Aruna Ramachandra Shanbaug v. Union of India & Ors.

Case Title: Aruna Ramachandra Shanbaug v. Union of India & Ors.  

Citation: (2011) 4 SCC 454  

Court: Supreme Court of India  

Bench: Justice Markandey Katju and Justice Gyan Sudha Misra  

Type of Bench: Division Bench  

Date of Judgment: 7 March 2011  

Background & Context 

The Aruna Shanbaug case stands as a landmark judgment in Indian constitutional law, particularly  under Article 21 of the Constitution, which guarantees the right to life and personal liberty. The  case explored the question of whether this right also includes the “right to die with dignity”,  especially in situations involving individuals in a persistent vegetative state (PVS). The petition  raised the broader constitutional and ethical issue of euthanasia, whether and to what extent a  person, or their surrogate, can choose to end life to escape unbearable suffering or terminal illness.  

Parties involved 

Petitioner  

A petition was filed under article 32 of the Constitution of India by Ms. Pinki Virani on behalf of  Ms. Aruna Ramchandra Shanbaug. Ms. Pinki Virani was a noted journalist, author, and social  activist based in Mumbai. She filed the writ petition under Article 32 of the Constitution, claiming  to act as the “next friend” of Aruna Shanbaug. Having written about Aruna’s plight in her book  Aruna’s Story (1998), Virani approached the Supreme Court seeking permission to withdraw  Aruna’s life-sustaining treatment, asserting that her continued existence in a persistent vegetative  state violated her right to live with dignity under Article 21. Her plea represented a broader  humanitarian and constitutional claim advocating for the recognition of passive euthanasia in  India.  

Respondents  

The respondents included the Union of India, the State of Maharashtra, and the King Edward  Memorial (KEM) Hospital, Mumbai. The Union of India opposed the petition, maintaining that  euthanasia was not legally permissible under Indian law and that only Parliament could decide such a sensitive moral issue. The State of Maharashtra also resisted the plea, emphasizing the  sanctity of life and warning against potential misuse. The KEM Hospital staff, who had cared for  Aruna for over 36 years, opposed the withdrawal of life support, affirming that Aruna was not  brain-dead and continued to receive affectionate and ethical care. The hospital staff’s stance  ultimately influenced the Court’s decision to reject the plea while recognizing passive euthanasia  in principle.  

Facts of the Case 

Aruna Ramchandra Shanbaug was a staff nurse employed in King Edward Memorial Hospital,  located in Mumbai. One of the sweepers of the hospital attacked her on 27th November 1973. He  choked and strangulated her via a dog chain in order to restrain any movement from her end in an  attempt to rape her. Upon realizing that Ms. Aruna was menstruating he sodomized her. The very  next day, on 28th November 1973 Ms. Aruna was found lying on the floor with blood everywhere  and all over her. One of the cleaners found her in an unconscious condition. The strangulation via  the dog chain ceased the supply of oxygen to her brain causing severe damage to the cortex of the  brain. She sustained brain stem contusion too along with cervical cord injury. From 1973 to 2010,  Aruna remained in KEM Hospital under the dedicated care of the hospital’s nurses and staff. She  was fed by a feeding tube and kept alive without mechanical ventilation. After 36 years of the  incident, her next friend, Ms. Pinki Virani, filed a petition under Article 32 of the Constitution of  India. The petition made requests for allowing euthanasia for Ms. Aruna Shanbaug due to her  bedridden state. The petition further explained that she was in a permanent vegetative state. She  had no sense of her surroundings and was virtually a dead individual. The petitioner prayed for  Ms. Aruna Shanbaug to be allowed to depart peacefully by terminating her life supporting  treatments and withdrawing the necessary medicine and other essentials that kept her alive. The  petition prayed for ending her pain and suffering. Following this, the Supreme Court appointed a  team of three distinguished doctors to examine her thoroughly and submit an elaborate report of  Aruna’s state to the Court.  

Issues Raised 

1. Whether the right to life under Article 21 includes the right to die or the right to die with dignity. 
2. Whether passive euthanasia should be legally permissible in India, and under what safeguards.  
3. Whether the petitioner (Pinki Virani) could be considered as Aruna Shanbaug’s “next friend” to  make such a request.  
4. What role the judiciary should play in authorizing or regulating euthanasia. 

