Hello
Pasting a posting from our member which did not come to the list.
Harish Kotian.
I do not know how I will thank you Vaishnavi for sending this.
We need to address the issue of revoking attempt to suicide as a criminal
offence as well. Large percentage of persons with psycho-social disabilities
are criminals under Section 309 IPC at present. What's the point of discussing
Legal capacity issues in Draft New Law if we do not talk about all these?
Shampa Sengupta
On Sun, Mar 13, 2011 at 7:08 PM, Vaishnavi Jayakumar
<jayakumar.vaishn...@gmail.com> wrote:
Where exactly do the Aruna Shanbaugs of India belong?
Where do abandoned elders belong? Or incapacitated destitute Indians?
Who protects their rights?
Who safeguards their lives?
Is Aruna disabled according to current Indian legislation - draft bill or law?
If so would she be eligible for protection and guardianship under the National
Trust Act or Disability Rights Authority?
Aruna has been physically and mentally incapacitated for over 3 decades now -
so who should be her 'guardian'?
And who shall guard the guardians themselves?
WHO DECIDES? AND HOW?
The Unaware Mascot of Limbo Land
ARUNA'S CHOICE
It's time India established public guardianship procedures - our default
assumption of sustained selflessness in long term familial or community 'duty'
towards someone profoundly incapacitated, is facile.
What about people who are destitute? What when the family can't/won't continue
providing care to the chronically incapacitated member? Suppose in that context
a friend or random stranger IS willing and able?
What happens when noone cares?
'Alive' today, Aruna is a testament to the KEM's commitment and sustained,
dedicated nursing. And I am truly awed by this phenomenon. What's disturbing is
her sudden poster-girl status and the tug of war 'custody' battle between
diametrically opposed parties who care for her. Albeit in different ways. Two
actively pursued options for a victim trapped in a permanent vegetative state
for decades, waiting for release. Passive prisoner in her own private hell,
Aruna is powerless to make a decision one way or another.
It makes one wonder... Do we want people alive for their sake or for ours?
Death is a big deal in India - mostly for the people one leaves behind.
Sadly, an individual silently suffering in Life comes a dismal second.
http://www.outlookindia.com/article.aspx?270853
Society / Opinion
MAGAZINE | MAR 21, 2011
TV Grab: A file photo of 60-year-old nurse Aruna Shanbaug who, since the last
37 years, has been living in a vegetative state in a Mumbai hospital. The
Supreme Court dismissed a plea for the mercy killing of Aruna.
OPINION
You Are Herewith Sentenced To Life
Let Aruna die? No, with her alive, there's more power, media attention. Hence,
the politics of mercy in medicine.
PINKI VIRANI
Lucknow airport. Late '90s. Khushwant Singh and I are waiting for our flights,
we talk about Prime Minister A.B. Vajpayee mentioning my book Once Was Bombay
in a speech on collapsing cities. He suddenly asks, "You wrote that book on the
woman who neither lives nor dies, you still see her?"
I say I'm banned by the hospital. Nothing new for me, though. Each time egos
change-deans, doctors, matrons-I've redone the process with these authorities
to stay in touch with Aruna Shanbaug. It's a pattern since 1982.
This time I should have been grateful for infrequent consent to visit her
locked room. Instead, I had questioned their mandate. I had reported to
newspaper editor Bachi Karkaria that the doctors had violated Aruna's right to
live with dignity. They had withdrawn permission for her complete medical
check-up. Granted, as it were, after my physical and telephonic running around
for several agonising days.
The full medical in a private hospital, at no cost to this municipal hospital,
would have inspected Aruna from head to toe. Testing would have ranged from
blood-routine to vital organs and a brain-scan. A skilled anaesthetist would
have made the procedures painless for Aruna. Her rotting teeth, due to infected
gums, would have also been dealt with. An ambulance with a private doctor would
have picked up Aruna in the night since she had not felt sunlight for more than
two-and-a-half decades. I also signed a letter taking all responsibility.
The idea, after the complete examination, was to consult top medical minds. On
their recommendation for follow-up treatment, I planned to approach the Bombay
High Court and point out that since Aruna's medical care was at the mercy of a
doctor-bureaucracy which had not conducted any further tests on its own, my
husband and I-as responsible, tax-paying citizens-were willing to be appointed
guardians. We would buy the best medicines, ensure the treatment.
Above is the pretty picture of Aruna, the one I released of a 16-yr-old. The
62-yr-old reality is a twisted, brittle skeleton.
Aruna is denied the medical tests, permission withdrawn at the last hour.
Reason given? None. After much angry persuasion, the response is the same as
that given by the nurses when preventing her from receiving physiotherapy:
"Supposing something happens to her?"
Aruna Shanbaug. Sodomised. Strangled with a dog-chain while being brutalised.
Extensive brain stem injury, partially brain-dead. Cortically blind. Cannot
speak. Or walk. No control over body movements. Administered mashed food,
swallows automatically, upchucks equally. Teeth loosening and falling-one by
one-on her bed. In pain. Shrieking. Howling. Weeping. Laughing manically. After
the initial days, no medicines prescribed by the doctors, so none given.
Abandoned by friends; authorities don't encourage their visits as they are not
blood relatives.Abandoned by relatives; they used to be constantly told by this
free hospital to "take her home". I've been told too. I would if I could; but
it doesn't change the fact that Nurse Aruna Shanbaug has every right to remain
in that hospital. Hers is a case of aggravated sexual harassment and assault in
the workplace. The hospital would have had to pay large cash compensation plus
provide permanent care had her relatives been well-educated, not poor, and had
access to a responsive legal system.
