Woman in deep coma for 36 years challenges Indian law



NEW DELHI // A petition seeking to allow a woman who has been in a coma for nearly four decades to be taken off life support is to be heard by the Indian Supreme Court, sparking a debate among activists about the implications of the court's ruling.

Aruna Shanbaug, 61, is living in the same hospital where she was sexually assaulted and paralysed in 1973. Following the attack, she was declared brain-dead and has been kept alive since then through feeding tubes. Ms Shanbaug, through her legal guardian, Pinkie Virani, filed a petition to the court to instruct the hospital authorities not to force-feed her and to carry out tests to ascertain her medical condition. In a ground-breaking move for the staunchly pro-life court, they agreed to hear the plea.

Euthanasia, or mercy killing, is illegal under the Indian constitution, and so far courts have rejected all requests. But legal experts and rights activists in India say that the Supreme Court's decision to hear the plea may set precedence that could legalise doctor-assisted suicide. It is he first time that a plea to end the life of a terminally ill patient has been considered by the Supreme Court. In the petition to the court, Shekhar Naphade, Ms Shanbaug's attorney, argued that the request was from a women who cannot lead a life with dignity, which is guaranteed under the Indian constitution.

"This is no human right, her life is worse than an animal's existence." The judges agreed to examine the merits of the petition and sought responses from the government and the hospital authorities on Ms Shanbaug's current medical condition. According to the several media reports, she hasn't undergone extensive medical tests for a quarter of a century. "I am deeply thankful to the Supreme Court for giving Aruna a voice to ask for justice", Ms Virani was quoted as saying by the Times of India.

Her book on the plight of Ms Shanbaug in 1998 revisited the trauma she has undergone. Aruna's Story: The True Account Of A Rape and Its Aftermath describes her as existing "in a totally pathetic state. Her bones are brittle. Her wrists are twisted inward, her fingers are bent and fisted towards her palms, resulting in growing nails tearing into the flesh very often. Her teeth are decayed and giving her pain. She is in a persistent vegetative state."

But some legal activists feel a decision by the court to allow Ms Shanbaug to die would lead to a dangerous, slippery slope. "If the court decides in favour of the petitioners, it will certainly set precedence," said Mahesh Rastogi, a Mumbai based lawyer who is opposed to the legalisation of euthanasia. "Ethically, and as per the law, we have no moral right to terminate her life. I am hopeful that the court will also pass a judgment against euthanasia."

But many activists support Ms Shanbaug's plea, and media coverage has created a wave of sympathy for her plight. Mumbai-based lawyer and human rights activist Flavia Agnes said Ms Shanbaug is an extreme case, and by keeping her alive, society is inflicting even more trauma on the hapless woman. "There is no remedy for her so what is the point in keeping her alive? If [force-feeding] is withdrawn, what difference does it make to her - she is brain-dead," Ms Agnes said. "I think she should be allowed to die."

Mr Naphade, while arguing before the Supreme Court judges last week, asked, "Is not keeping the women in this persistent vegetative state by force-feeding violative of her right to live with dignity guaranteed by the Indian constitution?" Ms Shanbaug had joined the King Edward Memorial Hospital in Bombay in 1966 as a nurse. In November 1973, while she was changing her clothes in one of the rooms in the hospital's basement, a janitor, Sohanlal Bharta Valmiki wrapped a dog chain around her neck and then beat, robbed and sodomised her.

The asphyxiation caused by the dog chain during the assault cut off oxygen to her brain, resulting in damage to her brainstem, which left her paralysed and in a coma. The incident took away her visual, hearing and speaking ability. After immense public pressure the assailant was arrested and sentenced in 1973 to seven years imprisonment on charges of theft and attempt to murder. The court decided there was no rape as the hymen of the victim was intact. After his release in 1980, Mr Valmiki reportedly moved to Delhi and is working as a ward boy in a Delhi hospital.

For the past 36 years, Ms Shanbaug has been permanently bedridden, curled up in an awkward foetal position in a room with restricted entry. She is force-fed by nurses five times a day. No one from her family visits her, except for occasional visits by her former fiancée, who was a doctor at the hospital. Surendra Delia, a member of the Mumbai-based Society for the Right to Die with Dignity, while supporting the plea, cautioned against treating all cases alike.

"I am not saying that anybody who comes and says 'I am terminally ill and want a peaceful exit' should be allowed to do so. We should have proper safeguards," he said. @Email:foreign.desk@thenational.ae

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”