NEW DELHI — Aruna Shanbaug was working as a nurse in Mumbai when she was brutally raped and assaulted by a co-worker — an attack that left her in a vegetative state for the past four decades. Her case inspired a best-selling book and sparked a heated debate about euthanasia in India.
Now, a law has taken effect that may help Indians facing a similar tragedy. But it still may not alter Shanbaug’s condition. Last month, India adopted a landmark Supreme Court decision to allow “passive euthanasia” for patients who are in a permanent vegetative state or are declared brain-dead. The procedure involves withdrawing medical treatment and allowing death to occur — as opposed to “active euthanasia,” in which a life is ended through a lethal dose of drugs or other means. A handful of other countries, including Sweden and the Netherlands, have similar legislation.
In a culture steeped in traditional notions of karma, destiny and duty, the new law is unlikely to be widely invoked, some say. In Shanbaug’s case, hospital staff are vowing they will continue to care for her.
“Euthanasia does not even enter our minds as a thought. It does not exist in our vocabulary. Everybody in the hospital loves Aruna so much,” said Shubhangi Parkar, dean of the KEM Hospital and Medical College where Shanbaug worked. Her family abandoned her years ago and the hospital is fighting to keep her alive. “The nurses go out of the way to care for her, celebrating festivals in her room, keeping her clean. They spend personal time with her even after duty hours.”
Shanbaug’s saga began in 1973, when she was raped and choked with a dog chain by a janitor. The incident left her blind and deaf and suffering from a severe brain stem injury. Shanbaug, now 66, has not responded to people for decades. Her attacker was convicted of attempted murder, but not rape. He served six years in prison.
Shanbaug’s condition moved author Pinki Virani to write a 1998 book about her that became popular. Eleven years later, Virani went to the Supreme Court to plead for passive euthanasia for Shanbaug.
In her five-year crusade, Virani faced extensive criticism from the hospital’s nurses as well as from religious figures, she recalled.
But the euthanasia issue was widely debated on radio phone-in programs, social media and prime-time TV talk shows. And slowly, Virani said, there was a perceptible shift away from the “crushing emotional burden of duty” to individual rights.
A medical team appointed by the Supreme Court examined Shanbaug and declared in 2011 that she showed all the signs of being in a “permanent vegetative state.” Virani’s petition said Shanbaug was lying in the hospital room like a “dead animal” — her bones brittle, her hands twisted, and her skin “like papier-mâché stretched over a skeleton.”
But the hospital fought in court against ending Shanbaug’s treatment. The court eventually passed a judgment permitting passive euthanasia in India. The judges said that Shanbaug’s primary caregiver was the Mumbai hospital, however — so it can choose whether to pursue euthanasia.
Last month, India’s health minister, J.P. Nadda, confirmed the judgment in Parliament, saying the ruling should now be “followed and treated as law.”
The debate generated by Virani’s court case also affected the anti-rape law that India passed two years ago. The measure treats a violent act that results in a victim being left in a vegetative state as on par with murder.
While the law on passive euthanasia is historic, the practice may not find wide acceptance among Indians, Parkar said.
“We come from a culture which believes in destiny, duty and compassion,” Parkar said. “We are not an individualistic society like the West.”
Analysts say that the law is a sign that Indian society is changing in fundamental ways.
“That such a significant law is accepted fairly noiselessly tells us something about the pressures and rhythms of contemporary Indian society,” said Santosh Desai, a social commentator in New Delhi. “The traditional Indian family support system upon which so much of our social custom is predicated is crumbling. This — coupled with rising health costs and urban lifestyles — [has] brought a degree of pragmatism.”
Meanwhile, Shanbaug’s life is caught between those who want to protect her and those who wish that her slow decline ends soon . Her teeth have deteriorated and are falling out, according to Parkar and Virani. She is fed through a tube. Her fingernails grow into the skin of her palm.
Virani calls the bed she lies in a “prison.”Tags: end of life, India, passive euthanasia