In an unprecedented verdict, the Supreme Court on Monday opened the window to permitting “mercy killing” of terminally ill patients agonising in hospital for long, with no hope of survival, by laying down comprehensive guidelines to process “passive euthanasia” through a petition in the high court concerned till Parliament passes any law on the issue.
However, a bench comprising Justices Markandey Katju and Gyan Sudha Misra dismissed the plea for the mercy killing of a Mumbai nurse who has been lying in a vegetative state in King Edward Memorial Hospital for the past 37 years as her case did not fully meet the criteria laid down by the court.
While dismissing the petition to allow “passive euthanasia” to be carried out in the case of Aruna Ramchandra Shanbaug, who, according to a team of three expert doctors, has been reduced to a “vegetative” state, the apex court said the guidelines laid down by it would act as “judicial legislation” in the same manner as its guidelines regarding “sexual harassment” of women at the workplace are already in force since 1999 (Vishakha case).
While making a clear distinction between “active euthanasia”, which means ending the life of a patient by injecting a drug, and “passive euthanasia”, which means permitting doctors to withdraw life-support to a terminally ill patient, the apex court said there was no ambiguity in the law on “active euthanasia”, which is a crime under Sections 302 (murder), 304 (homicide) and 306 (abetment to suicide) of the IPC.
Therefore, the court was only concerned with “passive euthanasia”, which could be permitted on the plea of close relatives of patients, or a body of persons who can act as the “next friend” of the patient for the purpose, or the doctors who are attending the patient. However, the decision by any of the listed persons should be taken “bona fide” in the interest of the patient, the top court said.
In the case of Aruna, reduced to her present state after being sexually assaulted 37 years ago by a hospital cleaner, the bench said, “We have noted that her parents are dead and other close relatives are not interested in her ever since. And the KEM Hospital staff are amazingly taking care of her for the past 37 years (sic).” Since the dean of KEM Hospital opposed the petition of Pinky Virani, who pleaded for “passive euthanasia” to be allowed in Aruna’s case, the court said her petition could not be allowed as it did not meet the criteria laid down in its guidelines. Ms Virani claimed to have had a long association with the nurse as she had also written a book on her.
The other important criteria laid down by the court was that the listed persons first have to move the high court concerned, which will then set up a special bench to deal with the case and appoint a committee of three expert doctors to examine the patient.
“The expert doctors should preferably be a neurologist, psychiatrist and physician, and they will have detailed consultations with government authorities and the doctors and staff of the hospital where the patient is admitted, before forming any opinion on passive euthanasia,” the apex court said.
Issuing of notices by the HC to relatives of the patient and the government of the state where the hospital is located would be mandatory to seek their views. The relatives, whose opinion would matter, could be parents, spouses, brothers and sisters and, in the absence of any of them, someone in close relation to the patient who could take a “bona fide” decision on behalf of the patient.
“After hearing the matter in detail, the HC should give its verdict as early as possible. The procedure should be followed all over the country until Parliament enacts legislation on the subject,” the Supreme Court ordered.
The tight guidelines for processing “passive euthanasia” pleas through HCs were laid down by the top court to prevent “misuse” of its order by “unscrupulous” persons to “grab the property” of any patient.
“Considering the low ethical levels prevailing in our society today, and the rampant commercialisation and corruption, we cannot rule out the possibility of unscrupulous persons who, with the help of some unscrupulous doctors, may fabricate material to show that it is a terminal case with no chance of recovery,” the apex court said while sounding a note of caution to all those who would be associated with the process of deciding such a plea.