Arguments of the Parties 

Arguments by the Petitioner  

The counsel for the petitioner contended that the right to life guaranteed under article 21 includes  the right to life with utmost dignity. It must therefore also include the right to die with dignity. Any  individual suffering from any terminal illness or is in a permanent vegetative state must be included  under the ambit of the “right to die” in order to end the prolonged suffering and agony. She lacks  any awareness of her surroundings, is even devoid of the ability to chew her food, can’t express  anything on her own, and is just bedridden for the past 36 years with no scope of improvement.  The patient is virtually dead and the respondents by not feeding Ms. Shanbaug won’t be killing  her. Continuing Aruna’s life artificially, despite her irreversible vegetative state, was argued to be  an “unnatural prolongation of biological existence”, devoid of dignity or purpose. The petitioner  relied on judicial pronouncements suggesting that life under Article 21 is not mere animal existence  but a life of dignity. The petitioner emphasized that she was not seeking active euthanasia (a  deliberate act to end life) but passive euthanasia (withdrawal of life-sustaining treatment). It was  contended that passive euthanasia is morally and legally distinct from active killing, as it merely  allows nature to take its course. The petitioner referred to the earlier judgment in Gian Kaur v.  State of Punjab (1996), where the Supreme Court recognized that the “right to life” includes a  dignified life until death, and that the right to die with dignity in natural circumstances is not  inconsistent with Article 21. International precedents such as Airedale NHS Trust v. Bland [1993], were cited to support the distinction between withdrawal of treatment and active killing. It was  submitted that in several democratic jurisdictions, passive euthanasia was recognized under strict  medical and judicial supervision. Since Aruna was incapable of expressing consent, Pinki Virani,  having written about her condition and advocated for her, claimed the status of “next friend” under  law to represent her interests before the Court.  

Arguments by the Respondents  

The dean of the Hospital contended that Ms. Shanbaug was being fed and taken care of by the  nurse and hospital staff for as many as 36 years. The staff had exceptionally and with utmost  responsibility and willingness to take care of her. Therefore, they oppose and resent the idea of  Ms. Shanbaug being euthanized. Now that the patient has crossed as many as 60 years of age she  might naturally succumb to death. They begged the court to not permit the act of killing. The staff  has been diligently and with respect taking care of all her fundamental necessities and  prerequisites. On the off chance that this is legitimized, the act of euthanasia can be profoundly  inclined to abuse and taking a life intentionally which would violate Section 302 and Section 304  of the Indian Penal Code (IPC) concerning culpable homicide and murder. The petitioner unlike  the clinic staff neglects to have such a close-to home association with the patients and lacks the  necessary emotional attachment. The hospital staff has an emotional connection with the patient to  the extent that one of the nurses is ready to look after Mrs. Shanbaug for the rest of her life without being renumerated. The hospital’s staff’s exceptional and selfless service must also be taken into  consideration. Furthermore, since the patient herself is not in a condition to give consent for  withdrawal from the life support system the next big question to come into the picture Is who  would consent for Ms. Shanbaug.  

The Union of India opposed euthanasia on constitutional and legislative grounds. It argued that  there was no legal framework in India to regulate euthanasia. Permitting it through judicial  interpretation would amount to judicial legislation, encroaching upon the legislative domain. The  matter involved complex moral, social, and religious questions, which should be left to Parliament  to decide. The Union also cited Gian Kaur v. State of Punjab to argue that the right to life cannot be interpreted to include a right to die, as suicide and abetment of suicide remain punishable under  Sections 309 and 306 IPC. Furthermore, the government highlighted the potential for misuse,  particularly against the elderly, disabled, or economically vulnerable persons, if euthanasia were  allowed without strict oversight.  

The Attorney General contended that euthanasia involves “delicate issues of life and death” and  hence requires a comprehensive legislative framework rather than case-by-case judicial discretion.  It was stressed that India’s medical infrastructure and accountability systems were not yet robust  enough to ensure safeguards against abuse. He urged the Court to adopt an interim framework, if  at all, until Parliament enacts legislation.  

