By John B Monteiro

Nov 26: Senior Congress leader, West Bengal Congress’ former president and former Union Minister Priya Ranjan Dasmunsi, 72, died at a hospital in Delhi on November 20, 2017. On October 12, 2008, Dasmunsi fell into a coma after suffering a stroke from which he never recovered.

A lot of important people, across party lines, said very nice things about him. But, since 2008, he was a breathing cadaver (my term), supported by life-prolonging breathing and other medical devices. May his soul rest in peace.

While he is dead, he leaves behind some painful issues. When he got his stroke, he was a central minister and apparently the bills of the star hospital where he died were paid by the government while he lay in a vegetative state for nine long years. But, this article is not quibbling about hospitalisation duration and cost or who met them, but about larger issues of pro-life, right to die, assisted suicide, mercy-killing and euthanasia.

Compared to Dasmunsi, at least two other persons had been preserved as breathing cadavers for even longer time. I have tracked the subject, and written on it, for over a decade and two instances are focused on here.

The first of these, holding a world record for such vegetative living, was set in Mumbai. It concerned Aruna Shanbaug who lived in a vegetative state in KEM Hospital, where she was sexually assaulted by an hospital orderly. She was in that state for 42 years, though her case for withdrawing life support system went to the Supreme Court in December 2009 where permission was not granted on final hearing, in 2011, with the hospital opposing it.

Aruna was kept in a room strictly off bounds for all except those attending on her. Her eyes were open and staring vacantly into space. She had been lying in this vegetative way, in the twilight zone between life and death, since the night of November 27, 1973, when she was attacked by a ward boy who tied a dog chain around her neck, cutting off air supply to parts of her brain, and sodomised her in the basement of KEM Hospital at Parel, where she worked as a nurse. It is said that due to strangulation by the chain, the cortex was damaged and she also had brain stem contusion injury associated with cervical cord injury. Aruna was unable to speak, see, walk or even move voluntarily, though she could still feel the pain. She had been lying in this state with twisted form, rotting teeth and nails growing into her clenched palms, kept alive by mashed food which she automatically swallowed.

The Supreme Court admitted Aruna’s petition through her ‘next friend’, Pinki Virani, the journalist-activist, who first brought Aruna’s cruel fate to light through a book on her and had since kept her in the public domain. Her petition in the Supreme Court had argued that since Aruna had consistently been denied the right guaranteed in Article 21 of the Constitution, she asked the Court to define ‘life with dignity’ and that her face-feeding to be stopped. Her petition highlighted Aruna’s “persistent vegetative state” for the last 37 years (then) and stated that there was no possibility of improvement in her condition. It pointed out that she “lives in sub-human conditions” and was “lying in a hospital bed like a dead animal”. It went on to argue that to keep her in this state by feeding her “violates the right to live with dignity” guaranteed by Article 21”.

When the Court asked KEM Hospital, its Dean, Sanjay Oak, brazenly responded with some PR-type insensitive statement claiming that Aruna ‘accepted food in the normal course’ and was ‘led’ to the toilet by nurses when she made indicative sounds. He said: “It is our foremost duty to take care of her. The way she has been taken care of also speaks volumes about the nursing at the hospital. She is really precious. Unless the ailing person himself or herself expresses such a desire, who are we to decide that he or she should no longer live?”

This takes us to the second case set in USA in the first decade of the present century when George Bush was the US President, involving Terry Schiavo whose case had thrown up legal, moral and ethical debates across the US, and even worldwide, with media widely covering the case and taking editorial note of. But, again, first the facts.

Terri was the daughter of Robert and Mary Schinder, married to Michael Schiavo. Terri, the 41 years old woman (then) had been in what doctors called a persistent vegetative state for fifteen years following a heart attack. Her husband, who was her legal guardian, said that his wife would not want to be kept alive artificially and should be allowed to die. Her parents said that her condition could improve with treatment.

All that kept Terri alive was the feeding tube. There had been a legal battle with Terri’s husband on one side and her parents on the other, about removal of the feeding tube and allowing her to die. Nearly two dozen judges of first instance, appeal and review had upheld the husband’s plea for disconnecting the feeding tube.

Then the subject jumped from law to politics. Jeb Bush, Governor of Florida and brother of President George Bush, got into the act to rush through a fresh law enabling Federal Judges to review the cases of State Judiciary. Even President Bush backed up this move because a significant Republican vote bank was said to be pro-life. Jeb Bush became a purveyor of medical facts and gave a new twist to the case. He said that “the neurologist review indicated that Terri may have been misdiagnosed and it is more likely she was in a state of minimal consciousness rather than a persistent vegetative state”.

Analysing the situation, Sydney Blumanthal, former Senior Advisor to President Clinton, writing in The Guardian (London), had this to say: “Terri Schiavo cannot speak or gesture, but to true believers, even though she is silent, she is making sounds only they can hear. They say what they want to in order to believe, and they believe in order to see. For the first time public policy in US is made on the basis of pitting invisible signs versus science”.

Beyond the facts of the case, there were, and are, wider issues. It is to be noted that in the US there were (then) 35,000 other people in persistent vegetative state. India and the rest of the world are not free of this situation.
Therefore, the question starts as to who should have the final say in cases like Aruna and Terri – the legal guardian (husband in Terry’s case) or the parents who have no legal status. What is the role of doctors in this context – as they are sworn to uphold life? Is the situation open to abuse so that recoverable person can be killed to grab his property and assets? The whole subject has implications beyond Terri-like cases and these were not buried with Terry, or cremated with Aruna and Dasmunsi.