Abandoned, too, by municipal doctors; and here is the supreme irony. The daily
devotion of her nursing colleagues has been so systematically thrust upfront
that it has successfully masked the medical mismanagement of Aruna's case by
key municipal doctors. Hypocrites also take the Hippocratic oath. After Aruna
was brutally assaulted, no doctor at the hospital was willing to file a
complaint that drew attention to the fact that she had been anally raped, even
though there are now claimants to "being there first to treat her". The result:
the sodomiser walked free after a mere seven years in jail for robbery.
And so, equally abandoned by the law.
Aruna Shanbaug. Born June 1, 1948. Murdered-but-not-killed November 27, 1973.
Khushwant Singh then asks his second question,
"You think there is a God?"
***
Delhi. 2009. I'm standing below the flag of India that flies above the main
dome of the Supreme Court. I look up at it. If God has abandoned Aruna too,
can't we at least ensure that her pain is validated by her country?
My plea as her "next friend" must have been heard by some divine force,
listening in just then. For the Supreme Court decides to accord that dignity to
Aruna Shanbaug which has been denied to her for more than three-and-a-half
decades by admitting the case.
The plea simplified: Please define Right to Live with Dignity as enshrined in
Article 21 of the Constitution. And if this is not it, please taper out the
force-feed.
Cut to 2011. Because of the Supreme Court's orders, after 37 years, Aruna
Shanbaug gets what she should receive annually: a medical check-up.
If I were consulted, I would have recommended two doctors. From the UK, where
vegetative pain management intertwines with compassion. From Liege, where
research combines with machines to evaluate levels of patient consciousness.
The medical report confirms that she fulfils most criteria of those in a
permanently vegetative state. Such patients do not have favourite foods, music,
people. Their smiles are not reactions to external influences. She is incurable.
But Aruna Shanbaug must not, cannot, die. Not when there are medical names
involved in this medico-legal case. There are promotions, file-markings,
resident quarters, spacious flats in prime residential areas. Everyone can move
on to private practice or retirement; none need return to her locked room.
Meanwhile, with Aruna alive, there is more power, more media attention,
international conferences. And so they play their politics around the motives
of mercy in medicine.
The medical report comes with a brief CD on Aruna as she is today. It is shown
in the packed court-room.
The might of the state against the individual starts its road-roller grinding.
Look, no bed sores.
Listen, she is not completely brain-dead or she would not be making those
noises.
See, she moved. She is not in a full coma.
Cures are being found everyday.
When the state is looking after the suffering, outsiders need not be concerned.
It is against Indian culture.
My poor, poor Aruna. All I have, standing in this one corner, is my choice to
be morally accountable for you, no matter the consequences in the Court of God.
And then, his voice cutting through the clutter of righteousness, I hear the
judge use the words "passive euthanasia".
***
This, too, is how landmark judgements come to a country.
Please see the Supreme Court website where it has been uploaded. Please see
whether the court thinks Aruna's current situation is a "life" even though it
rules that she must "live". The status quo of the caregivers as deciders of her
fate has been maintained, but do read the bit that tells you they can approach
the high court should they ever come to "change their mind".
Meanwhile, because of this broken woman denied the choice, all of India has
one. Passive euthanasia is legalised-it remains in effect at least till
Parliament rules otherwise-and none need suffer the way Aruna Shanbaug has. And
continues to.
Another gift. The order on euthanasia offers clarity on organ donation in
medico-legal cases. Crucial time tends to get lost over definitions of brain
death, consequently healthy vital organs are frequently wasted.
That CD shown in the court? It is so gruesome that even the generally
no-holds-barred regional television channels are unable to run it in full.
Thus, what you have been seeing is the pretty picture, the one I released of a
16-year-old girl who had it framed and put up in her village home before she
left it.
The 62-year-old reality has been locked away. Always in pain, no palliatives
prescribed. No teeth. White cropped hair. A feed-pipe running from her nose to
her stomach. Feral sounds from a twisted and brittle skeleton. From which
finger nails continue to grow, cut into her palms. Prone to diarrhoea, yet no
catheter. Doomed to a very painful, and very slow, death.
Aruna Shanbaug. Prisoner of the state, held hostage by the quality of its mercy.
________________________________________
(Pinki Virani, a national award-winning author and activist, moved the Supreme
Court on behalf of Aruna Shanbaug asking for her force-feeding to be stopped so
that she could die peacefully. While not permitting that, the apex court
delivered a landmark judgement on passive euthanasia.)
Click here to see the article in its standard web format
SUGGESTED READING (especially before responding!)
Definitions here:
http://www.merckmanuals.com/professional/sec16/ch212/ch212b.html
Interesting POVs here:
http://www.issuesinmedicalethics.org/072or054.html
http://www.timesonline.co.uk/tol/life_and_style/health/article3004892.ece
http://omarkasule-04.tripod.com/id1334.html
http://www.newscientist.com/blogs/shortsharpscience/2009/11/detecting-consciousness-ways-t.html
And for assisted suicide, active / passive euthanasia and mercy killing
disctinctions:
http://www.bbc.co.uk/ethics/euthanasia/overview/activepassive_1.shtml
http://www.novelguide.com/a/discover/epop_01/epop_01_00118.html
http://www.articlesbase.com/health-articles/mental-health-ethics-euthanasia-139798.html
http://www.supremecourtofindia.nic.in/outtoday/wr1152009.pdf
http://www.columbianeuroicu.org/patient-information.html
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