Judgment 

The court drew the distinction between active and passive euthanasia. Active euthanasia can be  seen as the positive and deliberate termination of one’s life by injecting and administering lethal  substances. It is considered to be a crime worldwide except permitted by legislation. In India,  active euthanasia is a straight infringement of section 302 and section 304 of the IPC. Moreover,  physician-assisted suicide is an offense under section 309 of IPC. Passive euthanasia on the other  hand is the withdrawal of life-supporting systems or medical treatment. The main distinction  between active and passive euthanasia is that in “active” something is done deliberately to end life  whereas in “passive” something is not done. A proper procedure and guidelines were enlisted by  the apex court for granting passive euthanasia in the “rarest of rare circumstances” while rejecting  the plea made by the petitioner. The High Court under article 226 would be entitled to make  decisions regarding the withdrawal of the life support system. The application could be made by  parents, spouse, close relatives, or the doctor/hospital treating the patient. A bench must be  constituted by the Chief Justice of the High Court when an application is received, before which a  committee of three reputed doctors nominated must be referred. There should be a thorough  examination of the patient and state and family members are provided with a notice issued by the  bench. The High Court must give a speedy decision. The High Court must issue notice to the State  and the patient’s relatives, and if unrepresented, appoint an amicus curiae to assist the Court. The  petitioner Pinki Virani could not be considered Aruna’s “next friend”, as the KEM hospital staff  who had cared for her for decades were more appropriately suited for that role. Only those directly  involved in caring for the patient, or the patient’s close relatives, could be recognized as legitimate  representatives for such decisions. This finding ensured that euthanasia decisions are not misused  by third parties or those with ulterior motives. The Supreme Court revisited the relationship  between right to life and right to die under Article 21. Referring to Gian Kaur v. State of Punjab,  (1996), the Bench clarified that while the “right to die” per se is not part of Article 21, the right to  die with dignity in the case of terminal illness or a persistent vegetative state may fall within the  ambit of the right to life. The Court held that “the right to live with dignity” includes not only  dignified living but also a dignified process of dying, especially in circumstances of irreversible  suffering. Hence, the judgment marked a constitutional expansion of Article 21, balancing dignity  with sanctity of life. The Bench observed that while euthanasia raises complex moral and religious  questions, the judiciary’s role is to ensure a constitutional balance between compassion and  protection of life. The judgment highlighted that Indian society’s cultural and moral ethos still  viewed life as sacred, and hence the law must tread cautiously. The Bench further requested that  Parliament enact legislation on euthanasia to ensure clarity and prevent misuse.  

Judicial Reasoning and Analysis 

The Court appointed Senior Advocate T.R. Andhyarujina and a panel of three eminent doctors (Dr.  J.V. Divatia, Dr. Roop Gurshani, and Dr. Nilesh Shah) to assist in an objective evaluation. From  the above examination by the team of doctors, the honourable court held that it cannot be said that  Aruna Shanbaug is dead. Whatever the condition of her cortex, her brain stem is certainly alive.  She does not need a heart lung machine. She breathes on her own without the help of a respirator.  She digests food, and her body performs other involuntary function without any help. She was  making some sounds, blinking, eating food put in her mouth, and even licking with her tongue  morsels on her mouth. Even from the report of Committee of Doctors which we have quoted above it appears that she has some brain activity, though very little. She recognizes that persons are  around her and expresses her like or dislike by making some vocal sound and waving her hand by  certain movements. Thus, taking away her life support when she is very much alive would be a  violation of her fundamental rights.  

The Court’s approach towards article 21 was interpretative rather than literal. Relying on the  doctrine of expansive interpretation, the Bench reiterated that the phrase “right to life” cannot be  confined to mere animal existence. It must include the quality and dignity of life, as recognized in  earlier precedents: Maneka Gandhi v. Union of India, (1978), Francis Coralie Mullin v.  Administrator, Union Territory of Delhi, (1981) and Bandhua Mukti Morcha v. Union of India,  (1984).

However, the Court clarified that this right is not equivalent to a right to die at will or commit  suicide. It is limited to circumstances where medical science confirms irreversible deterioration  and absence of cognitive function.  

Thus, the Court adopted a qualified recognition:  

“The right to live with dignity under Article 21 may, in certain circumstances, include the right to  die with dignity.”  

Thus the Aruna Shanbaug Bench harmonized rather than contradicted Gian Kaur.  

The Court referred extensively to foreign jurisprudence, particularly from the United Kingdom,  the United States, and the Netherlands, but only for persuasive value, not binding authority. The  most influential among these was Airedale NHS Trust v. Bland, [1993]. 

Justice Katju adopted similar reasoning, holding that withholding treatment is not the same as  actively causing death. This comparative approach allowed the Court to justify passive euthanasia  as a permissible omission rather than a culpable act. The Bench was conscious of the separation of  powers principle. It acknowledged that euthanasia involves complex moral and policy dimensions,  making it a matter more appropriate for legislative action. However, invoking Article 142 (power  to do complete justice), the Court held that until Parliament enacted a law, it was the judiciary’s  duty to fill the legal vacuum through temporary judicial guidelines.  

