Aruna Shanbaug - Martyred in indignity, without choice

Forty-two years ago, Aruna Shanbaug, surrendered her dignity and bodily integrity to her committed carers. The KEM Hospital nurse, aged 68, brutalised by a vengeful ward boy, breathed her last on May 18. All these years, successive batches of nurses, and deans, went out of their way to tend to a person reduced to a vegetable confined to a bed, unable to speak or communicate in any coherent manner.

The KEM Hospital authorities delayed the funeral and kept her body for public viewing, so that people could pay homage. Thousands- doctors, nurses, politicians, did. One isn't sure what the homage was for, because the person only existed behind a high wall of silence. Perhaps it was because, as is being repeated now, "gifted" Indians the right to passive euthanasia?

On 7 March 2011, the Supreme Court held that in certain circumstances, a person in a permanent vegetative state was entitled to physician-assisted suicide- termination of medical and ventilator support. However, the judges were of the opinion that Aruna didn't qualify for such a merciful release from prolonged suffering; her suffering was in fact only a minor issue in the course of legal proceedings.

But as the sordid tussle between her relatives and the nurses, over who shall perform her last rites showed, even in death, Aruna Shanbaug continued to belong to others who, by dint of their perseverance in looking after her, claimed her as one of their own, and by that logic, arrogated to themselves the right to make critical life choices on her behalf. 

Wither agency?

Aruna was rendered mute and immobile by the violent attack, turned into a lifelong vegetable, so there's no way to know if she was willing to let this happen. Although she did demonstrate signs of being alive-besides the usual breathing, that occasional flicker of a tortured consciousness, that rare instance of what was perceived as the conveying of emotions, no one knew if she was indeed "alive". In fact, that question was alien to the discourse, debate and legal fight over whether she should continue being kept on life support and fed through tubes.

During the hearing, all one got to know was the assertive claim of a certain section of the medical community - that it would be wrong to pull the plug and why a hitherto inexplicable faith in miracles should prevail over reasonable considerations.

When Pinky Virani's petition to the Supreme Court reignited the debate on whether euthanasia should be legalised, attempt to commit suicide should be decriminalised, or whether the right to die is a corollary of the fundamental right to life, not a thought was spared to her individual autonomy of making a choice, or her bodily integrity.

Instead, the clergy of different faiths cited scriptural injunctions to argue about the non-derogable sanctity of human life, even if it was to be maintained at the cost of what would be inhumane, silent, suffering. The government played tango, deliberately ignoring the fact that the goal of the law should be to protect the vulnerable who might have been driven to suicide by moments of weakness, and not to impinge upon an individual's informed and conscious choice to leave the mortal world in a manner s/he desired.

It's true that Aruna wasn't in a position to make such a choice on her own, but that shouldn't have precluded the authorities and authoritarian doctors from caring to broach the topic.

Constitutionality, over affection

This is reminiscent of the case of Theresa Schiavo in the US, whose body became a site for a bitter struggle between parental love and spousal understanding, a protracted legal battle between liberals and devout Catholic conservatives, and even Jeb Bush's platform for advancing his gubernatorial and political agenda. In the end, it became a tussle between the aspirations of doting parents and the concerns of a loving husband.

When, ideally, it should have been about the law and the constitution. It should have been about the cruel inequality - between a person who is in a position to take his own life, even by dangerous means, and if unsuccessful, risks a stiff criminal penalty, and one in a permanent vegetative state, who is left with no option but to suffer in silent, excruciating indignity. Everybody isn't in a position to afford the clinics in Switzerland or Belgium which lend a helpful hand of support in the journey to peace and freedom from pain.

Only glib naivete would fuel outrage-laced demands of repealing Section 309 of the Indian Penal Code (which penalises an unsuccessful attempt to commit suicide, and is also used to book doctors or anyone who helps or facilitates an individual's escape from the purgatory of helpless suffering) because there's a big political minefield to be negotiated. Similarly, demands for legalisation of the right to die ignores the sharp polarisation among the medical community, and also risks the superiority of the physicians' words prevailing over an individual's right to choose. This is exactly what happened in Aruna's case, which also saw the court putting undue and legally unsubstantiated faith in the "dedication" of her carers. The medical community at KEM, over the years, had lent it's unwavering support to Aruna, nurtured and tended to her as it's "child". Right now, it's impossible to keep at bay the presumption, if not the conclusion, that Aruna's contorted body became an advertising billboard for the "selfless" dedication of KEM's staff, which the apex court praised as "iconic".

The need of the hour is to have an informed debate on whether an individual could have the right to a non-ambivalent, non-coercive and fully conscious choice to end his life when medical science has proved to be a failure (without waiting for eternity). Stringent safeguards are essential to prevent manipulation and abuse, but for that to happen, the debate has to start. Aruna's life which ended and death shows that's not the case.