Understanding the Aruna Shanbaug case that prompted Supreme Court's verdict on passive euthanasia

The historic landmark passed by the Supreme Court on Friday over legalizing passive euthanasia – a condition where there is withdrawal of medical treatment with the deliberate intention to hasten the death of a terminally-ill patient – will be lauded by many, particularly those who advocated that nurse Aruna Shanbaug should die with dignity after she ended in a vegetative state 45 years ago after she was brutally raped.

On Friday, the Supreme Court bench headed by Chief Justice Dipak Misra, and comprising justices AK Sikri, AM Khanwilkar, DY Chandrachud and Ashok Bhushan, said right to die peacefully is part of fundamental right to life under Article 21 of the Constitution. Article 21 provides that "no person shall be deprived of his life or personal liberty except according to procedure established by law."

The apex court, however, had observed that there should be adequate safeguards and implementation of living will would be subject to medical board's certifying that the patient's comatose state is irreversible.

The top court had in 2011 recognised passive euthanasia in Aruna Shanbaug's case by which it had permitted withdrawal of life-sustaining treatment from patients not in a position to make an informed decision. The Centre had opposed recognition of 'living will' and said the consent for removal of artificial support system given by a patient may not be an informed one and without being aware of medical advancements. It had cited examples of various countries in disallowing creation of living will by patients.

The Supreme Court of India had in 2010 admitted a petition to grant euthansia to Shanbaug, because of her permanent vegetative state. However, it was turned down the following year.

Shanbaug had been assaulted on November 27, 1973 while she was changing in the hospital basement. The rapist choked her with a dog chain and then sodomized her. The asphyxiation cut off oxygen supply to her brain, resulting in brain stem contusion injury and cervical cord injury apart from leaving her cortically blind. After this she slipped into a vegetative state and has remained in that condition ever since.

The ward boy who assaulted Shanbaug, Sohanlal Bhartha Walmiki, has never been prosecuted for rape - because the then-Dean Dr Deshpande concealed the incident of anal rape from the investigation. However, Walmiki served two concurrent sentences for robbery and attempted murder.

Pinki Virani, a social activist, filed a petition in the Supreme Court arguing that the "continued existence of Aruna is in violation of her right to live in dignity".  This plea was rejected by the apex court that also laid down guidelines for passive euthanasia. According to these guidelines, passive euthanasia involves the withdrawing of treatment or food that would allow the patient to live.

Forms of active euthanasia, including the administration of lethal compounds, legal in a number of nations and jurisdictions including Luxemburg, Belgium and the Netherlands, as well as the US states of Washington and Oregon, are still illegal in India.