A nurse died Monday, May 18, 2015, after 42 years in a coma following a brutal rape, in a case that led India to ease some restrictions on euthanasia.
The 66-year-old Shanbaug had suffered a bout of pneumonia in recent days and was on a ventilator, officials at King Edward Hospital (KEM Hospital) in Mumbai told the Press Trust of India news agency.
Aruna Shanbaug Story
Aruna Shanbaug was a nurse working at the government-run KEM Hospital in Mumbai, India who suffered brain damage from a sexual assault and strangling on 27 November 1973 by Sohanlal Bhartha Valmiki , a cleaner at the hospital where she worked. Shanbaug was attacked in the basement of the hospital where she was discovered 11 hours later, blind and suffering from a severe brain stem injury.During the attack she was strangled with a dog chain before raping her, which led her spinal injury and the deprivation of oxygen has left her in a vegetative state ever since.
Left bedridden, she spent more than four decades being cared for by a team of doctors and nurses at the hospital.Her attacker was freed after a seven-year jail sentence.
“Her actual death happened in 1973 (the date of the attack). Now what has happened is her legal death,” her friend and journalist Pinki Virani told Zee News TV channel.
She has been treated at KEM since the incident and is kept alive by feeding tube.
Of behalf of Aruna, her friend 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”. The Supreme Court made its decision on 7 March 2011 rejecting the plea to discontinue Aruna’s life support but issued a set of broad guidelines legalizing passive euthanasia in India. The Supreme Court’s decision to reject the discontinuation of Aruna’s life support was based on the fact the hospital staff who treat and take care of her did not support eunthanizing her.
“I was the first one to find Aruna in the empty operation theatre in this hospital’s basement after she had been raped and brutally assaulted by that animal Sohanlal (Valmiki). She was sitting, leaning against a stool with a dog-chain around her neck. There was blood around her. I ran out and brought the matron. As soon as she saw matron Bellimal, her eyes welled up and tears streamed down her face. She tried to say something but could not… only her lips moved. And then, slowly she lost consciousness,” remembers Pramila Kushe, 80 years old retired nurse, her own eyes brimming.
Pramila made the trip to join serving and other retired nurses who were celebrating after the Supreme Court rejected the euthanasia plea for Aruna Shanbaug.
She hangs around with some other retired nurses outside the ward as they discuss Aruna’s one-time fiancé Sundeep Sardesai. The two were to marry.
Sundeep was a resident doctor in the hospital at the time of the attack on Aruna by wardboy Sohanlal Valmiki. Sundeep had waited patiently for Aruna to revive for four years — visiting her every day and talking to her for hours and crying by her bedside.
He had eventually moved on — married and settled down abroad.
On Monday, a day after the court verdict, young nursing students went about their daily chores while maintaining a tight vigil outside the locked door. Strains of devotional music wafted out. A brown curtain adjacent to the door remains determinedly drawn to prevent voyeurs from robbing Aruna of her dignity.
“She is sleeping now. The music plays on 24 hours — she likes it,” says Kalpana Gajula, a former staff nurse who is now a tutor.
“Nursing students, under the watchful eyes of senior nurses, take care of her. She is currently being fed by RC tubes. We feed and clean her every four hours. Pinki Virani calls this force-feeding. Tell me if a patient can’t be fed through mouth for some reason and has to be fed through nose, is it force-feeding? Aruna does respond to some of us who have known her for long hours. If she wets herself, she shouts till cleaned. She is not a vegetable as Pinki claims,” Gajula says.
The panel of doctors who examined Aruna on the court’s orders, however, has diagnosed her as being in a medically “vegetative state”.
“The claims about her recognition powers are mere wishful thinking of her caregivers who share an emotional bond with her. But I must point out that when we went to inspect her, the doctors of KEM hospital put cubes of sugar in her mouth and Aruna munched on them fondly,” said Dr Nilesh Shah, who was on the panel.
She was not in a state to munch sugar cubes on Monday — but the nurses say they will offer her sugar-infused water in one of her feeds to celebrate the Supreme Court verdict.
Aruna Shanbaug’s Life Shaped India’s Law on Death
“Pinki Virani murdabad.. Pinki Virani ke liye iccha maut (mercy killing)… Aruna Shanbaug zindabad.”