The judgment also ventured into ethical philosophy, reflecting the Court’s sensitivity to human  dignity and moral pluralism. The Court reaffirmed that life is sacred and the State has a duty to  protect it. However, sanctity does not mean prolonging life artificially when consciousness and  dignity are irretrievably lost. Borrowed from moral philosophy, the doctrine of double effect recognizes that actions having both good and bad effects may be permissible if the bad effect  (death) is unintended but incidental to the relief of suffering. Justice Katju emphasized that law  must strike a balance between compassion (for those suffering) and precaution (against potential  abuse). Thus, passive euthanasia was permitted only under judicial supervision, ensuring  accountability and preventing misuse.  

The Court invoked the doctrine of parens patriae, under which the State (and by extension, the  Court) acts as the guardian of those unable to care for themselves such as minors, mentally  incapacitated, or persons in vegetative states. Under this doctrine, the Court assumed responsibility  to decide on Aruna’s behalf, considering her best interests. The Court acknowledged India’s  socioeconomic realities, poverty, illiteracy, lack of medical oversight and warned that unrestricted  euthanasia could lead to exploitation of vulnerable individuals. Recognizing India’s religious  diversity, the judgment refrained from taking an absolutist moral position, instead upholding  pluralism and constitutional morality as guiding principles. The moral empathy displayed in  recognizing dignity even in dying marked a significant humanization of Indian constitutional law.  In sum, the Court struck a middle path, rejecting both blind sanctity of life and unregulated  autonomy, situating euthanasia within the constitutional ethos of dignity, compassion, and judicial  supervision. 

Subsequent Developments & Impact 

The Aruna Shanbaug decision generated widespread public, medical, and academic discourse  across India. While the Supreme Court did not allow euthanasia in Aruna’s own case, it effectively  legalized passive euthanasia for the first time in India, subject to judicial supervision. This created  a de facto legal framework in the absence of statutory law. High Courts across India were  henceforth empowered to entertain petitions for passive euthanasia under the guidelines laid down  by the Supreme Court.  

Notably, the judgment drew both praise and criticism. Praised for its compassion, prudence, and  humanistic approach to dignity in dying. Criticized for judicially legislating on a complex ethical  issue and for adopting the questionable “next friend” distinction in rejecting Pinki Virani’s petition.  Nevertheless, it became a milestone in Indian bioethics and constitutional law, symbolizing a shift  from a purely life-preserving approach to one acknowledging dignity and autonomy at the end of  life. Feminist and disability rights scholars expressed concern that recognizing euthanasia, even  passively, could expose vulnerable individuals to coercion and neglect in a socioeconomically  stratified society. Others questioned whether the Court, rather than Parliament, should have  ventured into this morally charged terrain. From a human rights standpoint, Aruna Shanbaug  expanded India’s jurisprudence towards personal autonomy, bodily integrity, and medical ethics  under Article 21. 

In 2012, the Law Commission of India (241st Report) revisited the issue in light of Aruna Shanbaug  and recommended that passive euthanasia be legalized through statutory safeguards. It proposed  the medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners)  Bill, 2006 be revised and enacted. The Report endorsed the Aruna guidelines but sought to embed  them within a legislative framework. However, no law was passed, leading the judiciary to remain  the primary regulatory authority in euthanasia-related cases.  

Conclusion 

Aruna Shanbaug’s personal story of immense suffering and the enduring compassion of her  caregivers transcended the courtroom. Her case transformed Into a symbol of the right to die with  dignity and catalyzed legal reform through human empathy. Even though the Court refused to  terminate her life, the judgment ensured that future individuals in similar conditions would not be  condemned to an undignified existence by legal vacuum.  

As Justice D.Y. Chandrachud later observed in Common Cause (2018), “The decision in Aruna  Shanbaug humanized the law by making dignity the measure of life and death alike.” Thus, her  case stands as both a moral landmark and a legal catalyst, bridging law, medicine, and humanity  within the fabric of India’s constitutional democracy. 

The balance between moral sensitivity and institutional restraint became the hallmark of the  judgment. The decision’s impact was not confined to the courtroom. It galvanized policy debate,  medical ethics reform, and legislative consideration of end-of-life care in India.  

