Apex court norms to decide fate of terminally-ill patients

By IANS,

New Delhi: The Supreme Court Monday laid down the guidelines on withdrawal of life support systems of terminally-ill patients. It was hearing a plea related to Aruna Shanbaug, 63, a comatose patient being nursed in a Mumbai hospital for the past 37 years.


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The apex court bench of Justice Markandey Katju and Justice Gyan Sudha Misra framed the procedure while disagreeing with Attorney General G. Vahanvati’s submission opposing putting terminally-ill patients to sleep on the grounds of mercy killing.

The attorney general said that such a step would be cruel and inhuman and against the ethos of the society.

He told the court that even the central government did not agree with the Law Commission’s recommendations on this.

The court agreed with amicus curiae T.R. Andhyarujina that passive euthanasia (withdrawal of life support systems of a terminally-ill patient) should be permitted in certain situations.

The judgment noted that safeguards in the procedure leading to passive euthanasia were essential to check “misuse by some unscrupulous persons who wish to inherit or otherwise grab the property of the (terminally-ill) patient”.

“A decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives or in the absence of any one of them such a decision can be taken even by a person or body of persons acting as a next friend. It can also be taken by the doctors attending to the patient. However, the decision should be taken bona fide in the best interest of the patient,” the court said.

The judges said “…even if the decision is taken by the near relatives, or doctors or the next friend to withdraw life support, such a decision requires approval from the high court concerned…”.

When an application is made before the chief justice of the high court for the grant of approval, the chief justice shall “forthwith constitute a bench of at least two judges to decide to grant approval or not”.

Before taking any decision, the high court bench should seek “the opinion of three reputed doctors to be nominated by the bench after consulting such medical authorities/practitioners as it may deem fit”.

The court said that preferably “one of these doctors should be a neurologist, one should be a psychiatrist and the third a physician”.

“The committee of three doctors nominated by the bench should carefully examine the patient and also consult the record of the patient as well as take the views of the hospital staff and submit its report to the high court bench,” the judgment said.

“Simultaneously, with the appointing of the committee of the doctors, the high court bench shall also issue notice to the state and close relatives – parents, spouse or brother/sisters – of the patient, and in their absence his/her next friend, and supply a copy of the report of the doctors’ committee to them as soon as it is available. After hearing them, the high court bench should give its verdict.”

“The high court shall give its decision speedily, since delay in the matter may result causing great mental agony to the relatives and persons close to the patient,” the judgment read.

“The above procedure should be followed all over India until parliament makes a legislation on this subject,” the apex court said.

Shanbaug, a nurse employed in Mumbai’s King Edward Memorial Hospital, has been in a “persistent vegetative state” for the past 37 years after being sodomised by a hospital sweeper.

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