In a case that has profoundly shaped India’s laws on life-support treatment, Aruna in Mumbai has died after spending nearly a half-century in a vegetative state after a brutal rape.
“Our Aruna has given our country a big thing in the form of a law on passive euthanasia,” Pinki Virani said.
Aruna is a mascot for many of these nurses and the verdict brings them a sense of closure, though the court has given the hospital the option to approach Bombay High Court with a petition for passive euthanasia.
Until Ms. Shanbaug’s case, there was no statutory provision in India covering the legal procedure for withdrawing life support to a person in a permanent vegetative state or who is otherwise not capable of taking a decision about ending their own life support.
Shanbaug’s plight became a focal point of debate on euthanasia in India after Virani appealed to India’s top court in 1999 to allow her to die with dignity.
The court examined the question of whether it was in the best interest of the patient that her life should be prolonged by life-support treatment.
“This is an extremely important question in India,” the two-judge bench said. “The Court has to be very cautious that unscrupulous persons who wish to inherit the property of someone may not get him eliminated by some crooked method.”
The court concluded that Ms. Shanbaug couldn’t be described as dead. “She breathes on her own without the help of a respirator. She digests food, and her body performs other involuntary function without any help,” according to the judgment.
The court also laid out some rules: It said that such a decision required the approval of the High Court, and also specified that the High Court should explain how the decision was in the patient’s best interest. The process also required getting the opinions of three doctors who had examined the patient. In Ms. Shanbaug’s case that meant the hospital staff, in part because her parents had passed away.
“The High Court should give its decision speedily at the earliest, since delay in the matter may result in causing great mental agony to the relatives and persons close to the patient,” the court said.
Euthanasia is a crime in India. The court had to consider whether what is known as passive euthanasia, or failing to give life-saving care, is illegal. Furthermore, the court weighed at what stage, if ever, a person responsible for feeding such a person might lawfully stop doing so.
In India, abetment to suicide is a crime punishable with 10 years in jail.
On May 17, Sunday night — hours before the Supreme Court verdict — Sundeep had called KEM matron M.P. Khaladkar. “He called again on Monday after the verdict. He spoke very little, asked how she was. He seemed very relieved with the judgment,” said Khaladkar, unwilling to give out more details.
She walks away, nodding at staff nurses as they distribute sweets and raise slogans against writer Pinki Virani who filed the petition seeking Aruna’s mercy killing.
Indian laws do not permit euthanasia or self-starvation to the point of death.
In Ms. Shanbaug’s case, the court said doctors and nurses at the Mumbai hospital where she was a patient were of the opinion that she was still “very much alive” and her care should continue. Thus, the judges dismissed the petition for doctors to discontinue feeding her.
As a result of the rulings, Ms. Shanbaug’s life and the manner of her death have become a model for the treatment of people on life support in India.
But in 2011 the Supreme Court decided that life support could be legally removed for some terminally ill patients in a landmark ruling that allowed “passive euthanasia” for the first time.
The court said withdrawing life support could be allowed in exceptional circumstances, provided the request was from family and supervised by doctors and the courts.
The supervision was required to prevent “unscrupulous” family members attempting to kill off wealthy relatives, the Supreme Court had said.
Shanta Nayak, her sole relative in Mumbai, died in September 2013. KEM Hospital employees said her relatives had stopped visiting her a few years after the rape. Since then, nurses and doctors had cared for her.
The court however rejected Virani’s request to stop Shanbaug being force-fed on the grounds that she was not legally eligible to make the demand on Shanbaug’s behalf.
Sohanlal Bhartha Valmiki Conviction
“Aruna’s rape and assault had sparked Independent India’s first nurse strike — demanding justice and treatment for her and better protection and working conditions for the nurses. It led to Sohan Lal’s arrest and conviction but unfortunately, he was never tried for rape. Today, the wheel of justice seems to have come full circle with the SC rejecting another attack on her life,” says an emotional Deepa Mehta, former matron of KEM and caregiver to Aruna for two decades.
Sohanlal was convicted and served two concurrent seven-year sentences for assault and robbery, and not for rape, molestation or alleged unnatural sex as a hospital official deleted parts of her medical report that proved Aruna had been sodomised.
