By – Amar Yumnam
The recent judgement of the Supreme Court of India on 11 March 2026 is one with many implications of the distinction between Theory and Law, understanding of Rationality, Public and Social, and State and the people. It relates to a case relating to: “Medical reports of the applicant indicate that he exhibits no evidence of awareness of his environment and is incapable of interacting with others. He also does not indicate by any facial gesture, grunting, or body movement if he is hungry, has soiled himself or is in any other discomfort. The family of the applicant have also conveyed that they have not noted any significant benefit from any of the several treatments, including hyperbaric oxygen therapy, that were tried over the span of the last 13 years. The applicant’s neurological condition has remained static with no improvement. He is unable to express his needs and has been dependent on all activities of self-care.” The Medical Primary Board to examine the case reported: “He had intact brainstem function but due to his vegetative state he requires external support for his feeding, bladder bowel and back. He needs constant physiotherapy and tracheostomy tube care. The chances of his recovery from this state is negligible.”This view was also shared by the Secondary Medical Board as well while they asserted of damage in the brain. This being the case, the Supreme Court ruled that “The medical treatment… being administered to the applicant shall be withdrawn and/or withheld.” This necessarily implies the death of the patient.
Without getting into the question of right or wrong of the judgement, I raise here the imperativeness for social debate on this judgement for certain reasons. First, the application for a judgement on the case was made by the parents on behalf of the patient in a case where the patient was in no position to talk or move. Can someone apply on the assumption of being behalf of a petition with no inclusion of expression of acceptance. Second, the question is why did the parents go to the Supreme Court directly without appealing to the state for attention and potential care in lieu of the parents. Third, the reports of the Primary and Secondary Medical Boards indicate the reality of Medical Research having come to a dead-end. Is this the case? Fourth, my greatest fear as a social scientist is that the Judgement has the potential to become a Social Institution (Social Norm) in seemingly similar cases; I am talking in the sense taught to us by Douglas North. Sixth, when the final decision came, what was the preference of the patient? This is a judgement with an incomplete public preference. Now this decision based on limited public preference has the potential to become a full-fledged social preference one.
Looking at the preference expressed by the parents opting for death instead of care, one would certainly feel to ask if it was a circumstantial or a fully conscientious one. There is the added one of the value enjoyed by the younger brother while playing with his brother (now a patient). Here we need to be fully aware of the concept and the application of Rationality. From a pure understanding of yielding benefits or otherwise earlier, from about the mid-1990s it has strongly become a concept which cannot be applied at all without the company of Justice and Morality; Justice alone is not enough, Morality has also to be necessarily there. In the present context, one would naturally recall of the contract between the state and her people. In the context of the social contract too, the values of justice and morality are core considerations today. It is certainly a painful affair for a family with a person who “needs constant physiotherapy and tracheostomy tube care” and particularly so when persons from the medical profession keeps uttering “The chances of his recovery from this state is negligible.”
Where is the state, which had entered into a contract with her people, to take care in such cases? The state – we are in – is definitely in a position of capability to afford the care of such cases. Let me end with a quotation from Kenneth R. Hammond from his Beyond Rationality: The Search for Wisdom In A trouble Time: “The greatest barrier to the competence of our judgment, and thus to wisdom, is uncertainty—not the subjective uncertainty we feel when we exercise our judgment, but the uncertainty in the world to which our judgments apply.”
