Harish Rana Can Die Because Aruna Shanbaug Lived: India's Euthanasia Journey

Fifty-three-years before the Supreme Court allowed Uttar Pradesh's Harish Rana to die, a 25-year-old nurse suffered a brutal sexual assault at Mumbai's King Edward Memorial Hospital. The assault, during which she was choked with a dog chain, caused severe brain damage and left her in a vegetative state for the next four decades. And her life would become the foundation for the 'right to die' in India. As the top court allows passive euthanasia for Harish Rana, a 31-year-old who has been in a vegetative state for the past 13 years, it is time to revisit the heartbreaking story of Aruna Shanbaug.

A Brutal Attack

According to reports, Aruna Shanbaug was about to leave the hospital after her shift ended on November 27, 1973, when she had an altercation with Sohanlal Valmiki, a janitor. Valmiki has said in multiple interviews that he had a troubled relationship with Shanbaug and accused her of picking on him. He has said that on the day of the incident, Shanbaug denied his leave request. In a fit of rage, he slapped her and left for home.

But Shanbaug was found with severe injuries, with blood all around her. She was leaning against a stool, a dog chain around her neck. Medical examination revealed that she was choked with the chain and raped. Valmiki was convicted of attempted murder and robbery for stealing Shanbaug's watch and earrings.

Pinki Virani, who documented Shanbaug's story in Aruna's Story: The True Account of a Rape and its Aftermath and later filed a euthanasia plea on her behalf, said, "The worst part: he (Valmiki) was not sentenced for rape because he had not committed the rape vaginally; it was anal."

The Lasting Damage

Shanbaug's colleagues have said that when they found her, she tried to speak but could not, and then she became unconscious. The choking with the dog chain had cut off the oxygen supply to her brain, leading to permanent damage. Her eyes could see, but her brain could not register the images. She also suffered a brain stem contusion and a cervical cord injury. This led to a vegetative state: she could not speak, emote, or use her limbs.

Shanbaug had eight siblings. Hospital authorities say most of them stopped visiting her after a while. The family members, however, have dismissed allegations that they abandoned her. They have said that they stopped visiting because the hospital authorities would ask them to take her, and they did not have the means to look after her.

So, it was the staff of the KEM Hospital, including Shanbaug's colleagues, who looked after her for over four decades.

At the time of the brutal attack, Shanbaug was in a relationship with Dr Pratap Desai, also working at KEM Hospital. In a 2015 interview with Mumbai Mirror, Dr Desai said he visited Shanbaug several times after the brutal attack. "Every time, I would try to speak to her," he said. "But her condition never improved, and it became really painful to see her like that." Dr Desai married in 1977, opened his clinic and got busy with what he described as "ordinary life".

The Euthanasia Judgment

In 2009, 36 years after Shanbaug suffered the injuries that would put her in a vegetative state, the Supreme Court admitted a plea to end her life. The petitioner was author-journalist Virani, who wrote a book about Shanbaug. The court consulted a medical panel, which concluded that Shanbaug met most of the criteria of being in a permanent vegetative state.

On March 7, 2011, the Supreme Court passed a landmark judgment. It issued a set of guidelines legalising passive euthanasia in India. The court ruled that a decision on discontinuing life support has to be taken by the individual's parents or spouse or other close relatives, and in their absence by a person or a body of persons acting as a next friend.

In Shanbaug's case, Virani had claimed to be the "next friend". The hospital disagreed. "...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 hospital staff stressed that they wanted Shanbaug to live, leading the court to reject the passive euthanasia plea. The court said that the hospital staff can approach the Bombay High Court if they change their mind and decide to withdraw life support in the future.

The Constitution Bench

In 2014, the Supreme Court referred the question of passive euthanasia to a five-judge Constitution bench. This happened after a petition filed by the NGO Common Cause argued that a person should be allowed to die with dignity.

The Centre had opposed it and said it would have serious repercussions. "A doctor's duty is to preserve life, not take it," the government had said, saying that such a policy should be decided by the Executive, not the Judiciary.

A year later, Shanbaug was diagnosed with pneumonia. On May 18, 2015, she died after efforts to revive her failed. The hospital's nurses, who cared for her for decades, performed her funeral.

In 2018, the Constitution Bench fully legalised passive euthanasia and recognised the right to die with dignity as a fundamental right. Procedures and safeguards for passive euthanasia were laid down. The court also allowed "living will", which lets people decide against artificial life support. "When the sanctity of life is destroyed, should we not allow them to cross the door and meet death with dignity? For some, even their death could be a moment of celebration," said the bench. 

The Harish Rana Case

Today, the Supreme Court allowed passive euthanasia for a 31-year-old man, who has been in a vegetative state for the past 13 years after a tragic accident. The court also urged the Centre to consider bringing a law on passive euthanasia.

Harish Rana, a student of Panjab University, fell off the fourth floor of a paying guest accommodation in 2013 and suffered serious injuries. He was put on life support. Since then, he has been confined to a bed with a tracheostomy tube for respiration and a gastrojejunostomy tube for feeding. His parents approached the court with a passive euthanasia plea.

The bench of Justice JB Pardiwala and Justice KV Viswanathan said, "Harish Rana was once a bright young 20-year-old boy pursuing education at Punjab University when he had a fall from the fourth floor of a building and sustained brain injuries. Harish was discharged, but a brain injury left him in a persistent vegetative state. He experiences a sleep-wake cycle and is dependent on others. The medical report shows no improvement in 13 years," the court said. The court said that while a doctor's duty is to treat a patient, "that duty no longer sustains when the patient has no hope of recovery".