This was done to ensure that she did not face any ostracism after her recovery and marital life with Sundeep. “But Aruna never recovered and Sohanlal got away with seven years. Recently, I heard he had contracted a life- threatening disease and is dying or is dead,” said Deepa.
After his release, Sohanlal went on to work in a private hospital in Delhi for many years. But he returned to attack the comatose Aruna again after he was released from jail after seven years. He had sneaked into her room and had brought down the rails of her bed in an attempt to push her down from the bed.
Aruna’s room is just outside Ward No. 4 and has been kept under lock and key since then with only doctors and caregivers allowed entry.
Can Sohanlal Bhartha Walmiki be tried for murder?
The Maharashtra government on Monday, May 18, said it will not reopen the case of Aruna Shanbaug, unless the court orders.
“If somebody goes to court asking for reopening of the case, the state government will do as per the court’s orders. The government cannot ask the police to take suo motu action. The (court) verdict has already been given. If we order the reopening of files, it will be disrespecting the court’s judgment,” minister of state for home Ranjit Patil said.
“If somebody comes with proof that a specific point was not considered by the court while delivering the verdict and if the court deems the proof to be valid, it may ask us to get the file reopened,” Patil said.
“Many times in the past the court has asked the government to reopen files. If any person or a rights organisation comes forward requesting the court…we will abide by the law and ensure complete co-operation,” he said.
Though Aruna has remained off and on in the limelight for decades, no one has caught a glimpse of Sohanlal in all these years, his current whereabouts remain a mystery.
“I tried desperately to get a picture of him, but it wasn’t anywhere in the records,” says author and activist Pinki Virani to The News Minute. Virani has championed Shanbaug’s case and says the entire thought of there not even being a picture of Valmiki is “funny and tragic”. Sohanlal walked free in 1980, but the hospital, jail, court and police files have no picture of his.
Valmiki was convicted of assault and robbery for which he was sentenced to two concurrent 7 year imprisonments; but, such was the mockery of life that he completed his term and was set free from the prison in six years, whereas, all that was left of Aruna was a screaming, vegetative body.
Journalist and writer Pinki Virani, who has written a book titled ‘Aruna’s Story’, says, “The worst part: he was not sentenced for rape because he had not committed the rape vaginally; it was anal.”
A report in The Times of India says that the examination of Aruna when she was found the next morning was by what is called the “two-finger test”. The test, which was banned in India in March last year, entailed the insertion of fingers into her vagina to check virginity. It confirmed that her hymen was intact and that was that. At the time, Aruna was engaged to a junior doctor at the hospital.
The then hospital dean chose not to report the anal rape to the police in order to spare the couple the public disclosure. Her fiancé was also discouraged from being a complainant. Instead, a sub-inspector became the complainant as no one else was willing.
The judgment against the rapist noted “that the victim was menstruating and the accused had gone there with the intention to rape.” But as Valmiki was not charged with rape, he was convicted only for attempt to murder and robbery.
He was sentenced to seven years, which was reduced to six because he had already served a year in lock up. According to Virani, some ward boys claimed Sohanlal who hailed from Bulandshar in Uttar Pradesh, changed identity and started living in Delhi.
The Bhoiwada police, who had registered the case in 1973, are exploring the possibility of registering a case of murder against Valmiki.
They first have to find out if the assailant is alive or not.
Shanbaug, we know, is not anymore.
Tributes to nurse who died after 42 years in vegetative state
On May 18, 2015, hundreds had gathered for the funeral of 66-year-old Aruna Shanbaug who died in a Mumbai hospital after developing pneumonia last week.
Shanbaug was laid to rest on Monday evening at a funeral attended by many hospital staff. Her case sparked a legal debate about the use of passive and active euthanasia in India.
Her last rites were performed by the dean of the hospital where she was warded, and her nephew. Nurses who had personally cared for Shanbaug bid a tearful farewell to her at the funeral.
Anju, a nurse who took care of Shanbaug, said: “The entire nurse fraternity at the hospital used to take care of Aruna.”
Kalpana, another nurse who took care of Shanbaug, said: “She was in vegetative state ever since the incident. We used to feed her non-vegetarian food after understanding her preferences. She used to scream when she got hungry.”
The Wall Street Journal
Channel News Asia