorities to stop feeding Aruna and to let her “die peacefully”. “….there is not the slightest possibility of any improvement in her condition and her body lies on the bed in the KEM Hospital, Mumbai like a dead animal, and this has been the position for the last 36 years,” the petitioner stated, as she rooted for stopping of withholding food to Aruna.
On his part, KEM Hospital’s dean Dr Sanjay Oak made a strong case against granting euthanasia to Aruna. “The very idea of withholding food or putting her to sleep by active medication (mercy killing) is extremely difficult for anybody working in Seth GSMC & KEM Hospital to accept and I sincerely make a plea to the learned Counsel and Hon’ble Judges of Supreme Court of India that this should not be allowed,” Oak stated in his touching affidavit filed before the apex court.
A three-member team of doctors, appointed by the Supreme Court, examined Aruna on January 28, 20111 and February 3, 2011, had stated in their medical report submitted to the apex court during the course of hearing of Virani’s petition seeking the grant of euthanasia for the sexual assault victim that she “somehow” recognised the presence of people around her and expresses her like or dislike by making certain types of vocal sounds and by waving her hands in certain manners. “She appears to be happy and smiles when she receives her favorite food items like fish and chicken soup. She accepts feed which she likes but may spit out food which she doesn’t like”.
The team of doctors had also told the Supreme court that she breathed normally and would not require a heart lung machine or intravenous tube for feeding. Her pulse rate and respiratory rate and blood pressure were normal.
Given that there was little likelihood of Aruna coming out of PVS and would have to remain in that state till her death and that there is no statutory provision in India which provides for withdrawing life support system to a person in PVS, the Supreme Court had - though rejected Virani’s plea seeking euthanasia for the once KEM hospital nurse -- after carefully considering the legal position - had vested the decision to the KEM Hospital staff to discontinue life support to the PVS patient.
Significantly enough, a two-member bench of the apex court - comprising Justices Markandey Katju and Gyan Sudha Misra had also come out legal guidelines, pending the enactment of a law by Parliament, in dealing with the situations vis-a-vis granting permission for passive euthanasia.
On their part, the two judges - while rejecting Virani’s plea for granting euthanasia for Aruna - observed in their landmark verdict of of March 7, 2011: “In the present case, we have already noted that Aruna Shanbaug’s parents are dead and other close relatives are not interested in her ever since she had the unfortunate assault on her. As already noted above, 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 few occasions and written a book on her. Hence it is for the KEM hospital staff to take that decision”.
However, the Judges made it clear that in the event of the KEM Hospital staff members changing its mind on the issue of continuing to take care of its one-time nurse, they would to seek the approval of the Bombay High Court for its decision to withdraw life support to Aruna.
As far as granting of approval for withdrawing life support to an incompetent person, the apex court not only suggested that the high court could invoke Article 226 of the Constitution to grant such an approval, but also laid down the procedure to be adopted by the two or more members’ HC bench to decide on granting such approvals.
“We do not mean to decry or disparage what Ms. Pinky Virani has done. Rather, we wish to express our appreciation of the splendid social spirit she has shown….. All that we wish to say is that however much her interest in Aruna Shanbaug may be it cannot match the involvement of the KEM hospital staff who have been taking care of Aruna day and night for 38 years,” the two judges observed.
“We also commend the entire staff of KEM Hospital, Mumbai (including the retired staff) for their noble spirit and outstanding, exemplary and unprecedented dedication in taking care of Aruna for so many long years. Every Indian is proud of them,” the two judges went onto note in the concluding portion of their judgement.