In the final analysis, Aruna Shanbaug v. Union of India is not merely a case about euthanasia; it is  a profound meditation on what it means to live and die with dignity under the Constitution. It  affirms that the right to life is inseparable from the right to live meaningfully, and that the right to  die with dignity is not a negation of life, but its ultimate affirmation.  

Reference(S):

Constitution of India 

Article 21: Protects the right to life and personal liberty, no one can be deprived of it except by  law. 

Article 32: Gives citizens the right to directly approach the Supreme Court to protect their  fundamental rights. 

Article 226: Lets High Courts issue writs to protect rights, similar to Article 32 but at the state  level. 

Article 142: Empowers the Supreme Court to pass any order necessary to ensure complete justice  in a case. 

Indian Penal Code 

Section 302: Punishment for murder, can lead to death penalty or life imprisonment. Section 304: Punishment for culpable homicide not amounting to murder (killing without full  intent) lesser sentence than murder. 

Section 306: Punishment for abetment of suicide, if someone encourages or helps another person  to die by suicide. 

Section 309: Punishment for attempting suicide, the person trying to take their own life can be  penalized (though this law is now mostly decriminalized in practice). 

CASE LAWS 

Aruna Ramachandra Shanbaug v. Union of India & Ors. AIR 2011 SC 1290 Gian Kaur v. State of Punjab AIR 1996 SC 946 

Rathinam v. Union of India (1994) 3SCC 394  

Airedale NHS Trust v. Bland 1993 AC 789 (House of Lords) 

Francis Coralie Mullin v. Administrator, Union Territory of Delhi AIR 1981 SC 746 Maneka Gandhi v. Union of India AIR 1978 SC 597

Bandhua Mukti Morcha v. Union of India AIR 1984 SC 802 

Aishwarya Agarwal, LawBhoomi, The Doctrine of Parens Patriae ( 24 January, 2025)  https://lawbhoomi.com/doctrine-of-parens-patriae/ 

Alison McIntyre, Stanford Encyclopedia of Philosophy, The doctrine of Double effect ( 2023)  https://plato.stanford.edu/entries/double-effect/ 

Gauri Gupta, ipleaders, Aruna Shanbaug (September 13, 2024) 

https://blog.ipleaders.in/aruna-ramchandra-shanbaug-vs-union-of-india-others-2011/ 

Indian Kanoon  

https://indiankanoon.org/doc/235821/ 

Tanisha Maheshwari, Manupatra, Case Analysis of Aruna Shanbaug v. Union of India (14 July,  2022) 

https://articles.manupatra.com/article-details/Case-analysis-of-Aruna-Ramchandra-Shanbaug-vs Union-of 

BBC NEWS (18 May, 2015) 

https://www-bbc-com.cdn.ampproject.org/v/s/www.bbc.com/news/world-asia-india 32776897.amp?amp_gsa=1&amp_js_v=a9&usqp=mq331AQIUAKwASCAAgM%3D#amp_tf= From%20%251%24s&aoh=17612090664869&referrer=https%3A%2F%2Fwww.google.com&a mpshare=https%3A%2F%2Fwww.bbc.com%2Fnews%2Fworld-asia-india-32776897 

Law Commission of India Reports 

241st Report (August 2012): Passive Euthanasia – A Relook. 

https://lawcommissionofindia.nic.in/reports/report241.pdf 

BBC News India, Aruna Shanbaug: The woman who triggered India’s euthanasia debate.” (18  May 2015) 

https://www.bbc.com/news/world-asia-india-32762408 

The Hindu, “Supreme Court allows passive euthanasia (7 March 2011) 

https://www.thehindu.com/news/national/supreme-court-allows-passive 

euthanasia/article15186207.ece 

MANU/SC/0176/2011 

MANU/SC/0335/1996 

Kumar, A. (2013). “Euthanasia and Right to Die with Dignity: A Critical Appraisal of Aruna  Shanbaug Case.” Indian Journal of Legal Philosophy, Vol. 1, Issue 2.

Singh, Neha. (2015). “Right to Die with Dignity: An Analysis of Aruna Shanbaug Judgment.”  International Journal of Law and Legal Jurisprudence Studies, Vol. 2(4). 

Gupta, Nidhi. (2012). “Euthanasia and the Indian Legal Scenario: Lessons from Aruna  Shanbaug.” Journal of the Indian Law Institute, 54(3). 

Bhat, Ishwara. (2011). “Life, Death and Dignity: Legal and Ethical Reflections on Aruna  Shanbaug.” NUJS Law Review, Vol. 4, Issue 2.